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Buote NJ. Looking to the Future; Veterinary Robotic Surgery. Vet Clin North Am Small Anim Pract 2024; 54:735-751. [PMID: 38538406 DOI: 10.1016/j.cvsm.2024.02.008] [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] [Indexed: 05/25/2024]
Abstract
This article details the rise of surgical robots in the human surgical sphere as well as their use in veterinary medicine. Sections will describe in detail the equipment required for these procedures and the advantages and disadvantages of their use. Specific attention is given to the articulated instrumentation, which affords psychomotor benefits not only for surgical precision but also for surgeon ergonomics. A discussion of the possible indications and current use of robotics in veterinary medicine and the challenges to integrating robotics is also provided.
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Affiliation(s)
- Nicole J Buote
- Minimally Invasive Surgery (Soft Tissue), Cornell University College of Veterinary Medicine, Small Animal Surgery, 930 Campus Road, Ithaca, NY 14853, USA.
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Singer Harel D, Lin Y, Lo CY, Cheng A, Davidson J, Chang TP, Matava C, Buyck M, Neveu G, Collia N, Fayyaz J, Manshadi K, Levy A, Pellerin S, Pirie J. Aerosol Box Use in Reducing Health Care Worker Contamination During Airway Procedures (AIRWAY) Study: Secondary Workload and Provider Outcomes in a Simulation-Based Trial. Pediatr Crit Care Med 2024:00130478-990000000-00352. [PMID: 38836694 DOI: 10.1097/pcc.0000000000003535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
OBJECTIVES An aerosol box aims to reduce the risk of healthcare provider (HCP) exposure to infections during aerosol generating medical procedures (AGMPs), but little is known about its impact on workload of team members. We conducted a secondary analysis of data from a prospective, multicenter, randomized controlled trial evaluating the impact of aerosol box use on patterns of HCP contamination during AGMPs. The objectives of this study are to: 1) evaluate the effect of aerosol box use on HCP workload, 2) identify factors associated with HCP workload when using an aerosol box, and 3) describe the challenges perceived by HCPs of aerosol box use. DESIGN Simulation-based randomized trial, conducted from May to December 2021. SETTING Four pediatric simulation centers. SUBJECTS Teams of two HCPs were randomly assigned to control (no aerosol box) or intervention groups (aerosol box). INTERVENTIONS Each team performed three scenarios requiring different pediatric airway management (bag-valve-mask [BVM] ventilation, laryngeal mask airway [LMA] insertion, and endotracheal intubation [ETI] with video laryngoscopy) on a simulated COVID-19 patient. National Aeronautics and Space Administration-Task Load Index (NASA-TLX) is a standard tool that measures subjective workload with six subscales. MEASUREMENTS AND MAIN RESULTS A total of 64 teams (128 participants) were recruited. The use of aerosol box was associated with significantly higher frustration during LMA insertion (28.71 vs. 17.42; mean difference, 11.29; 95% CI, 0.92-21.66; p = 0.033). For ETI, there was a significant increase in most subscales in the intervention group, but there was no significant difference for BMV. Average NASA-TLX scores were all in the "low" range for both groups (range: control BVM 23.06, sd 13.91 to intervention ETI 38.15; sd 20.45). The effect of provider role on workloads was statistically significant only for physical demand (p = 0.001). As the complexity of procedure increased (BVM → LMA → ETI), the workload increased in all six subscales (p < 0.05). CONCLUSIONS The use of aerosol box increased workload during ETI but not with BVM and LMA insertion. Overall workload scores remained in the "low" range, and there was no significant difference between airway provider and assistant.
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Affiliation(s)
- Dana Singer Harel
- Division of Emergency Medicine, Department of Pediatrics, University of Toronto, Hospital for Sick Children, Toronto, ON, Canada
| | - Yiqun Lin
- KidSIM-ASPIRE Simulation Research Program, Alberta Children's Hospital, University of Calgary, Calgary, AB, Canada
| | - Carl Y Lo
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Los Angeles, University of Southern California, Los Angeles, CA
| | - Adam Cheng
- Departments of Pediatrics and Emergency Medicine, Cumming School of Medicine, University of Calgary, KidSIM-ASPIRE Research Program, Alberta Children's Hospital, Calgary, AB, Canada
| | - Jennifer Davidson
- KidSIM-ASPIRE Simulation Research Program, Alberta Children's Hospital, University of Calgary, Calgary, AB, Canada
| | - Todd P Chang
- Department of Emergency Medicine, Children's Hospital of Los Angeles, University of Southern California, Los Angeles, CA
| | - Clyde Matava
- Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, ON, Canada
| | - Michael Buyck
- Department of Mother and Child Medicine, Division of Pediatric Emergency Medicine, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Guylaine Neveu
- Department of Respiratory Therapy, Sainte-Justine Hospital Mother-child Simulation Center, CHU Sainte-Justine, Université de Montréal, Montréal, QC, Canada
| | - Natasha Collia
- Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Jabeen Fayyaz
- Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Keya Manshadi
- Department of Emergency Medicine, Children's Hospital of Los Angeles, University of Southern California, Los Angeles, CA
| | - Arielle Levy
- Departments of Pediatrics and Emergency Medicine, Sainte-Justine Hospital Mother-child Simulation Center, CHU Sainte-Justine, Université de Montréal, Montréal, QC, Canada
| | - Stephanie Pellerin
- Department of Emergency Medicine, Sainte-Justine Hospital Mother-child Simulation Center, CHU Sainte-Justine, Université de Montréal, Montréal, QC, Canada
| | - Jonathan Pirie
- Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
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Schrijvershof P, Rahimi AM, Leone N, Bloemendaal A, Daams F, Arezzo A, Mintz Y, Horeman T. Design and evaluation of a smart passive dynamic arm support for robotic-assisted laparoscopic surgery. J Robot Surg 2024; 18:71. [PMID: 38340240 PMCID: PMC10858817 DOI: 10.1007/s11701-024-01820-1] [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: 12/20/2023] [Accepted: 01/08/2024] [Indexed: 02/12/2024]
Abstract
Surgeons performing robotic-assisted laparoscopic surgery experience physical stress and overuse of shoulder muscles due to sub-optimal arm support during surgery. The objective is to present a novel design and prototype of a dynamic arm support for robotic laparoscopic surgery to evaluate its ergonomics and performance on the AdLap-VR simulation training device. The prototype was designed using the mechanical engineering design process: Technical requirements, concept creation, concept selection, 3D-design and built of the prototype. A crossover study was performed on a marble sorting task on the AdLap-VR. The first group performed four trials without the arm support, followed by four trials with the arm support, and the other group executed the sequence vice versa. The performance parameters used were time to complete (s), path length (mm), and the number of collisions. Afterward, the participants filled out a questionnaire on the ergonomic experience regarding both situations. 20 students executed 160 performed trials on the AdLap-VR Significant decreases in the subjective comfort parameters mental demand, physical demand, effort and frustration were observed as a result of introducing the novel arm support. Significant decreases in the objective performance parameters path length and the number of collisions were also observed during the tests. The newly developed dynamic arm support was found to improve comfort and enhance performance through increased stability on the robotic surgery skills simulator AdLap-VR.
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Affiliation(s)
- Pim Schrijvershof
- Department of Biomechanical Engineering, Technical University of Delft, Delft, The Netherlands
| | - A Masie Rahimi
- Department of Surgery, Amsterdam UMC - VU University Medical Center, Amsterdam, The Netherlands.
- Amsterdam Skills Centre for Health Sciences, Amsterdam, The Netherlands.
- Cancer Center Amsterdam, Amsterdam, The Netherlands.
| | - Nicola Leone
- Department of Surgical Sciences, University of Torino, Torino, Italy
| | | | - Freek Daams
- Department of Surgery, Amsterdam UMC - VU University Medical Center, Amsterdam, The Netherlands
- Amsterdam Skills Centre for Health Sciences, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Alberto Arezzo
- Department of Surgical Sciences, University of Torino, Torino, Italy
| | - Yoav Mintz
- Department of General Surgery, Hadassah Hebrew-University Medical Center, Jerusalem, Israel
| | - Tim Horeman
- Department of Biomechanical Engineering, Technical University of Delft, Delft, The Netherlands
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