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Lee N, Choi SH, Won S, Jung YW, Kim SH, Lee JY, Lim CK, Yang JB, Ha JG, Seong SJ. Comparison of Surgical Outcomes of Two New Techniques Complementing Robotic Single-Site Myomectomy: Coaxial Robotic Single-Site Myomectomy vs. Hybrid Robotic Single-Site Myomectomy. J Pers Med 2024; 14:439. [PMID: 38673066 PMCID: PMC11050827 DOI: 10.3390/jpm14040439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/03/2024] [Accepted: 04/17/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND This study aimed to compare surgical outcomes between two new robotic single-site myomectomy (RSSM)-complementary techniques: coaxial robotic single-site myomectomy (Coaxial-RSSM) and hybrid robotic single-site myomectomy (Hybrid-RSSM). METHODS Medical records for 132 women undergoing Coaxial-RSSM and 150 undergoing Hybrid-RSSM, consecutively, were retrospectively reviewed. Patient characteristics and surgical outcomes were assessed and compared after propensity score matching (PSM). RESULTS In the outcomes of PSM, the Coaxial-RSSM group showed significantly reduced blood loss (79.71 vs. 163.75 mL, p < 0.001) and reduced hospital duration (4.18 ± 0.62 vs. 4.63 ± 0.90) relative to the Hybrid-RSSM group. Conversely, Hybrid-RSSM allowed for a shorter operative time compared with Coaxial-RSSM (119.19 vs. 156.01 min, p = 0.007). No conversions to conventional laparoscopy or laparotomy or any need for the multi-site robotic approach occurred in either group. Postoperative complications, including ileus, fever, and wound dehiscence, showed no statistically significant differences between the two groups. CONCLUSIONS Blood loss was lower with Coaxial-RSSM, and operative time was shorter for Hybrid-RSSM. A follow-up prospective study is warranted for more comprehensive comparison of surgical outcomes between the two techniques.
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Affiliation(s)
- Nara Lee
- Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University, Seoul 06135, Republic of Korea; (N.L.); (S.-H.C.); (S.W.); (Y.-W.J.)
| | - Su-Hyeon Choi
- Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University, Seoul 06135, Republic of Korea; (N.L.); (S.-H.C.); (S.W.); (Y.-W.J.)
| | - Seyeon Won
- Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University, Seoul 06135, Republic of Korea; (N.L.); (S.-H.C.); (S.W.); (Y.-W.J.)
| | - Yong-Wook Jung
- Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University, Seoul 06135, Republic of Korea; (N.L.); (S.-H.C.); (S.W.); (Y.-W.J.)
| | - Seung-Hyun Kim
- Department of Obstetrics and Gynecology, Eulji University Hospital, Eulji University School of Medicine, 95 Dunsanseo-ro, Seo-gu, Daejeon 35233, Republic of Korea; (S.-H.K.); (J.-Y.L.); (C.-K.L.); (J.-B.Y.)
| | - Jin-Yu Lee
- Department of Obstetrics and Gynecology, Eulji University Hospital, Eulji University School of Medicine, 95 Dunsanseo-ro, Seo-gu, Daejeon 35233, Republic of Korea; (S.-H.K.); (J.-Y.L.); (C.-K.L.); (J.-B.Y.)
| | - Chul-Kwon Lim
- Department of Obstetrics and Gynecology, Eulji University Hospital, Eulji University School of Medicine, 95 Dunsanseo-ro, Seo-gu, Daejeon 35233, Republic of Korea; (S.-H.K.); (J.-Y.L.); (C.-K.L.); (J.-B.Y.)
| | - Jung-Bo Yang
- Department of Obstetrics and Gynecology, Eulji University Hospital, Eulji University School of Medicine, 95 Dunsanseo-ro, Seo-gu, Daejeon 35233, Republic of Korea; (S.-H.K.); (J.-Y.L.); (C.-K.L.); (J.-B.Y.)
| | - Joong-Gyu Ha
- Department of Obstetrics and Gynecology, Eulji University Hospital, Eulji University School of Medicine, 95 Dunsanseo-ro, Seo-gu, Daejeon 35233, Republic of Korea; (S.-H.K.); (J.-Y.L.); (C.-K.L.); (J.-B.Y.)
| | - Seok-Ju Seong
- Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University, Seoul 06135, Republic of Korea; (N.L.); (S.-H.C.); (S.W.); (Y.-W.J.)
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Kim M, Zhang Y, Jin S. Soft tissue surgical robot for minimally invasive surgery: a review. Biomed Eng Lett 2023; 13:561-569. [PMID: 37872994 PMCID: PMC10590359 DOI: 10.1007/s13534-023-00326-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 09/08/2023] [Accepted: 09/26/2023] [Indexed: 10/25/2023] Open
Abstract
Purpose The current state of soft tissue surgery robots is surveyed, and the key technologies underlying their success are analyzed. State-of-the-art technologies are introduced, and future directions are discussed. Methods Relevant literature is explored, analyzed, and summarized. Results Soft tissue surgical robots had rapidly spread in the field of laparoscopic surgery based on the multi-degree-of-freedom movement of intra-abdominal surgical tools and stereoscopic imaging that are not possible in conventional surgery. The three key technologies that have made surgical robots successful are wire-driven mechanisms for multi-degree-of-freedom movement, master devices for intuitive remote control, and stereoscopic imaging technology. Recently, human-robot interaction technologies have been applied to develop user interfaces such as vision assistance and haptic feedback, and research on autonomous surgery has begun. Conclusion Robotic surgery not only replaces conventional laparoscopic surgery but also allows for complex surgeries that are not possible with laparoscopic surgery. On the other hand, it is also criticized for its high cost and lack of clinical superiority or patient benefit compared to conventional laparoscopic surgery. As various robots compete in the market, the cost of surgical robots is expected to decrease. Surgical robots are expected to continue to evolve in the future due to the need to reduce the workload of medical staff and improve the level of care demanded by patients.
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Affiliation(s)
- Minhyo Kim
- School of Mechanical Engineering, Pusan National University, 2, Busandaehak-ro 63beon-gil, Geumjeong-gu, Busan, 46241 Republic of Korea
| | - Youqiang Zhang
- School of Mechanical Engineering, Pusan National University, 2, Busandaehak-ro 63beon-gil, Geumjeong-gu, Busan, 46241 Republic of Korea
| | - Sangrok Jin
- School of Mechanical Engineering, Pusan National University, 2, Busandaehak-ro 63beon-gil, Geumjeong-gu, Busan, 46241 Republic of Korea
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Wu CF, Cheng C, Suen KH, Stein H, Chao YK. A Preclinical Feasibility Study of Single-Port Robotic Subcostal Anatomical Lung Resection and Subxiphoid Thymectomy Using the da Vinci ® SP System. Diagnostics (Basel) 2023; 13:diagnostics13030460. [PMID: 36766565 PMCID: PMC9914746 DOI: 10.3390/diagnostics13030460] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 01/22/2023] [Accepted: 01/24/2023] [Indexed: 01/28/2023] Open
Abstract
Despite the recent introduction of technologically advanced single-port (SP) robotic systems, their use in the field of thoracic surgery has been rarely explored. Here, we report our preclinical experience concerning SP robotic thoracic surgery using the da Vinci® SP system. The da Vinci® SP system was used to perform subcostal anatomical lung resection and subxiphoid thymectomy in three cadavers. The operative settings that best met the surgeon's requirements for each resection were also determined. Four subcostal anatomical lung resections and two subxiphoid thymectomies were completed. While both procedures did not require additional incisions, the use of an observation port in the intercostal spaces was strongly recommended to safely create subcostal access. Dissection of hilar structures and mediastinal lymph nodes was feasible. However, due to the current unavailability of a robotic stapler, a handheld stapling instrument was required to perform a transection of vital structures. When the stapling process proved to be difficult, the table surgeon temporarily removed a robotic arm to acquire the necessary space to complete the procedure. Our data represent a promising preclinical step in understanding the feasibility of using the da Vinci® SP system to perform an SP subcostal anatomical lung resection and a subxiphoid thymectomy.
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Affiliation(s)
- Ching Feng Wu
- Division of Thoracic Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 333323, Taiwan
| | - Chuan Cheng
- Division of Thoracic Surgery, New Taipei Municipal Tu-Cheng Hospital, New Taipei City 25162, Taiwan
| | - Ka Hei Suen
- Department of Surgical Applications Engineering, Intuitive Surgical Inc., Sunnyvale, CA 94086, USA
| | - Hubert Stein
- Department of Surgical Applications Engineering, Intuitive Surgical Inc., Sunnyvale, CA 94086, USA
| | - Yin Kai Chao
- Division of Thoracic Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 333323, Taiwan
- Correspondence: ; Tel.: +886-3-3281200 (ext. 2118); Fax: +886-3-3285818
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Solís‐Peña A, Cirera A, Kraft Carré M, Pellino G, Espín‐Basany E. A standardized stepwise approach to minimally invasive ileocolic anastomosis: Tips and tricks for laparoscopic and robotic surgery. Colorectal Dis 2022; 24:1238-1242. [PMID: 35460173 PMCID: PMC9790292 DOI: 10.1111/codi.16159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/28/2022] [Accepted: 04/12/2022] [Indexed: 12/30/2022]
Abstract
AIM Intracorporeal anastomosis has been associated with earlier recovery of postoperative bowel function, shorter length of stay and lower surgical site infection rates. The aim of this work is to describe a step-by-step standardized technique for intracorporeal ileocolic and ileosigmoid anastomosis suitable for laparoscopic and robotic colectomy. METHOD Each step of the technique is illustrated using a composite collection of three operative patient videos. Two procedures were performed robotically and one was laparoscopic. Tips are provided to construct a two-layer anastomosis (both posteriorly and anteriorly). The procedures are presented in stepwise fashion, discussing the advantages and feasibility of the technique. RESULTS The standardized technique described herein was used in three patients for this report, of whom two underwent right colectomy and one subtotal colectomy for cancer. The median operating time was 255 (206-333) min. There were no intraoperative complications. No major postoperative complications or 30-day readmissions occurred. The median length of stay was 4 (3-5) days. CONCLUSION The described technique of a two-layer anastomosis can be used with any available minimally invasive approach. It is safe and feasible. Using a standardized approach, the technique can be easily taught and mastered, optimizing operating times and reducing adverse events.
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Affiliation(s)
- Alejandro Solís‐Peña
- Colorectal SurgeryVall d'Hebron University HospitalUniversitat Autònoma de Barcelona (UAB)BarcelonaSpain
| | - Arturo Cirera
- Colorectal SurgeryVall d'Hebron University HospitalUniversitat Autònoma de Barcelona (UAB)BarcelonaSpain
| | - Miquel Kraft Carré
- Colorectal SurgeryVall d'Hebron University HospitalUniversitat Autònoma de Barcelona (UAB)BarcelonaSpain
| | - Gianluca Pellino
- Colorectal SurgeryVall d'Hebron University HospitalUniversitat Autònoma de Barcelona (UAB)BarcelonaSpain,Department of Advanced Medical and Surgical SciencesUniversità degli Studi della Campania “Luigi Vanvitelli”NaplesItaly
| | - Eloy Espín‐Basany
- Colorectal SurgeryVall d'Hebron University HospitalUniversitat Autònoma de Barcelona (UAB)BarcelonaSpain
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[Development and clinical application of robot-assisted technology in traumatic orthopedics]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2022; 36:915-922. [PMID: 35979779 PMCID: PMC9379455 DOI: 10.7507/1002-1892.202206097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To review and evaluate the basic principles and advantages of orthopedic robot-assisted technology, research progress, clinical applications, and limitations in the field of traumatic orthopedics, especially in fracture reduction robots. METHODS An extensive review of research literature on the principles of robot-assisted technology and fracture reduction robots was conducted to analyze the technical advantages and clinical efficacy and shortcomings, and to discuss the future development trends in this field. RESULTS Orthopedic surgical robots can assist orthopedists in intuitive preoperative planning, precise intraoperative control, and minimally invasive operations. It greatly expands the ability of doctors to evaluate and treat orthopedic trauma. Trauma orthopedic surgery robot has achieved a breakthrough from basic research to clinical application, and the preliminary results show that the technology can significantly improve surgical precision and reduce surgical trauma. However, there are still problems such as insufficient evaluation of effectiveness, limited means of technology realization, and narrow clinical indications that need to be solved. CONCLUSION Robot-assisted technology has a broad application prospect in traumatic orthopedics, but the current development is still in the initial stage. It is necessary to strengthen the cooperative medical-industrial research, the construction of doctors' communication platform, standardized training and data sharing in order to continuously promote the development of robot-assisted technology in traumatic orthopedics and better play its clinical application value.
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Artificial Intelligence-Empowered 3D and 4D Printing Technologies toward Smarter Biomedical Materials and Approaches. Polymers (Basel) 2022; 14:polym14142794. [PMID: 35890571 PMCID: PMC9319487 DOI: 10.3390/polym14142794] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/05/2022] [Accepted: 07/06/2022] [Indexed: 12/17/2022] Open
Abstract
In the last decades, 3D printing has played a crucial role as an innovative technology for tissue and organ fabrication, patient-specific orthoses, drug delivery, and surgical planning. However, biomedical materials used for 3D printing are usually static and unable to dynamically respond or transform within the internal environment of the body. These materials are fabricated ex situ, which involves first printing on a planar substrate and then deploying it to the target surface, thus resulting in a possible mismatch between the printed part and the target surfaces. The emergence of 4D printing addresses some of these drawbacks, opening an attractive path for the biomedical sector. By preprogramming smart materials, 4D printing is able to manufacture structures that dynamically respond to external stimuli. Despite these potentials, 4D printed dynamic materials are still in their infancy of development. The rise of artificial intelligence (AI) could push these technologies forward enlarging their applicability, boosting the design space of smart materials by selecting promising ones with desired architectures, properties, and functions, reducing the time to manufacturing, and allowing the in situ printing directly on target surfaces achieving high-fidelity of human body micro-structures. In this review, an overview of 4D printing as a fascinating tool for designing advanced smart materials is provided. Then will be discussed the recent progress in AI-empowered 3D and 4D printing with open-loop and closed-loop methods, in particular regarding shape-morphing 4D-responsive materials, printing on moving targets, and surgical robots for in situ printing. Lastly, an outlook on 5D printing is given as an advanced future technique, in which AI will assume the role of the fifth dimension to empower the effectiveness of 3D and 4D printing for developing intelligent systems in the biomedical sector and beyond.
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Lyu K, Yang L, Song C. Motion Measurement and Analysis of Different Instruments for Single-Incision Laparoscopic Surgery. Appl Bionics Biomech 2022; 2022:3057485. [PMID: 35694278 PMCID: PMC9177342 DOI: 10.1155/2022/3057485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/21/2022] [Accepted: 05/10/2022] [Indexed: 11/29/2022] Open
Abstract
Objective To objectively compare and analyze the range of motion of three types of instruments for single-incision laparoscopic surgery. Material and Methods. Ten experienced participants were recruited. Straight instruments (Group A), straight/articulating instruments (Group B), and precurved instruments (Group C) were used to complete the transferring task through one site in a laparoscopic simulator. Straight instruments via two separate sites (Group D) served as control. The operation time of each group was recorded. Instrument positions were measured by an optical tracking system. The inserted length and pivoting angles were derived via MATLAB. Results There was a significant difference in operation time between groups (D < A < B < C, p < 0.01). The range of motion of instruments was different on instrument types and surgical approaches. A significant difference in the inserted length was found between groups. Instrument conflicts and inadequate triangulation were found in Group A; instrument conflicts were found in Group B; no obvious conflicts and triangulation problems were observed in Group C. The operation in Group C was similar to the operation in Group D but differed on the left/right pivoting angles. Conclusion Different types of instruments have different ranges of motion in single-incision laparoscopic surgery. Working with precurved instruments seems like a compromise to traditional laparoscopic surgery if the transmission property, and shaft curvature of the instruments could be improved. An integrated mechanical platform or robotic system might be the ultimate solution for single-incision laparoscopic surgery to pursue even less trauma.
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Affiliation(s)
- Kunyong Lyu
- School of Information Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - Lixiao Yang
- Equipment Department, Shanghai Changhai Hospital, Shanghai 200433, China
| | - Chengli Song
- Shanghai Institute for Minimally Invasive Therapy, School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China
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Guo N, Liu H. Application of robotic laparoendoscopic single-site in gynecologic surgery. Asian J Surg 2022; 45:1644-1645. [PMID: 35367099 DOI: 10.1016/j.asjsur.2022.03.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 03/17/2022] [Indexed: 11/28/2022] Open
Affiliation(s)
- Na Guo
- The Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, 610041, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, 610041, China
| | - Hui Liu
- The Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, 610041, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, 610041, China.
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Kwak YH, Lee H, Seon K, Lee YJ, Lee YJ, Kim SW. Da Vinci SP Single-Port Robotic Surgery in Gynecologic Tumors: Single Surgeon's Initial Experience with 100 Cases. Yonsei Med J 2022; 63:179-186. [PMID: 35083904 PMCID: PMC8819406 DOI: 10.3349/ymj.2022.63.2.179] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 10/31/2021] [Accepted: 11/10/2021] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To report preliminary experience of single-port robotic surgery using the da Vinci SP surgical system in gynecologic tumors. MATERIALS AND METHODS This was a retrospective study on 100 consecutive patients who underwent da Vinci SP single-port robotic surgery between November 2018 and January 2021. All procedures were performed by an experienced gynecologic surgeon using a single 2.5-cm umbilical incision. RESULTS Of the 100 cases, the procedures included myomectomy (n=76), hysterectomy (n=2), endometrial cancer surgical staging (n=14), radical hysterectomy (n=3), radical trachelectomy (n=3), and ovarian cystectomy (n=2). None of the cases was converted to robotic multiport or open surgery. The median docking time was 5.0 minutes [interquartile range (IQR), 3.0-7.0], the median console time was 107.5 minutes (IQR, 78.7-155.8), and the median total operation time was 250.0 minutes (IQR, 215.0-310.0). The median estimated blood loss was 50.0 mL (IQR, 30.0-100.0), and the median change in hemoglobin level was 0.8 g/dL (IQR, 0.3-1.3). The median pain scores rated on a numerical rating scale immediately after and at 6, 12, and 24 hours after surgery were 5, 2, 2, and 2, respectively. The mean duration of postoperative hospitalization was 2.8 days. CONCLUSION Da Vinci SP single-port robotic surgery was successfully performed in various gynecologic tumors without significant complications. Therefore, this surgical system could be applied in patients who want precise gynecologic surgery while minimizing surgical incision.
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Affiliation(s)
- Young Hwa Kwak
- Department of Obstetrics and Gynecology, Women's Cancer Center, Yonsei Cancer Center, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Hwajung Lee
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
| | - Kieun Seon
- Department of Obstetrics and Gynecology, Women's Cancer Center, Yonsei Cancer Center, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Young Joo Lee
- Department of Obstetrics and Gynecology, Women's Cancer Center, Yonsei Cancer Center, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Yong Jae Lee
- Department of Obstetrics and Gynecology, Women's Cancer Center, Yonsei Cancer Center, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Wun Kim
- Department of Obstetrics and Gynecology, Women's Cancer Center, Yonsei Cancer Center, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea.
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Analysis and Comparison of Electromagnetic Microrobotic Platforms for Biomedical Applications. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12010456] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Magnetic microrobotics is a promising technology for improving minimally invasive surgery (MIS) with the ambition of enhancing patient care and comfort. The potential benefits include limited incisions, less hemorrhaging and postoperative pain, and faster recovery time. To achieve this, a key issue relies on the design of a proper electromagnetic actuation (EMA) setup which is based on the use of magnetic sources. The magnetic field and its gradient generated by the EMA platform is then used to induce magnetic torque and force for microrobot manipulations inside the human body. Like any control systems, the EMA system must be adapted to the given controlled microrobot and customized for the application. With great research efforts on magnetic manipulating of microrobots, the EMA systems are approaching commercial applications, and their configurations are becoming more suitable to be employed in real medical surgeries. However, most of the proposed designs have not followed any specific rule allowing to take into account the biomedical applications constraints. Through reviewing the different proposed EMA systems in the literature, their various specifications and configurations are comprehensively discussed and analyzed. This study focus on EMA platforms that use electromagnets. From this review and based on the biomedical application specifications, the appropriate EMA system can be determined efficiently.
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Letter to the Editor: Are Adrenal Lesions of 6 cm or More in Diameter a Contraindication to Laparoscopic Adrenalectomy? A Case Control Study. World J Surg 2021; 45:2301-2302. [PMID: 33796921 DOI: 10.1007/s00268-021-06085-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2021] [Indexed: 10/21/2022]
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Wang Y, Cao Q, Zhu X, Wang P. A cable-driven distal end-effector mechanism for single-port robotic surgery. Int J Comput Assist Radiol Surg 2021; 16:301-309. [PMID: 33389605 DOI: 10.1007/s11548-020-02290-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 10/30/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE The development of surgery is to be minimally invasive and collaborative with robot systems, which has caught increasing attention in recent years. However, the narrow access routes and confined working spaces in vivo usually make distal end-effectors of surgical systems not easy to operate. To overcome this problem, a novel cable-driven distal end-effector mechanism designed for single-port robotic surgery was proposed. METHODS A cable-driven joint structure and the corresponding methods of threading cables were proposed which can maintain the length and even the tension force of cables constant during operation. Based on the proposed joint structure, the cable-driven distal end-effector mechanism consists of a parallelogram mechanism and a snake mechanism. The parallelogram mechanism is used to enlarge its reachable workspace through establishing the triangulation of operation. The snake mechanism is used to achieve the expected pose through providing sufficient bending degrees of freedom. All of the degrees of freedom can be decoupled at the expense of a slightly more tedious process of threading cables. RESULTS The primary prototype and its miniature assembled and threaded manually performed as expected regardless of bend, translation and their combination. But the inadequate tension force of cables and assembly errors affect the load capacity and accuracy, which need to be improved by automatic assembly. CONCLUSION A cable-driven distal end-effector mechanism composed of a parallelogram mechanism, and a snake mechanism used for single-port robotic surgery was proposed. The mechanism adopts a novel cable-driven joint structure and corresponding methods of threading cables to keep the length and even the tension force of cables constant during surgery.
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Affiliation(s)
- Yizhao Wang
- School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Qixin Cao
- School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China.,Institute of Medical Robotics, Shanghai Jiao Tong University, shanghai, 200240, China
| | - Xiaoxiao Zhu
- School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China.
| | - Pengfei Wang
- School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
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Guadagni S, Palmeri M, Bianchini M, Gianardi D, Furbetta N, Minichilli F, Di Franco G, Comandatore A, Di Candio G, Morelli L. Ileo-colic intra-corporeal anastomosis during robotic right colectomy: a systematic literature review and meta-analysis of different techniques. Int J Colorectal Dis 2021; 36:1097-1110. [PMID: 33486533 PMCID: PMC8119253 DOI: 10.1007/s00384-021-03850-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/15/2021] [Indexed: 02/05/2023]
Abstract
PURPOSE Robotic assistance could increase the rate of ileo-colic intra-corporeal anastomosis (ICA) during robotic right colectomy (RRC). However, although robotic ICA can be accomplished with several different technical variants, it is not clear whether some of these technical details should be preferred. An evaluation of the possible advantage of one respect to another would be useful. METHODS We conducted a systematic review of literature on technical details of robotic ileo-colic ICA, from which we performed a meta-analysis of clinical outcomes. The extracted data allowed a comparative analysis regarding the outcome of overall complication (OC), bleeding rate (BR) and leakage rate (LR), between (1) mechanical anastomosis with robotic stapler, versus laparoscopic stapler, versus totally hand-sewn anastomosis and (2) closure of enterocolotomy with manual double layer, versus single layer, versus stapled. RESULTS A total of 30 studies including 2066 patients were selected. Globally, the side-to-side, isoperistaltic anastomosis, realized with laparoscopic staplers, and double-layer closure for enterocolotomy, is the most common technique used. According to the meta-analysis, the use of robotic stapler was significantly associated with a reduction of the BR with respect to mechanical anastomosis with laparoscopic stapler or totally hand-sewn anastomosis. None of the other technical aspects significantly influenced the outcomes. CONCLUSIONS ICA fashioning during RRC can be accomplished with several technical variants without evidence of a clear superiority of anyone of these techniques. Although the use of robotic staplers could be associated with some benefits, further studies are necessary to draw conclusions.
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Affiliation(s)
- Simone Guadagni
- General Surgery Unit, Department of Translational Research and new Technologies in Medicine and Surgery, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy
| | - Matteo Palmeri
- General Surgery Unit, Department of Translational Research and new Technologies in Medicine and Surgery, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy
| | - Matteo Bianchini
- General Surgery Unit, Department of Translational Research and new Technologies in Medicine and Surgery, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy
| | - Desirée Gianardi
- General Surgery Unit, Department of Translational Research and new Technologies in Medicine and Surgery, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy
| | - Niccolò Furbetta
- General Surgery Unit, Department of Translational Research and new Technologies in Medicine and Surgery, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy
| | - Fabrizio Minichilli
- Unit of Environmental Epidemiology and Disease Registries, Institute of Clinical Physiology, National Council of Research, Pisa, Italy
| | - Gregorio Di Franco
- General Surgery Unit, Department of Translational Research and new Technologies in Medicine and Surgery, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy
| | - Annalisa Comandatore
- General Surgery Unit, Department of Translational Research and new Technologies in Medicine and Surgery, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy
| | - Giulio Di Candio
- General Surgery Unit, Department of Translational Research and new Technologies in Medicine and Surgery, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy
| | - Luca Morelli
- General Surgery Unit, Department of Translational Research and new Technologies in Medicine and Surgery, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy ,Endo-CAS (Center for Computer Assisted Surgery), University of Pisa, Pisa, Italy
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14
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Bosi HR, Savaris RF, Zanirati T, Cavazzola LT. Simple Trick for Placement of the Robotic Single-Site Device in Obese Patients. Obes Surg 2020; 30:4675-4676. [PMID: 32740827 DOI: 10.1007/s11695-020-04867-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 07/12/2020] [Accepted: 07/17/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND The creation of the da Vinci Single-Site© Surgical Platform (DVSSP) allowed robotic surgery to perform single portal procedures. Due to the characteristics of the robotic single-site system, the triangulation of the instruments was optimized, facilitating the execution of the movements. For this, the care in the placement of the portal have fundamental importance. In overweight and patients with obesity, the subcutaneous can impede the ideal positioning of the portal, affecting the movement of the robotic arms and creating discomfort for the surgeon and bringing risks to the patient. TECHNIQUE Three points are made for subcutaneous reduction, allowing better adaptation of the device. EXPERIENCE This technique is performed in all patients with obesity submitted to single-site robotic surgery at our service. CONCLUSION It is a simple, fast, and low-cost method, allowing more safety to patient and comfort for the surgeon.
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15
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Review of surgical robotic systems for keyhole and endoscopic procedures: state of the art and perspectives. Front Med 2020; 14:382-403. [DOI: 10.1007/s11684-020-0781-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 03/05/2020] [Indexed: 02/06/2023]
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16
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Overcoming Abdominal and Pelvic Cavity Workspace Constraints in Robotic-Assisted NOTES. JOURNAL OF ROBOTICS 2020. [DOI: 10.1155/2020/8590539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Despite early enthusiasm in robotic-assisted NOTES, several technical challenges exist. Various spinopelvic anatomical constraints can significantly act as obstacles and affect entry and space availability for the deployment of straight and rigid transvaginal/transanal NOTES instruments. Anatomical constraints such as the sacral slope, position, and distance to the target organs are defined. Transvaginal access to the surgical site required a high insertion angle between 20° and 30° to overcome the pronounced sacral slope resulting in dexterity and reachability limitations. A new set of robotic parameters was generated to introduce a 7 degrees of freedom robotic arm. Workspace simulation and phantom precision measurements have shown a significant improvement in the reachability and maneuverability of the robotic platform. While the robotic arms provided stable dexterity, it is constrained when reaching target sites in larger patients. This study has provided an insight and a solution in rigid instrument design, paving a safe route for transvaginal/transanal access for abdominal surgeries towards robotic-assisted NOTES.
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17
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Na JC, Lee HH, Yoon YE, Jang WS, Choi YD, Rha KH, Han WK. True Single-Site Partial Nephrectomy Using the SP Surgical System: Feasibility, Comparison with the Xi Single-Site Platform, and Step-By-Step Procedure Guide. J Endourol 2020; 34:169-174. [DOI: 10.1089/end.2019.0528] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- Joon Chae Na
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyung Ho Lee
- Department of Urology, National Health Insurance Service Ilsan Hospital, Gyeonggi-do, Republic of Korea
| | - Young Eun Yoon
- Department of Urology, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Won Sik Jang
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young Deuk Choi
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Koon Ho Rha
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Woong Kyu Han
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
- Brain Korean 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
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18
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10-mm Laparo-Endoscopic Single-Site Cholecystectomy Using Multiple Magnetically Anchored and Controlled Instruments. J Surg Res 2019; 239:166-172. [DOI: 10.1016/j.jss.2019.02.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 01/22/2019] [Accepted: 02/06/2019] [Indexed: 12/11/2022]
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19
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Peng Y, Zhang W, Zhang G, Wang X, Zhang S, Ma X, Tang P, Zhang L. Using the Starr Frame and Da Vinci surgery system for pelvic fracture and sacral nerve injury. J Orthop Surg Res 2019; 14:29. [PMID: 30683121 PMCID: PMC6347760 DOI: 10.1186/s13018-018-1040-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 12/12/2018] [Indexed: 11/25/2022] Open
Abstract
Background Sacral fracture and sacral nerve injury remain problems in orthopedics, especially in a sacral fracture combined with an anterior sacral nerve injury. Treating a sacral nerve injury with open reduction neurolysis or more conservative treatment cannot meet the clinical needs. Open reduction sacral nerve neurolysis will increase the number of severe, life-threatening injuries, regardless of whether the anterior or posterior approach is used. In recent years, computer- and robot-assisted orthopedic surgery has emerged as part of many clinical treatments. Methods For an unstable pelvic fracture with an anterior sacral nerve injury, we established a comprehensive and integrated solution. To achieve closed reduction, minimally invasive fixation, and minimally invasive anterior sacral nerve neurolysis, the Starr Frame, navigation robot, and Da Vinci robot were jointly applied. Results The Starr Frame is very helpful for closed reduction percutaneous fixation in complex pelvic fractures. In this study, a minimally invasive fixation technique for the navigation robot in the pelvic fracture was explored. Although the patient had delayed anterior sacral nerve compression pain after surgery, we developed an approach and surgical method using the Da Vinci robot to explore the sacral nerve by celiac decompression. The patient was relieved of nerve pressure and pain. Conclusions This treatment method could be an alternative treatment for pelvic fractures and sacral nerve injury. The application of this treatment is a safe and feasible option that can be employed to manage early and late nerve repair with sacral fractures when open surgery or conservative treatment is unsuitable.
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Affiliation(s)
- Ye Peng
- Department of Orthopaedic Surgery, General Hospital of Chinese People's Liberation Army, 28 Fu-Xing Road, Beijing, 100853, People's Republic of China
| | - Wei Zhang
- Department of Orthopaedic Surgery, General Hospital of Chinese People's Liberation Army, 28 Fu-Xing Road, Beijing, 100853, People's Republic of China
| | - Gongzi Zhang
- Department of Orthopaedic Surgery, General Hospital of Chinese People's Liberation Army, 28 Fu-Xing Road, Beijing, 100853, People's Republic of China
| | - Xiang Wang
- Department of Orthopaedic Surgery, General Hospital of Chinese People's Liberation Army, 28 Fu-Xing Road, Beijing, 100853, People's Republic of China
| | - Shuwei Zhang
- Department of Orthopaedic Surgery, General Hospital of Chinese People's Liberation Army, 28 Fu-Xing Road, Beijing, 100853, People's Republic of China
| | - Xin Ma
- Department of Urology Surgery, General Hospital of Chinese People's Liberation Army, 28 Fu-Xing Road, Beijing, 100853, People's Republic of China.
| | - Peifu Tang
- Department of Orthopaedic Surgery, General Hospital of Chinese People's Liberation Army, 28 Fu-Xing Road, Beijing, 100853, People's Republic of China.
| | - Lihai Zhang
- Department of Orthopaedic Surgery, General Hospital of Chinese People's Liberation Army, 28 Fu-Xing Road, Beijing, 100853, People's Republic of China.
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20
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Chen AF, Kazarian GS, Jessop GW, Makhdom A. Robotic Technology in Orthopaedic Surgery. J Bone Joint Surg Am 2018; 100:1984-1992. [PMID: 30480604 DOI: 10.2106/jbjs.17.01397] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Antonia F Chen
- Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Gregory S Kazarian
- Department of Orthopaedic Surgery, Rothman Institute, Sidney Kimmel Medical College, Philadelphia, Pennsylvania
| | - Galen W Jessop
- Department of Orthopaedic Surgery, Rothman Institute, Sidney Kimmel Medical College, Philadelphia, Pennsylvania
| | - Asim Makhdom
- Department of Orthopaedic Surgery, Rothman Institute, Sidney Kimmel Medical College, Philadelphia, Pennsylvania
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21
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Medina MG, Tsoraides SS, Dwyer AM. Review and update: robotic transanal surgery (RTAS). Updates Surg 2018; 70:369-374. [PMID: 30120742 DOI: 10.1007/s13304-018-0580-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 08/05/2018] [Indexed: 02/06/2023]
Abstract
As the field of surgery advances, new approaches have allowed surgeons additional flexibility to perform further interventions with minimal or no external incisions. For many years, single site access (SSA) has been used for transanal procedures, and platforms allowing modified endoscopic approaches have been available. These platforms have limitations related to access, visualization, dexterity, camera control, and instrumentation. Recently, surgical robotics companies have developed and introduced new technologies and platforms, which may help address some of these limitations. Comprehensive internet, open access, and medical and industry conference reviews of robotic surgery platforms and technology available for use in SSA surgery were conducted and 30 articles were found using keywords "robotic surgery, transanal, single site, robotic transanal surgery". A PubMed, Medline, Journals @OVID and open access search for data related to these platforms and technologies was also performed yielding 11 articles. Abstracts were reviewed for those written in the English language, leaving 40 articles which were then filtered for those pertaining to robotic surgery, transanal. 58 abstracts were found, duplicates were eliminated, and the remaining 35 articles were read in their entirety by two reviewers. Several new and existing platforms are identified for use in SSA surgery for transanal surgery as well as abdominal and transoral surgery. These are reviewed, including brand, features, approved and suggested uses, and potential limitations. New robotic technologies serve to enhance the ability of surgeons to perform SSA surgery. This next generation of robotic surgery technology overcomes some of the limitations of preceding endoscopic SSA surgery technology and will enhance the advancement of robotic transanal surgery, but outcomes and performance data are still limited.
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Affiliation(s)
- Melissa G Medina
- University of Illinois College of Medicine at Peoria, Office of Graduate Medical Education, Peoria, IL, USA.,Department of General Surgery, University of Illinois College of Medicine at Peoria, Peoria, IL, USA
| | - Steven S Tsoraides
- University of Illinois College of Medicine at Peoria, Office of Graduate Medical Education, Peoria, IL, USA.,Department of General Surgery, University of Illinois College of Medicine at Peoria, Peoria, IL, USA
| | - Anthony M Dwyer
- University of Illinois College of Medicine at Peoria, Office of Graduate Medical Education, Peoria, IL, USA.
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22
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Abstract
The teleoperation of nonhumanoid robots is often a demanding task, as most current control interfaces rely on mappings between the operator’s and the robot’s actions, which are determined by the design and characteristics of the interface, and may therefore be challenging to master. Here, we describe a structured methodology to identify common patterns in spontaneous interaction behaviors, to implement embodied user interfaces, and to select the appropriate sensor type and positioning. Using this method, we developed an intuitive, gesture-based control interface for real and simulated drones, which outperformed a standard joystick in terms of learning time and steering abilities. Implementing this procedure to identify body-machine patterns for specific applications could support the development of more intuitive and effective interfaces. The accurate teleoperation of robotic devices requires simple, yet intuitive and reliable control interfaces. However, current human–machine interfaces (HMIs) often fail to fulfill these characteristics, leading to systems requiring an intensive practice to reach a sufficient operation expertise. Here, we present a systematic methodology to identify the spontaneous gesture-based interaction strategies of naive individuals with a distant device, and to exploit this information to develop a data-driven body–machine interface (BoMI) to efficiently control this device. We applied this approach to the specific case of drone steering and derived a simple control method relying on upper-body motion. The identified BoMI allowed participants with no prior experience to rapidly master the control of both simulated and real drones, outperforming joystick users, and comparing with the control ability reached by participants using the bird-like flight simulator Birdly.
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23
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Honda M, Morizane S, Hikita K, Takenaka A. Current status of robotic surgery in urology. Asian J Endosc Surg 2017; 10:372-381. [PMID: 28905493 DOI: 10.1111/ases.12381] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 03/08/2017] [Indexed: 12/12/2022]
Abstract
As a result of ergonomics, optimal magnification of the operative field, surgeon dexterity, and precision of surgical manipulation, robotic technology has been shown to overcome many difficulties associated with pure laparoscopy. With the recent expansion of robot-assisted surgery in the field of urology and following the success of robot-assisted prostatectomy and robot-assisted partial nephrectomy, robot-assisted surgery is being applied to treat many other genitourinary diseases, such as bladder cancer and ureteropelvic junction obstruction. The aim of the present review is to discuss the role of robotic surgery in urology and summarize recent developments in the field of urologic robotic surgery.
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Affiliation(s)
- Masashi Honda
- Department of Urology, Tottori University Faculty of Medicine, Yonago, Japan
| | - Shuichi Morizane
- Department of Urology, Tottori University Faculty of Medicine, Yonago, Japan
| | - Katsuya Hikita
- Department of Urology, Tottori University Faculty of Medicine, Yonago, Japan
| | - Atsushi Takenaka
- Department of Urology, Tottori University Faculty of Medicine, Yonago, Japan
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24
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Ngu JCY, Tsang CBS, Koh DCS. The da Vinci Xi: a review of its capabilities, versatility, and potential role in robotic colorectal surgery. ROBOTIC SURGERY (AUCKLAND) 2017; 4:77-85. [PMID: 30697566 PMCID: PMC6193435 DOI: 10.2147/rsrr.s119317] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The Xi is the latest da Vinci surgical system approved for use in colorectal surgery. With its novel overhead architecture, slimmer boom-mounted arms, extended instrument reach, guided targeting, and integrated auxiliary technology, the Xi manages to address several limitations of earlier models. The versatility of this new system allows it to be implemented in a wide range of colorectal procedures - from complex multiquadrant colectomies to challenging mesorectal dissections in the pelvis. While commonly criticized for its cost and prolonged operative time, robotic colorectal surgery holds the potential for enhanced ergonomics, superior precision, and a reduction in the learning curve involved in training an expert surgeon. This review appraises the existing literature on robotic colorectal surgery while elaborating how the improved capabilities of the Xi serve to usher in a new era of minimally invasive colorectal surgery.
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Affiliation(s)
| | - Charles Bih-Shiou Tsang
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore
- Colorectal Clinic Associates, Mount Elizabeth Novena Specialist Center, Singapore
| | - Dean Chi-Siong Koh
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore
- Colorectal Clinic Associates, Mount Elizabeth Novena Specialist Center, Singapore
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25
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Shang J, Leibrandt K, Giataganas P, Vitiello V, Seneci CA, Wisanuvej P, Liu J, Gras G, Clark J, Darzi A, Yang GZ. A Single-Port Robotic System for Transanal Microsurgery—Design and Validation. IEEE Robot Autom Lett 2017. [DOI: 10.1109/lra.2017.2668461] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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26
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Robotic single-site plus ONE port distal pancreatectomy. Surg Endosc 2017; 31:4258-4259. [DOI: 10.1007/s00464-017-5476-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 02/15/2017] [Indexed: 02/06/2023]
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27
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Bosi HR, Guimarães JR, Cavazzola LT. ROBOTIC ASSISTED SINGLE SITE FOR BILATERAL INGUINAL HERNIA REPAIR. ABCD-ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA 2017; 29:109-11. [PMID: 27438038 PMCID: PMC4944747 DOI: 10.1590/0102-6720201600020011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 01/26/2016] [Indexed: 02/07/2023]
Abstract
Background: The inguinal hernia is one of the most frequent surgical diseases, being frequent
procedure and surgeon´s everyday practice. Aim: To present technical details in making hernioplasty using robotic equipment on
bilateral inguinal hernia repair with single port and preliminary results with the
method. Method: The bilateral inguinal hernia repair was performed by using the
Single-Site(c) Da Vinci Surgical Access Platform to the abdominal
cavity and the placement of clamps. Results: This technique proved to be effective for inguinal hernia and have more aesthetic
result when compared to other techniques. Conclusions: Inguinal hernia repair robot-assisted with single-trocar is feasible and
effective. However, still has higher costs needing surgical team special
training.
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Affiliation(s)
- Henrique Rasia Bosi
- Department of General Surgery, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - José Ricardo Guimarães
- Department of General Surgery, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Leandro Totti Cavazzola
- Department of General Surgery, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
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28
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Lee S, Kim JK, Kim YN, Jang DS, Kim YM, Son T, Hyung WJ, Kim HI. Safety and feasibility of reduced-port robotic distal gastrectomy for gastric cancer: a phase I/II clinical trial. Surg Endosc 2017; 31:4002-4009. [DOI: 10.1007/s00464-017-5435-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 01/20/2017] [Indexed: 11/28/2022]
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