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Molle F, Savastano MC, Giannuzzi F, Fossataro C, Brando D, Molle A, Rebecchi MT, Falsini B, Mattei R, Mirisola G, Poretti E, Cestrone V, D'Agostino E, Bassi P, Scambia G, Rizzo S. 3D Da Vinci robotic surgery: is it a risk to the surgeon's eye health? J Robot Surg 2023; 17:1995-2000. [PMID: 37103772 PMCID: PMC10492867 DOI: 10.1007/s11701-023-01604-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 04/16/2023] [Indexed: 04/28/2023]
Abstract
Da Vinci three-dimensional (3D) system has been increasingly used in customary surgical settings, gaining fundamental relevance for abdominal, urological, and gynecological laparoscopic surgery. The aim of this research is to evaluate the degree of discomfort and potential changes in the binocular vision and ocular motility of surgical operators, who employ 3D vision systems during Da Vinci robotic surgery. Twenty-four surgeons were enrolled in the study, including twelve who typically use the 3D Da Vinci system and twelve who routinely employ 2D system. Routine general ophthalmological and orthoptic examinations were conducted at baseline (T0), the day before surgery, and 30 min after the 3D or 2D surgery (T1). In addition, surgeons were interviewed using a questionnaire of 18 symptoms, with each item containing three questions regarding the frequency, severity, and bothersomeness of the symptoms, in order to evaluate the degree of discomfort. Mean age at evaluation was 45.28 ± 8.71 years (range 33-63 years). Cover test, uncover test, and fusional amplitude showed no statistically significant difference. After surgery, no statistical difference was observed in the Da Vinci group on the TNO stereotest (p > 0.9999). However, the difference in the 2D group resulted statistically significant (p = 0.0156). Comparing participants (p 0.0001) and time (T0-T1; p = 0.0137), the difference between the two groups was statistically significant. Surgeons using 2D systems reported more discomfort than those using 3D systems. The absence of short-term consequences following surgery with the Da Vinci 3D system is a promising conclusion, considering the numerous advantages of this technology. Nonetheless, multicenter investigations and more studies are required to verify and interpret our findings.
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Affiliation(s)
- Fernando Molle
- Ophthalmology Unit, "Fondazione Policlinico Universitario A. Gemelli, IRCCS", Largo A. Gemelli, 8, 00168, Rome, Italy
- Catholic University "Sacro Cuore", 00168, Rome, Italy
| | - Maria Cristina Savastano
- Ophthalmology Unit, "Fondazione Policlinico Universitario A. Gemelli, IRCCS", Largo A. Gemelli, 8, 00168, Rome, Italy
- Catholic University "Sacro Cuore", 00168, Rome, Italy
| | - Federico Giannuzzi
- Ophthalmology Unit, "Fondazione Policlinico Universitario A. Gemelli, IRCCS", Largo A. Gemelli, 8, 00168, Rome, Italy.
- Catholic University "Sacro Cuore", 00168, Rome, Italy.
| | - Claudia Fossataro
- Ophthalmology Unit, "Fondazione Policlinico Universitario A. Gemelli, IRCCS", Largo A. Gemelli, 8, 00168, Rome, Italy
- Catholic University "Sacro Cuore", 00168, Rome, Italy
| | - Davide Brando
- Ophthalmology Unit, "Fondazione Policlinico Universitario A. Gemelli, IRCCS", Largo A. Gemelli, 8, 00168, Rome, Italy
- Catholic University "Sacro Cuore", 00168, Rome, Italy
| | - Andrea Molle
- Ophthalmology Unit, "Fondazione Policlinico Universitario A. Gemelli, IRCCS", Largo A. Gemelli, 8, 00168, Rome, Italy
- Catholic University "Sacro Cuore", 00168, Rome, Italy
| | - Maria Teresa Rebecchi
- Ophthalmology Unit, "Fondazione Policlinico Universitario A. Gemelli, IRCCS", Largo A. Gemelli, 8, 00168, Rome, Italy
- Catholic University "Sacro Cuore", 00168, Rome, Italy
| | - Benedetto Falsini
- Ophthalmology Unit, "Fondazione Policlinico Universitario A. Gemelli, IRCCS", Largo A. Gemelli, 8, 00168, Rome, Italy
- Catholic University "Sacro Cuore", 00168, Rome, Italy
| | - Roberta Mattei
- Ophthalmology Unit, "Fondazione Policlinico Universitario A. Gemelli, IRCCS", Largo A. Gemelli, 8, 00168, Rome, Italy
- Catholic University "Sacro Cuore", 00168, Rome, Italy
| | - Giorgia Mirisola
- Ophthalmology Unit, "Fondazione Policlinico Universitario A. Gemelli, IRCCS", Largo A. Gemelli, 8, 00168, Rome, Italy
- Catholic University "Sacro Cuore", 00168, Rome, Italy
| | - Eleonora Poretti
- Ophthalmology Unit, "Fondazione Policlinico Universitario A. Gemelli, IRCCS", Largo A. Gemelli, 8, 00168, Rome, Italy
- Catholic University "Sacro Cuore", 00168, Rome, Italy
| | - Valentina Cestrone
- Ophthalmology Unit, "Fondazione Policlinico Universitario A. Gemelli, IRCCS", Largo A. Gemelli, 8, 00168, Rome, Italy
- Catholic University "Sacro Cuore", 00168, Rome, Italy
| | - Elena D'Agostino
- Ophthalmology Unit, "Fondazione Policlinico Universitario A. Gemelli, IRCCS", Largo A. Gemelli, 8, 00168, Rome, Italy
- Catholic University "Sacro Cuore", 00168, Rome, Italy
| | - Pierfrancesco Bassi
- Catholic University "Sacro Cuore", 00168, Rome, Italy
- Urology Department, Sacro Cuore Catholic University, A. Gemelli University Hospital, 00168, Rome, Italy
| | - Giovanni Scambia
- Catholic University "Sacro Cuore", 00168, Rome, Italy
- Department of Woman, Child, and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, 00168, Rome, Italy
| | - Stanislao Rizzo
- Ophthalmology Unit, "Fondazione Policlinico Universitario A. Gemelli, IRCCS", Largo A. Gemelli, 8, 00168, Rome, Italy
- Catholic University "Sacro Cuore", 00168, Rome, Italy
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Patra A, Pushpa NB, Ravi KS. Visualization in Anatomy Education. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1406:171-186. [PMID: 37016115 DOI: 10.1007/978-3-031-26462-7_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
In the post-pandemic era, one of the significant challenges for anatomy teachers is to reciprocate the experience of practical exposure while teaching the subject to undergraduates. These challenges span from conducting cadaveric dissections to handling real human bones, museum specimens, and tissue sections in the histology lab. Such exposures help the instructors to develop interactive communication with their fellow students and thus help to enhance communication skills among them. Recently, anatomy teachers all over the world started using cutting-edge educational technologies to make teaching-learning experiences for students more engaging, interesting, and interactive. Utilizing such cutting-edge educational technologies was an "option" prior to the pandemic, but the pandemic has significantly altered the situation. What was previously an "option" is now a "compulsion." Despite the fact that the majority of medical schools have resumed their regular on-campus classes, body donation and the availability of cadavers remain extremely limited, resulting in a deadlock. Anatomy teachers must incorporate cutting-edge educational technologies into their teaching and learning activities to make the subject more visual. In this chapter, we have attempted to discuss various new technologies which can provide a near-realistic perception of anatomical structures as a complementary tool for dissection/cadaver, various visualization techniques currently available and explore their importance as a pedagogic alternative in learning anatomy. We also discussed the recent advancement in visualization techniques and the pros and cons of technology-based visualization. This chapter identifies the limitations of technology-based visualization as a supplement and discusses effective utilization as an adjunct to the conventional pedagogical approaches to undergraduate anatomy education.
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Affiliation(s)
- Apurba Patra
- Department of Anatomy, All India Institute of Medical Sciences, Bathinda, Bathinda, Punjab, India
| | | | - Kumar Satish Ravi
- Department of Anatomy, All India Institute of Medical Sciences, Rishikesh, Rishikesh, Uttarakhand, India
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Tuna MB, Kilavuzoglu AE, Mourmouris P, Argun OB, Doganca T, Obek C, Ozisik O, Kural AR. Impact of Refractive Errors on Da Vinci SI Robotic System. JSLS 2020; 24:JSLS.2020.00031. [PMID: 32831541 PMCID: PMC7434396 DOI: 10.4293/jsls.2020.00031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Objective To investigate the impact of refractive errors on binocular visual acuity while using the Da Vinci SI robotic system console. Methods Eighty volunteers were examined on the Da Vinci SI robotic system console by using a near vision chart. Refractive errors, anisometropia status, and Fly Stereo Acuity Test scores were recorded. Spherical equivalent (SE) were calculated for all volunteers' right and left eyes. Visual acuity was assessed by the logarithm of the minimal angle of resolution (LogMAR) method. Binocular uncorrected and best corrected (with proper contact lens or glasses) LogMAR values of the subjects were recorded. The difference between these values (DiffLogMAR) are affected by different refractive errors. Results In the myopia and/or astigmatism group, uncorrected SE was found to have significant impact on the DiffLogMAR (p < 0.001) and myopia greater than 1.75 diopter had significantly higher DiffLogMAR values (p < 0.05). Subjects with presbyopia had significantly higher DiffLogMAR values (p < 0.01), and we observed positive correlation between presbyopia and DiffLogMAR values (p = 0.33, p < 0.01). The cut off value of presbyopia that correlated the most with DiffLogMAR differences was found to be 1.25 diopter (p < 0.001). In 13 hypermetropic volunteers, we found significant correlation between hypermetropia value and DiffLogMAR (p > 0.7, p < 0.01). The statistical analysis between Fly test and SE revealed a significant impact of presbyopia and hypermetropia to the stereotactic view of the subject (p = -0.734, p < 0.05). Conclusion Surgeons suffering from myopia greater than 1.75 diopter, presbyopia greater than 1.25 diopter (D), and hypermetropia regardless of grade must always perform robotic surgeries with the proper correction.
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Affiliation(s)
| | - Ayse Ebru Kilavuzoglu
- Department of Ophthalmology, Acibadem Mehmet Ali Aydinlar University Medical Faculty
| | - Panogiotis Mourmouris
- 2nd Department of Urology, National and Kapodistrian University of Athens, Sismanoglio Hospital
| | - Omer Burak Argun
- Department of Urology, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey
| | | | - Can Obek
- Department of Urology, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey
| | | | - Ali Riza Kural
- Department of Urology, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey
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Dal Moro F, Zazzara M, Morlacco A, Gardiman MP, Costa G, Zattoni F. Is "extreme" bladder neck preservation in robot-assisted radical prostatectomy a safe procedure? Urologia 2020; 87:149-154. [PMID: 31964317 DOI: 10.1177/0391560319899253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The aim was to investigate the surgical and pathological outcomes of an "extreme" bladder neck preservation in prostate cancer patients treated with robotic radical prostatectomy. The greatest concern about the "extreme" bladder neck preservation is the potential risk of creating a positive surgical margin at the level of bladder neck. MATERIALS AND METHODS We prospectively collected data from 88 patients with diagnosed prostate cancer who underwent robotic radical prostatectomy with "'extreme' bladder neck preservation." All surgical procedures were performed by the same expert surgeon (F.D.M.). In this study, "'extreme' bladder neck preservation" was considered when the length of the spared intraprostatic segment of bladder neck was ⩾1 cm. We compared the histopathologic data with those of a homogeneous similar cohort of 88 consecutive patients who underwent robotic radical prostatectomy without bladder neck preservation. RESULTS The two groups analyzed were comparable according to clinical and pathological characteristics. A positive surgical margin at the level of bladder neck was found in five (5.7%) cases in the "extreme" bladder neck preservation group and in six cases (6.8%) in the no-bladder neck preservation group. The prostatic base was involved by neoplasia in 14 and 19 patients (15.9% and 21.6%, respectively); of these, five (35.7%) and six (31.6%) had positive surgical margin at the level of bladder neck, respectively. The pathological staging in positive surgical margin at the level of bladder neck patients was pT3 in five (100%) cases in the "extreme" bladder neck preservation group and in four (66.7%) cases when we decided not to preserve the bladder neck. CONCLUSION We demonstrated that "extreme" bladder neck preservation is a safe oncological procedure with similar pathologic findings of a comparable no-bladder neck preservation series. Positive surgical margins at the level of bladder neck are linked to neoplasia with adverse pathological features, rather than the "extreme" bladder neck preservation procedure.
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Affiliation(s)
- Fabrizio Dal Moro
- Department of Surgery, Oncology and Gastroenterology-Urology, University of Padova, Padova, Italy.,Urologic Clinic, "Santa Maria della Misericordia" Hospital, University of Udine, Udine, Italy
| | - Michele Zazzara
- Department of Surgery, Oncology and Gastroenterology-Urology, University of Padova, Padova, Italy
| | - Alessandro Morlacco
- Department of Surgery, Oncology and Gastroenterology-Urology, University of Padova, Padova, Italy
| | | | - Giovanni Costa
- Department of Surgery, Oncology and Gastroenterology-Urology, University of Padova, Padova, Italy
| | - Fabio Zattoni
- Urologic Clinic, "Santa Maria della Misericordia" Hospital, University of Udine, Udine, Italy
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