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Cowan B, Gomes C, Morris P, Fryrear R, Petraiuolo W, Walton M, Alseidi A, Horgan S, Hagen M. Robotic technology in surgery; a classification system of soft tissue surgical robotic devices. Surg Endosc 2024; 38:3645-3653. [PMID: 38772960 DOI: 10.1007/s00464-024-10861-4] [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: 02/29/2024] [Accepted: 04/10/2024] [Indexed: 05/23/2024]
Abstract
BACKGROUND The field of robotic-assisted surgery is rapidly growing as many robotic surgical devices are in development and about to enter the market. Currently, there is no universally accepted language for labeling the different robotic systems. To facilitate this communication, we created what is, to our knowledge, the first classification of surgical robotic technologies that organizes and classifies surgical robots used for endoscopy, laparoscopy and thoracoscopy. METHODS We compiled a list of surgical robots intended to be used for endoscopy, laparoscopy, and/or thoracoscopy by searching United States, European, Hong Kong, Japan, and Korean databases for approved devices. Devices showcased at the 2023 Annual Meeting for the Society of Robotic Surgery were added. We also systematically reviewed the literature for any existing surgical robotic classifications or categorizations. We then created a multidisciplinary committee of 8 surgeons and 2 engineers to construct a proposed classification of the devices included in our search. RESULTS We identified 40 robotic surgery systems intended to be used for endoscopy, laparoscopy and/or thoracoscopy. The proposed classification organizes robotic devices with regard to architecture, port design, and configuration (modular carts, multi-arm integrated cart, table-attachable or arm-table integration). CONCLUSION This 3-level classification of robotic surgical devices used for endoscopy, laparoscopy and/or thoracoscopy describes important characteristics of robotic devices systematically.
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Affiliation(s)
- Brandon Cowan
- Department of Surgery, University of California San Francisco, San Francisco, CA, USA
- Johnson and Johnson MedTech, Santa Clara, CA, USA
- UCSF, East Bay Surgery, 1411 E 31stSt, QIC 22134, Oakland, CA, 94602, USA
| | - Camilla Gomes
- Department of Surgery, University of California San Francisco, San Francisco, CA, USA.
- Johnson and Johnson MedTech, Santa Clara, CA, USA.
| | - Paul Morris
- Johnson and Johnson MedTech, Santa Clara, CA, USA
| | | | | | - Matt Walton
- Johnson and Johnson MedTech, Santa Clara, CA, USA
| | - Adnan Alseidi
- Department of Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Santiago Horgan
- Department of Surgery, University of California San Diego, San Diego, CA, USA
| | - Monika Hagen
- Department of Surgery, University Hospital Geneva, Geneva, Switzerland
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Cruz J, Gonçalves SB, Neves MC, Silva HP, Silva MT. Intraoperative Angle Measurement of Anatomical Structures: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2024; 24:1613. [PMID: 38475148 DOI: 10.3390/s24051613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 02/22/2024] [Accepted: 02/28/2024] [Indexed: 03/14/2024]
Abstract
Ensuring precise angle measurement during surgical correction of orientation-related deformities is crucial for optimal postoperative outcomes, yet there is a lack of an ideal commercial solution. Current measurement sensors and instrumentation have limitations that make their use context-specific, demanding a methodical evaluation of the field. A systematic review was carried out in March 2023. Studies reporting technologies and validation methods for intraoperative angular measurement of anatomical structures were analyzed. A total of 32 studies were included, 17 focused on image-based technologies (6 fluoroscopy, 4 camera-based tracking, and 7 CT-based), while 15 explored non-image-based technologies (6 manual instruments and 9 inertial sensor-based instruments). Image-based technologies offer better accuracy and 3D capabilities but pose challenges like additional equipment, increased radiation exposure, time, and cost. Non-image-based technologies are cost-effective but may be influenced by the surgeon's perception and require careful calibration. Nevertheless, the choice of the proper technology should take into consideration the influence of the expected error in the surgery, surgery type, and radiation dose limit. This comprehensive review serves as a valuable guide for surgeons seeking precise angle measurements intraoperatively. It not only explores the performance and application of existing technologies but also aids in the future development of innovative solutions.
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Affiliation(s)
- João Cruz
- IDMEC, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais 1, 1049-001 Lisboa, Portugal
| | - Sérgio B Gonçalves
- IDMEC, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais 1, 1049-001 Lisboa, Portugal
| | | | - Hugo Plácido Silva
- IT-Instituto de Telecomunicações, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais 1, 1049-001 Lisboa, Portugal
| | - Miguel Tavares Silva
- IDMEC, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais 1, 1049-001 Lisboa, Portugal
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Chatterjee S, Das S, Ganguly K, Mandal D. Advancements in robotic surgery: innovations, challenges and future prospects. J Robot Surg 2024; 18:28. [PMID: 38231455 DOI: 10.1007/s11701-023-01801-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: 10/17/2023] [Accepted: 12/16/2023] [Indexed: 01/18/2024]
Abstract
The use of robots has revolutionized healthcare, wherein further innovations have led to improved precision and accuracy. Conceived in the late 1960s, robot-assisted surgeries have evolved to become an integral part of various surgical specialties. Modern robotic surgical systems are equipped with highly dexterous arms and miniaturized instruments that reduce tremors and enable delicate maneuvers. Implementation of advanced materials and designs along with the integration of imaging and visualization technologies have enhanced surgical accuracy and made robots safer and more adaptable to various procedures. Further, the haptic feedback system allows surgeons to determine the consistency of the tissues they are operating upon, without physical contact, thereby preventing injuries due to the application of excess force. With the implementation of teleoperation, surgeons can now overcome geographical limitations and provide specialized healthcare remotely. The use of artificial intelligence (AI) and machine learning (ML) aids in surgical decision-making by improving the recognition of minute and complex anatomical structures. All these advancements have led to faster recovery and fewer complications in patients. However, the substantial cost of robotic systems, their maintenance, the size of the systems and proper surgeon training pose major challenges. Nevertheless, with future advancements such as AI-driven automation, nanorobots, microscopic incision surgeries, semi-automated telerobotic systems, and the impact of 5G connectivity on remote surgery, the growth curve of robotic surgery points to innovation and stands as a testament to the persistent pursuit of progress in healthcare.
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Affiliation(s)
- Swastika Chatterjee
- Department of Biomedical Engineering, JIS College of Engineering, Kalyani, West Bengal, India
| | | | - Karabi Ganguly
- Department of Biomedical Engineering, JIS College of Engineering, Kalyani, West Bengal, India
| | - Dibyendu Mandal
- Department of Biomedical Engineering, JIS College of Engineering, Kalyani, West Bengal, India.
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Saad A, Mayne AIW, Pagkalos J, Ollivier M, Botchu R, Davis ET, Sharma AD. An evaluation of factors influencing the adoption and usage of robotic surgery in lower limb arthroplasty amongst orthopaedic trainees: a clinical survey. J Robot Surg 2024; 18:2. [PMID: 38175317 DOI: 10.1007/s11701-023-01811-8] [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: 11/11/2023] [Accepted: 12/23/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND The rise of robotics in orthopaedic training, driven by the demand for better training outcomes and patient care, presents specific challenges for junior trainees due to its novelty and steep learning curve. This paper explores how orthopaedic trainees perceive and adopt robotic-assisted lower limb arthroplasty. METHODS The study utilised the UTUAT model questionnaire as the primary data collection tool, employing targeted questions on a five-point Likert scale to efficiently gather responses from a large number of participants. Data analysis was conducted using partial least squares (PLS), a well-established method in previous technology acceptance research. RESULT The findings indicate a favourable attitude amongst trainees towards adopting robotic technology in orthopaedic training. They acknowledge the potential advantages of improved surgical precision and patient outcomes through roboticassisted procedures. Social factors, including the views of peers and mentors, notably influence trainees' decision-making. However, the availability of resources and expert mentors did not appear to have a significant impact on trainees' intention to use robotic technology. CONCLUSION The study contributes to the understanding of factors influencing trainees' interest in robotic surgery and emphasises the importance of creating a supportive environment for its adoption.
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Affiliation(s)
- Ahmed Saad
- Department of Trauma & Orthopaedics, Royal Orthopaedic Hospital, Bristol Rd S, Northfield, Birmingham, B31 2AP, UK.
| | - Alistair I W Mayne
- Department of Trauma & Orthopaedics, Royal Orthopaedic Hospital, Bristol Rd S, Northfield, Birmingham, B31 2AP, UK
| | - Joseph Pagkalos
- Department of Trauma & Orthopaedics, Lower Limb Reconstruction Unit, Royal Orthopaedic Hospital, Bristol Rd S, Northfield, Birmingham, B31 2AP, UK
| | - Matthieu Ollivier
- Institute Movement Science, Aix Marseille University, CNRS, Marseille, France
| | - Rajesh Botchu
- Department of MSK Radiology, Royal Orthopaedic Hospital, Bristol Rd S, Northfield, Birmingham, B31 2AP, UK
| | - Edward T Davis
- Department of Trauma & Orthopaedics, Lower Limb Reconstruction Unit, Royal Orthopaedic Hospital, Bristol Rd S, Northfield, Birmingham, B31 2AP, UK
| | - Akash D Sharma
- Department of Trauma & Orthopaedics, Lower Limb Reconstruction Unit, Royal Orthopaedic Hospital, Bristol Rd S, Northfield, Birmingham, B31 2AP, UK
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Lin T, Xie Q, Peng T, Zhao X, Chen D. The role of robotic surgery in neurological cases: A systematic review on brain and spine applications. Heliyon 2023; 9:e22523. [PMID: 38046149 PMCID: PMC10686875 DOI: 10.1016/j.heliyon.2023.e22523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 10/20/2023] [Accepted: 11/14/2023] [Indexed: 12/05/2023] Open
Abstract
The application of robotic surgery technologies in neurological surgeries resulted in some advantages compared to traditional surgeries, including higher accuracy and dexterity enhancement. Its success in various surgical fields, especially in urology, cardiology, and gynecology surgeries was reported in previous studies, and similar advantages in neurological surgeries are expected. Surgeries in the central nervous system with the pathology of millimeters through small working channels around vital tissue need especially high precision. Applying robotic surgery is therefore an interesting dilemma for these situations. This article reviews various studies published on the application of brain and spine robotic surgery and discusses the current application of robotic technology in neurological cases.
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Affiliation(s)
- Tong Lin
- Neurosurgery, Guangxi Hospital Division of The First Affiliated Hospital, Sun Yat-Sen University, 535000, Nanning, China
| | - Qinghai Xie
- Neurosurgery, Qinzhou First People's Hospital, Qinzhou City, 535000, China
| | - Tao Peng
- Neurosurgery, Qinzhou First People's Hospital, Qinzhou City, 535000, China
| | - Xianxiao Zhao
- Neurosurgery, Qinzhou First People's Hospital, Qinzhou City, 535000, China
| | - Dongliang Chen
- Neurosurgery, Qinzhou First People's Hospital, Qinzhou City, 535000, China
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Mills JF, Monaghan NP, Nguyen SA, Pang J, Asarkar AA, Nathan CAO. Editorial: Special Issue on the Epidemiology of Human Papilloma Virus-Associated Oropharyngeal Squamous Cell Carcinoma. Cancers (Basel) 2023; 15:4608. [PMID: 37760577 PMCID: PMC10526138 DOI: 10.3390/cancers15184608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
In this Special Issue of Cancers, the role of oncogenic human papilloma virus (HPV) with oropharyngeal squamous cell carcinoma is explored […].
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Affiliation(s)
- John F. Mills
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC 29425, USA; (J.F.M.); (N.P.M.)
| | - Neil P. Monaghan
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC 29425, USA; (J.F.M.); (N.P.M.)
| | - Shaun A. Nguyen
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC 29425, USA; (J.F.M.); (N.P.M.)
| | - John Pang
- Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, Shreveport, LA 71103, USA; (J.P.); (A.A.A.); (C.-A.O.N.)
| | - Ameya A. Asarkar
- Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, Shreveport, LA 71103, USA; (J.P.); (A.A.A.); (C.-A.O.N.)
| | - Cherie-Ann O. Nathan
- Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, Shreveport, LA 71103, USA; (J.P.); (A.A.A.); (C.-A.O.N.)
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Lee A, Torkamani-Azar M, Zheng B, Bednarik R. Unpacking the Broad Landscape of Intraoperative Stressors for Clinical Personnel: A Mixed-Methods Systematic Review. J Multidiscip Healthc 2023; 16:1953-1977. [PMID: 37484819 PMCID: PMC10361288 DOI: 10.2147/jmdh.s401325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 06/09/2023] [Indexed: 07/25/2023] Open
Abstract
Purpose The main goals of this mixed-methods systematic review are to identify what types of intraoperative stressors for operating room personnel have been reported in collected studies and examine the characteristics of each intraoperative stressor. Methods With a systematic literature search, we retrieved empirical studies examining intraoperative stress published between 2010 and 2020. To synthesize findings, we applied two approaches. First, a textual narrative synthesis was employed to summarize key study information of the selected studies by focusing on surgical platforms and study participants. Second, a thematic synthesis was employed to identify and characterize intraoperative stressors and their subtypes. Results Ninety-four studies were included in the review. Regarding the surgical platforms, the selected studies mainly focused on minimally invasive surgery and few studies examined issues around robotic surgery. Most studies examined intra-operative stress from surgeons' perspectives but rarely considered other clinical personnel such as nurses and anesthetists. Among seven identified stressors, technical factors were the most frequently examined followed by individual, operating room environmental, interpersonal, temporal, patient, and organizational factors. Conclusion By presenting stressors as multifaceted elements affecting collaboration and interaction between multidisciplinary team members in the operating room, we discuss the potential interactions between stressors which should be further investigated to build a safe and efficient environment for operating room personnel.
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Affiliation(s)
- Ahreum Lee
- Samsung Electronics Co. Ltd., Suwon, Gyeonggi-do, Republic of Korea
| | | | - Bin Zheng
- Department of Surgery, University of Alberta, Edmonton, Canada
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Rivero-Moreno Y, Echevarria S, Vidal-Valderrama C, Pianetti L, Cordova-Guilarte J, Navarro-Gonzalez J, Acevedo-Rodríguez J, Dorado-Avila G, Osorio-Romero L, Chavez-Campos C, Acero-Alvarracín K. Robotic Surgery: A Comprehensive Review of the Literature and Current Trends. Cureus 2023; 15:e42370. [PMID: 37621804 PMCID: PMC10445506 DOI: 10.7759/cureus.42370] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2023] [Indexed: 08/26/2023] Open
Abstract
Robotic surgery (RS) is an evolution of minimally invasive surgery that combines medical science, robotics, and engineering. The first robots approved by the Food and Drug Administration (FDA) were the Da Vinci Surgical System and the ZEUS Robotic Surgical System, which have been improving over time. Through the decades, the equipment applied to RS had undergone a wide transformation as a response to the development of new techniques and facilities for the assembly and implementation of the own. RS has revolutionized the field of urology, enabling surgeons to perform complex procedures with greater precision and accuracy, and many other surgical specialties such as gynecology, general surgery, otolaryngology, cardiothoracic surgery, and neurosurgery. Several benefits, such as a better approach to the surgical site, a three-dimensional image that improves depth perception, and smaller scars, enhance range of motion, allowing the surgeon to conduct more complicated surgical operations, and reduced postoperative complications have made robotic-assisted surgery an increasingly popular approach. However, some points like the cost of surgical procedures, equipment-instrument, and maintenance are important aspects to consider. Machine learning will likely have a role to play in surgical training shortly through "automated performance metrics," where algorithms observe and "learn" individual surgeons' techniques, assess performance, and anticipate surgical outcomes with the potential to individualize surgical training and aid decision-making in real time.
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Affiliation(s)
| | | | | | - Luigi Pianetti
- General Surgery, Universidad Nacional del Litoral, Argentina, ARG
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Martinho FC, Griffin IL, Corazza BJM. Current Applications of Dynamic Navigation System in Endodontics: A Scoping Review. Eur J Dent 2023; 17:569-586. [PMID: 36044911 PMCID: PMC10569848 DOI: 10.1055/s-0042-1749361] [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: 10/14/2022] Open
Abstract
This scoping review (SCR) was conducted to map the existing literature on dynamic navigation system (DNS), to examine the extent, range, and nature of research activity. Additionally, this SCR disseminates research findings, determines the value of conducting a full systematic review with meta-analysis, and identifies gaps in the existing literature and future directions. This SCR followed Arksey and O'Malley's five stages framework. The electronic search was performed in PubMed (Medline), Scopus (Elsevier), and Web of Science (Clarivate Analytics) databases using a search strategy. Five themes emerged during the descriptive analysis that captured the DNS application in endodontics. The DNS has been explored for creating access cavities (8/18, 44.44%), locating calcified canals (4/18, 22.2%), microsurgery (3/18, 16.6%), post removal (2/18, 11.1%), and intraosseous anesthesia (1/18, 5.5%). Out of the 18 studies included, 12 are in vitro (66.6%), five are in vivo (case report) (27.7%), and one is ex vivo (5.5%). The DNS demonstrated accuracy and efficiency in performing minimally invasive access cavities, locating calcified canals, and performing endodontic microsurgery, and it helped target the site for intraosseous anesthesia.
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Affiliation(s)
- Frederico Canato Martinho
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Ina Laurie Griffin
- Division of Endodontics, Department of Restorative Dentistry, São Paulo State University, Institute of Science and Technology, São José dos Campos, São Paulo, Brazil
| | - Bruna Jordão Motta Corazza
- Division of Endodontics, Department of Restorative Dentistry, São Paulo State University, Institute of Science and Technology, São José dos Campos, São Paulo, Brazil
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Niculescu M, Honțaru OS, Popescu G, Sterian AG, Dobra M. Challenges of Integrating New Technologies for Orthopedic Doctors to Face up to Difficulties during the Pandemic Era. Healthcare (Basel) 2023; 11:1524. [PMID: 37297666 PMCID: PMC10288938 DOI: 10.3390/healthcare11111524] [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: 04/03/2023] [Revised: 05/19/2023] [Accepted: 05/21/2023] [Indexed: 06/12/2023] Open
Abstract
In the field of orthopedics, competitive progress is growing faster because new technologies used to facilitate the work of physicians are continuously developing. Based on the issues generated in the pandemic era in this field, a research study was developed to identify the intention of orthopedic doctors to integrate new medical technologies. The survey was based on a questionnaire that was used for data collection. The quantitative study registered a sample of 145 orthopedic doctors. The data analysis was performed based on the IBM SPSS program. A multiple linear regression model was applied, which analyzed how the independent variables can influence the dependent variables. After analyzing the data, it was observed that the intention of orthopedic doctors to use new medical technologies is influenced by the advantages and disadvantages perceived by them, the perceived risks, the quality of the medical technologies, the experience of physicians in their use, and their receptivity to other digital tools. The obtained results are highly important both for hospital managers and authorities, illustrating the main factors that influence doctors to use emergent technologies in their clinical work.
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Affiliation(s)
- Marius Niculescu
- Faculty of Medicine, “Titu Maiorescu” University of Bucharest, 031593 Bucharest, Romania;
- Colentina Hospital, Șoseaua Ștefan cel Mare 19-21, 020125 Bucharest, Romania
| | - Octavia-Sorina Honțaru
- Faculty of Sciences, Physical Education and Informatics, University of Pitesti, Târgul din Vale 1, 110040 Arges, Romania
- Department of Public Health Arges, Exercitiu 39 bis, 110438 Arges, Romania
| | - George Popescu
- Emergency Clinical Hospital Dr. Bagdasar-Arseni, Șoseaua Berceni 12, 041915 Bucharest, Romania
| | - Alin Gabriel Sterian
- Emergency Hospital for Children Grigore Alexandrescu, 30-32 Iancu de Hunedoara Boulevard, 011743 Bucharest, Romania;
- Department of Pediatric Surgery and Orthopedics, University of Medicine and Pharmacy “Carol Davila” Bucharest, 020021 Bucharest, Romania
| | - Mihai Dobra
- Center of Uronephrology and Renal Transplant Fundeni, University of Medicine and Pharmacy “Carol Davila” Bucharest, 020021 Bucharest, Romania;
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Lee Y, Samarasinghe Y, Chen LH, Jong A, Hapugall A, Javidan A, McKechnie T, Doumouras A, Hong D. Fragility of statistically significant findings from randomized trials in comparing laparoscopic versus robotic abdominopelvic surgeries. Surg Endosc 2023:10.1007/s00464-023-10063-4. [PMID: 37095233 DOI: 10.1007/s00464-023-10063-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/01/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND Utility of robotic over laparoscopic approach has been an area of debate across all surgical specialties over the past decade. The fragility index (FI) is a metric that evaluates the frailty of randomized controlled trials (RCTs) findings by altering the status of patients from an event to non-event until significance is lost. This study aims to evaluate the robustness of RCTs comparing laparoscopic and robotic abdominopelvic surgeries through the FI. METHODS A search was conducted in MEDLINE and EMBASE for RCTs with dichotomous outcomes comparing laparoscopic and robot-assisted surgery in general surgery, gynecology, and urology. The FI and reverse fragility Index (RFI) metrics were used to assess the strength of findings reported by RCTs, and bivariate correlation was conducted to analyze relationships between FI and trial characteristics. RESULTS A total of 21 RCTs were included, with a median sample size of 89 participants (Interquartile range [IQR] 62-126). The median FI was 2 (IQR 0-15) and median RFI 5.5 (IQR 4-8.5). The median FI was 3 (IQR 1-15) for general surgery (n = 7), 2 (0.5-3.5) for gynecology (n = 4), and 0 (IQR 0-8.5) for urology RCTs (n = 4). Correlation was found between increasing FI and decreasing p-value, but not sample size, number of outcome events, journal impact factor, loss to follow-up, or risk of bias. CONCLUSION RCTs comparing laparoscopic and robotic abdominal surgery did not prove to be very robust. While possible advantages of robotic surgery may be emphasized, it remains novel and requires further concrete RCT data.
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Affiliation(s)
- Yung Lee
- Division of General Surgery, McMaster University, Hamilton, ON, Canada
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | | | - Lucy H Chen
- Division of General Surgery, McMaster University, Hamilton, ON, Canada
| | - Audrey Jong
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Akithma Hapugall
- Division of General Surgery, McMaster University, Hamilton, ON, Canada
| | - Arshia Javidan
- Division of Vascular Surgery, University of Toronto, Toronto, ON, Canada
| | - Tyler McKechnie
- Division of General Surgery, McMaster University, Hamilton, ON, Canada
- Department of Health Research Methods and Evidence, McMaster University, Hamilton, ON, Canada
| | | | - Dennis Hong
- Division of General Surgery, McMaster University, Hamilton, ON, Canada.
- Division of General Surgery, St. Joseph's Healthcare, 50 Charlton Avenue East, Hamilton, ON, L8N 4A6, Canada.
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Lokmic-Tomkins Z, Bhandari D, Bain C, Borda A, Kariotis TC, Reser D. Lessons Learned from Natural Disasters around Digital Health Technologies and Delivering Quality Healthcare. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4542. [PMID: 36901559 PMCID: PMC10001761 DOI: 10.3390/ijerph20054542] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 02/21/2023] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
As climate change drives increased intensity, duration and severity of weather-related events that can lead to natural disasters and mass casualties, innovative approaches are needed to develop climate-resilient healthcare systems that can deliver safe, quality healthcare under non-optimal conditions, especially in remote or underserved areas. Digital health technologies are touted as a potential contributor to healthcare climate change adaptation and mitigation, through improved access to healthcare, reduced inefficiencies, reduced costs, and increased portability of patient information. Under normal operating conditions, these systems are employed to deliver personalised healthcare and better patient and consumer involvement in their health and well-being. During the COVID-19 pandemic, digital health technologies were rapidly implemented on a mass scale in many settings to deliver healthcare in compliance with public health interventions, including lockdowns. However, the resilience and effectiveness of digital health technologies in the face of the increasing frequency and severity of natural disasters remain to be determined. In this review, using the mixed-methods review methodology, we seek to map what is known about digital health resilience in the context of natural disasters using case studies to demonstrate what works and what does not and to propose future directions to build climate-resilient digital health interventions.
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Affiliation(s)
- Zerina Lokmic-Tomkins
- School of Nursing and Midwifery, Monash University, 35 Rainforest Walk, Clayton, Melbourne, VIC 3800, Australia
| | - Dinesh Bhandari
- School of Nursing and Midwifery, Monash University, 35 Rainforest Walk, Clayton, Melbourne, VIC 3800, Australia
| | - Chris Bain
- Digital Health Theme, Department of Human-Centered Computing, Faculty of Information Technology, Monash University, Melbourne, VIC 3800, Australia
| | - Ann Borda
- Melbourne Medical School, The University of Melbourne, Parkville, VIC 3010, Australia
- Department of Information Studies, University College London, London WC1E 6BT, UK
| | - Timothy Charles Kariotis
- School of Computing and Information System, The University of Melbourne, Melbourne, VIC 3010, Australia
- Melbourne School of Government, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - David Reser
- Graduate Entry Medicine Program, Monash Rural Health-Churchill, Churchill, VIC 3842, Australia
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Özelçi E, Mailand E, Rüegg M, Oates AC, Sakar MS. Deconstructing body axis morphogenesis in zebrafish embryos using robot-assisted tissue micromanipulation. Nat Commun 2022; 13:7934. [PMID: 36566327 PMCID: PMC9789989 DOI: 10.1038/s41467-022-35632-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 12/14/2022] [Indexed: 12/25/2022] Open
Abstract
Classic microsurgical techniques, such as those used in the early 1900s by Mangold and Spemann, have been instrumental in advancing our understanding of embryonic development. However, these techniques are highly specialized, leading to issues of inter-operator variability. Here we introduce a user-friendly robotic microsurgery platform that allows precise mechanical manipulation of soft tissues in zebrafish embryos. Using our platform, we reproducibly targeted precise regions of tail explants, and quantified the response in real-time by following notochord and presomitic mesoderm (PSM) morphogenesis and segmentation clock dynamics during vertebrate anteroposterior axis elongation. We find an extension force generated through the posterior notochord that is strong enough to buckle the structure. Our data suggest that this force generates a unidirectional notochord extension towards the tailbud because PSM tissue around the posterior notochord does not let it slide anteriorly. These results complement existing biomechanical models of axis elongation, revealing a critical coupling between the posterior notochord, the tailbud, and the PSM, and show that somite patterning is robust against structural perturbations.
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Affiliation(s)
- Ece Özelçi
- grid.5333.60000000121839049Institute of Mechanical Engineering, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland ,grid.5333.60000000121839049Institute of Bioengineering, EPFL, 1015 Lausanne, Switzerland
| | - Erik Mailand
- grid.5333.60000000121839049Institute of Mechanical Engineering, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - Matthias Rüegg
- grid.5333.60000000121839049Institute of Mechanical Engineering, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - Andrew C. Oates
- grid.5333.60000000121839049Institute of Bioengineering, EPFL, 1015 Lausanne, Switzerland
| | - Mahmut Selman Sakar
- grid.5333.60000000121839049Institute of Mechanical Engineering, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland ,grid.5333.60000000121839049Institute of Bioengineering, EPFL, 1015 Lausanne, Switzerland
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14
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Xin Y, Sun ZJ, Gu W, Yu L. Experimental Research on a Capsule Robot with Spring-Connected Legs. MICROMACHINES 2022; 13:2042. [PMID: 36557341 PMCID: PMC9785607 DOI: 10.3390/mi13122042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/13/2022] [Accepted: 11/18/2022] [Indexed: 06/17/2023]
Abstract
Based on a previous study of a novel capsule robot (CR) with spring-connected legs that could collect intestinal juice for biopsy, in this research, an experiment system is designed, and two experiments are carried out. One of the experiments measures the torque and cutting force of this CR, and the other experiment tests and evaluates the biopsy function of this CR. In the measuring experiment, we analyze how the magnetic torque exerted on this CR changes. In the experiment with a biopsy, we decompose the biopsy actions and select the most effective biopsy action. The result of the experiments shows that this CR can collect and store biopsy samples ideally, and the most effective biopsy action is the rotation with legs extended.
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15
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Teranishi R, Takahashi T, Kurokawa Y, Sugase T, Saito T, Yamamoto K, Yamashita K, Tanaka K, Makino T, Yamasaki M, Motoori M, Omori T, Nakajima K, Eguchi H, Doki Y. Robotic Distal Gastrectomy Reduces Drain Amylase Values in Patients With a Small Pancreas-left Gastric Artery Angle. Surg Laparosc Endosc Percutan Tech 2022; 32:311-318. [PMID: 35583613 PMCID: PMC9162270 DOI: 10.1097/sle.0000000000001038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 12/15/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Pancreatic fistula is a severe complication after laparoscopic distal gastrectomy (LDG). We previously evaluated the pancreas-left gastric artery angle (PLA) as a risk indicator for developing a pancreatic fistula after LDG. This study evaluated the incidence of pancreatic fistula with robotic distal gastrectomy (RDG) in comparison to LDG from the view of the PLA. MATERIALS AND METHODS An association between the PLA and the incidence of pancreatic fistula in 165 patients who underwent either RDG (n=45) or LDG (n=120) was investigated retrospectively. RESULTS RDG patients had significantly lower drain amylase values (postoperative day 2) than LDG patients. As opposed to LDG patients, drain amylase values were similar for patients with small (PLA <62 degrees) and large (PLA ≥62 degrees) PLA in RDG patients. CONCLUSION Robotic surgery may reduce the risk of postoperative pancreatic fistula in patients with a small PLA.
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Affiliation(s)
- Ryugo Teranishi
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita
| | - Tsuyoshi Takahashi
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita
| | - Yukinori Kurokawa
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita
| | | | - Takuro Saito
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita
| | - Kazuyoshi Yamamoto
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita
| | - Kotaro Yamashita
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita
| | - Koji Tanaka
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita
| | - Tomoki Makino
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita
| | - Makoto Yamasaki
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita
| | - Masaaki Motoori
- Department of Surgery, Osaka General Medical Center, Osaka, Osaka Prefecture, Japan
| | - Takeshi Omori
- Department of Surgery, Osaka International Cancer Institute
| | - Kiyokazu Nakajima
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita
| | - Hidetoshi Eguchi
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita
| | - Yuichiro Doki
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita
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16
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Islam MN, Mustafina SN, Mahmud T, Khan NI. Machine learning to predict pregnancy outcomes: a systematic review, synthesizing framework and future research agenda. BMC Pregnancy Childbirth 2022; 22:348. [PMID: 35546393 PMCID: PMC9097057 DOI: 10.1186/s12884-022-04594-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 03/21/2022] [Indexed: 11/10/2022] Open
Abstract
Machine Learning (ML) has been widely used in predicting the mode of childbirth and assessing the potential maternal risks during pregnancy. The primary aim of this review study is to explore current research and development perspectives that utilizes the ML techniques to predict the optimal mode of childbirth and to detect various complications during childbirth. A total of 26 articles (published between 2000 and 2020) from an initial set of 241 articles were selected and reviewed following a Systematic Literature Review (SLR) approach. As outcomes, this review study highlighted the objectives or focuses of the recent studies conducted on pregnancy outcomes using ML; explored the adopted ML algorithms along with their performances; and provided a synthesized view of features used, types of features, data sources and its characteristics. Besides, the review investigated and depicted how the objectives of the prior studies have changed with time being; and the association among the objectives of the studies, uses of algorithms, and the features. The study also delineated future research opportunities to facilitate the existing initiatives for reducing maternal complacent and mortality rates, such as: utilizing unsupervised and deep learning algorithms for prediction, revealing the unknown reasons of maternal complications, developing usable and useful ML-based clinical decision support systems to be used by the expecting mothers and health professionals, enhancing dataset and its accessibility, and exploring the potentiality of surgical robotic tools. Finally, the findings of this review study contributed to the development of a conceptual framework for advancing the ML-based maternal healthcare system. All together, this review will provide a state-of-the-art paradigm of ML-based maternal healthcare that will aid in clinical decision-making, anticipating pregnancy problems and delivery mode, and medical diagnosis and treatment.
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Affiliation(s)
- Muhammad Nazrul Islam
- Department of Computer Science and Engineering, Military Institute of Science and Technology, Dhaka, 1216, Bangladesh.
| | - Sumaiya Nuha Mustafina
- Department of Computer Science and Engineering, Military Institute of Science and Technology, Dhaka, 1216, Bangladesh
| | - Tahasin Mahmud
- Department of Computer Science and Engineering, Military Institute of Science and Technology, Dhaka, 1216, Bangladesh
| | - Nafiz Imtiaz Khan
- Department of Computer Science and Engineering, Military Institute of Science and Technology, Dhaka, 1216, Bangladesh
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17
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Galyfos G, Liakopoulos D, Sigala F, Filis K. New paradigms in minimally-invasive vascular surgery. Expert Rev Cardiovasc Ther 2022; 20:207-214. [PMID: 35341434 DOI: 10.1080/14779072.2022.2058492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Vascular surgery has been greatly evolved during the last decades and novel minimally invasive techniques have been introduced. Aim of this review is to briefly present all these advances and compare them with traditional repairs. AREAS COVERED The authors have extensively searched literature through the Pubmed and Embase databases. All articles published up to December 2021 referring to minimally invasive techniques used for treatment of peripheral artery disease, carotid disease, aortic aneurysms and venous disease were evaluated. Minimally invasive techniques under investigation included endovascular and hybrid techniques, robot-assisted and laparoscopic approaches. EXPERT OPINION Several minimally invasive techniques such as endovascular and hybrid approaches have been extensively used during the last two decades to treat vascular surgery patients offering them lower mortality and morbidity risks. Novel robot assisted techniques have shown promising results in preclinical studies although further clinical evaluation is needed.
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18
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Anaesthesia for transoral robotic surgery. BJA Educ 2022; 22:118-123. [PMID: 35211329 PMCID: PMC8847838 DOI: 10.1016/j.bjae.2021.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2021] [Indexed: 11/22/2022] Open
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19
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Tucker M, Lacayo M, Joseph S, Ross W, Chongsathidkiet P, Fecci P, Codd PJ. Creation of Non-Contact Device for Use in Metastatic Melanoma Margin Identification in ex vivo Mouse Brain. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2022; 11945:1194507. [PMID: 35619993 PMCID: PMC9131976 DOI: 10.1117/12.2608975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Because contemporary intraoperative tumor detection modalities, such as intraoperative MRI, are not ubiquitously available and can disrupt surgical workflow, there is an imperative for an accessible diagnostic device that can meet the surgeon's needs in identifying tissue types. The objective of this paper is to determine the efficacy of a novel non-contact tumor detection device for metastatic melanoma boundary identification in a tissue-mimicking phantom, evaluate the identification of metastatic melanoma boundaries in ex vivo mouse brain tissue, and find the error associated with identifying this boundary. To validate the spatial and fluorescence resolution of the device, tissue-mimicking phantoms were created with modifiable optical properties. Phantom tissue provided ground truth measurements for fluorophore concentration differences with respect to spatial dimensions. Modeling metastatic disease, ex vivo melanoma brain metastases were evaluated to detect differences in fluorescence between healthy and neoplastic tissue. This analysis includes determining required-to-observe fluorescence differences in tissue. H&E staining confirmed tumor presence in mouse tissue samples. The device detected a difference in normalized average fluorescence intensity in all three phantoms. There were differences in fluorescence with the presence and absence of melanin. The estimated tumor boundary of all tissue phantoms was within 0.30 mm of the ground truth tumor boundary for all boundaries. Likewise, when applied to the melanoma-bearing brains from ex vivo mice, a difference in normalized fluorescence intensity was successfully detected. The potential prediction window for the tumor boundary location is less than 1.5 mm for all ex vivo mouse brain tumors boundaries. We present a non-contact, laser-induced fluorescence device that can identify tumor boundaries based on changes in laser-induced fluorescence emission intensity. The device can identify phantom ground truth tumor boundaries within 0.30 mm using instantaneous rate of change of normalized fluorescence emission intensity and can detect endogenous fluorescence differences in melanoma brain metastases in ex vivo mouse tissue.
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Affiliation(s)
- Matthew Tucker
- Duke University, Department of Mechanical Engineering and Materials Science, Durham, NC, USA
| | - Matthew Lacayo
- Duke University School of Medicine, Department of Neurosurgery, Durham, NC, USA
| | | | - Weston Ross
- Duke University, Department of Mechanical Engineering and Materials Science, Durham, NC, USA
- Duke University School of Medicine, Department of Neurosurgery, Durham, NC, USA
| | | | - Peter Fecci
- Duke University School of Medicine, Department of Neurosurgery, Durham, NC, USA
| | - Patrick J Codd
- Duke University, Department of Mechanical Engineering and Materials Science, Durham, NC, USA
- Duke University School of Medicine, Department of Neurosurgery, Durham, NC, USA
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20
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AYGİN D, GÜL A. Geçmişten Günümüze Cerrahi ve Cerrahi Hemşireliğinin Yeri. İSTANBUL GELIŞIM ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2021. [DOI: 10.38079/igusabder.973827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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21
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Zhu W, Li Z, Fan S, Wang X, Yang K, Xiong G, Li X, Zhou L. Management of tuberculous-contracted bladder with bilateral duplex collecting system: a case report with modified robotic urinary tract reconstructive surgery. Transl Androl Urol 2021; 10:3891-3898. [PMID: 34804831 PMCID: PMC8575570 DOI: 10.21037/tau-21-535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 09/01/2021] [Indexed: 11/20/2022] Open
Abstract
Tuberculous bladder contracture with a bilateral duplicated collecting system is rare. According to anatomic variation, the surgical treatment strategy is highly individualized. We illustrate our robotic technique of urinary tract reconstruction. A 19-year-old girl with a history of pulmonary tuberculosis (TB) as a young child presented with a complaint of increasing frequency of micturition, nocturia, urgency, and urge incontinence starting at the age of 17. Clinical and imaging examinations demonstrated tuberculous contracted bladder with a bilateral duplex collecting system. The patient underwent a robot-assisted Institute of Urology Peking University (IUPU) orthotopic ileal neobladder reconstruction. This is a modified urinary tract reconstructive method, including resection of the end of the duplex ureters and diseased contracted bladder with preservation of the proximal urethra and bladder neck, ileal harvesting and IUPU strategy to reconstruct an ileal neobladder, uretero-ileal anastomosis and neobladder-bladder neck anastomosis. The patient remained symptom-free without recurrence of TB and had improved renal function during the one-year follow-up after surgery. Thus, our robot-assisted IUPU orthotopic ileal neobladder reconstruction method is an effective approach for this benign case. It can effectively increase bladder capacity, reduce intravesical pressure, and improve symptoms such as urination frequency and urgency.
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Affiliation(s)
- Weijie Zhu
- Department of Urology, Peking University First Hospital, Beijing, China.,Institute of Urology, Peking University, Beijing, China.,National Urological Cancer Centre, Beijing, China
| | - Zhihua Li
- Department of Urology, Peking University First Hospital, Beijing, China.,Institute of Urology, Peking University, Beijing, China.,National Urological Cancer Centre, Beijing, China
| | - Shubo Fan
- Department of Urology, Peking University First Hospital, Beijing, China.,Institute of Urology, Peking University, Beijing, China.,National Urological Cancer Centre, Beijing, China
| | - Xiang Wang
- Department of Urology, Peking University First Hospital, Beijing, China.,Institute of Urology, Peking University, Beijing, China.,National Urological Cancer Centre, Beijing, China
| | - Kunlin Yang
- Department of Urology, Peking University First Hospital, Beijing, China.,Institute of Urology, Peking University, Beijing, China.,National Urological Cancer Centre, Beijing, China
| | - Gengyan Xiong
- Department of Urology, Peking University First Hospital, Beijing, China.,Institute of Urology, Peking University, Beijing, China.,National Urological Cancer Centre, Beijing, China
| | - Xuesong Li
- Department of Urology, Peking University First Hospital, Beijing, China.,Institute of Urology, Peking University, Beijing, China.,National Urological Cancer Centre, Beijing, China
| | - Liqun Zhou
- Department of Urology, Peking University First Hospital, Beijing, China.,Institute of Urology, Peking University, Beijing, China.,National Urological Cancer Centre, Beijing, China
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22
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Dawood AB, Fras J, Aljaber F, Mintz Y, Arezzo A, Godaba H, Althoefer K. Fusing Dexterity and Perception for Soft Robot-Assisted Minimally Invasive Surgery: What We Learnt from STIFF-FLOP. APPLIED SCIENCES 2021; 11:6586. [DOI: 10.3390/app11146586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
In recent years we have seen tremendous progress in the development of robotic solutions for minimally invasive surgery (MIS). Indeed, a number of robot-assisted MIS systems have been developed to product level and are now well-established clinical tools; Intuitive Surgical’s very successful da Vinci Surgical System a prime example. The majority of these surgical systems are based on the traditional rigid-component robot design that was instrumental in the third industrial revolution—especially within the manufacturing sector. However, the use of this approach for surgical procedures on or around soft tissue has come under increasing criticism. The dangers of operating with a robot made from rigid components both near and within a patient are considerable. The EU project STIFF-FLOP, arguably the first large-scale research programme on soft robots for MIS, signalled the start of a concerted effort among researchers to investigate this area more comprehensively. While soft robots have many advantages over their rigid-component counterparts, among them high compliance and increased dexterity, they also bring their own specific challenges when interacting with the environment, such as the need to integrate sensors (which also need to be soft) that can determine the robot’s position and orientation (pose). In this study, the challenges of sensor integration are explored, while keeping the surgeon’s perspective at the forefront of ourdiscussion. The paper critically explores a range of methods, predominantly those developed during the EU project STIFF-FLOP, that facilitate the embedding of soft sensors into articulate soft robot structures using flexible, optics-based lightguides. We examine different optics-based approaches to pose perception in a minimally invasive surgery settings, and methods of integration are also discussed.
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23
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Meli D, Sridharan M, Fiorini P. Inductive learning of answer set programs for autonomous surgical task planning. Mach Learn 2021. [DOI: 10.1007/s10994-021-06013-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AbstractThe quality of robot-assisted surgery can be improved and the use of hospital resources can be optimized by enhancing autonomy and reliability in the robot’s operation. Logic programming is a good choice for task planning in robot-assisted surgery because it supports reliable reasoning with domain knowledge and increases transparency in the decision making. However, prior knowledge of the task and the domain is typically incomplete, and it often needs to be refined from executions of the surgical task(s) under consideration to avoid sub-optimal performance. In this paper, we investigate the applicability of inductive logic programming for learning previously unknown axioms governing domain dynamics. We do so under answer set semantics for a benchmark surgical training task, the ring transfer. We extend our previous work on learning the immediate preconditions of actions and constraints, to also learn axioms encoding arbitrary temporal delays between atoms that are effects of actions under the event calculus formalism. We propose a systematic approach for learning the specifications of a generic robotic task under the answer set semantics, allowing easy knowledge refinement with iterative learning. In the context of 1000 simulated scenarios, we demonstrate the significant improvement in performance obtained with the learned axioms compared with the hand-written ones; specifically, the learned axioms address some critical issues related to the plan computation time, which is promising for reliable real-time performance during surgery.
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24
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The Higher Education Sustainability before and during the COVID-19 Pandemic: A Spanish and Ecuadorian Case. SUSTAINABILITY 2021. [DOI: 10.3390/su13116363] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Information and communication technologies (ICTs) are key to create sustainable higher education institutions (HEIs). Most researchers focused on the students’ perspective, especially during the online teaching caused by COVID-19; however, university teachers are often forgotten, having their opinion missing. This study’s objective was to determine the factors that contribute to the inclusion of ICTs. The research based on a comparative study through an online qualitative survey focused on the inclusion and use of ICTs in two HEIs and two different moments (pre-and post-lockdowns). There were differences regarding country and working experience (p < 0.001), being linked to the ICTs use, evaluation of obstacles, and the role given to ICTs (p < 0.05). The COVID-19 caused modifications of the teachers’ perspectives, including an improvement of the opinion of older teachers regarding the essentialness of ICTs in the teaching process (p < 0.001) and worsening their perception about their ICTs skill (p < 0.05). Additionally, an initial model focused only on the university teachers and their use of ICTs has been proposed. In conclusion, the less experienced university teachers used more ICTs, identified more greatly the problematic factors, and considered more important the ICTs, with the perception of all teachers modified by COVID-19.
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25
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De Togni G, Erikainen S, Chan S, Cunningham-Burley S. What makes AI 'intelligent' and 'caring'? Exploring affect and relationality across three sites of intelligence and care. Soc Sci Med 2021; 277:113874. [PMID: 33901725 PMCID: PMC8135128 DOI: 10.1016/j.socscimed.2021.113874] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/03/2021] [Accepted: 03/18/2021] [Indexed: 01/04/2023]
Abstract
This paper scrutinises how AI and robotic technologies are transforming the relationships between people and machines in new affective, embodied and relational ways. Through investigating what it means to exist as human 'in relation' to AI across health and care contexts, we aim to make three main contributions. (1) We start by highlighting the complexities of philosophical issues surrounding the concepts of "artificial intelligence" and "ethical machines." (2) We outline some potential challenges and opportunities that the creation of such technologies may bring in the health and care settings. We focus on AI applications that interface with health and care via examples where AI is explicitly designed as an 'augmenting' technology that can overcome human bodily and cognitive as well as socio-economic constraints. We focus on three dimensions of 'intelligence' - physical, interpretive, and emotional - using the examples of robotic surgery, digital pathology, and robot caregivers, respectively. Through investigating these areas, we interrogate the social context and implications of human-technology interaction in the interrelational sphere of care practice. (3) We argue, in conclusion, that there is a need for an interdisciplinary mode of theorising 'intelligence' as relational and affective in ways that can accommodate the fragmentation of both conceptual and material boundaries between human and AI, and human and machine. Our aim in investigating these sociological, philosophical and ethical questions is primarily to explore the relationship between affect, relationality and 'intelligence,' the intersection and integration of 'human' and 'artificial' intelligence, through an examination of how AI is used across different dimensions of intelligence. This allows us to scrutinise how 'intelligence' is ultimately conveyed, understood and (technologically or algorithmically) configured in practice through emerging relationships that go beyond the conceptual divisions between humans and machines, and humans vis-à-vis artificial intelligence-based technologies.
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Affiliation(s)
- Giulia De Togni
- Centre for Biomedicine, Self and Society (CBSS) - USHER Institute - University of Edinburgh Medical School: Molecular, Genetic and Population Health Sciences, United Kingdom.
| | - Sonja Erikainen
- Centre for Biomedicine, Self and Society (CBSS) - USHER Institute - University of Edinburgh Medical School: Molecular, Genetic and Population Health Sciences, United Kingdom.
| | - Sarah Chan
- Centre for Biomedicine, Self and Society (CBSS) - USHER Institute - University of Edinburgh Medical School: Molecular, Genetic and Population Health Sciences, United Kingdom.
| | - Sarah Cunningham-Burley
- Centre for Biomedicine, Self and Society (CBSS) - USHER Institute - University of Edinburgh Medical School: Molecular, Genetic and Population Health Sciences, United Kingdom.
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26
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Cacciamani GE, Sebben M, Tafuri A, Nassiri N, Cocci A, Russo GI, Hung A, de Castro Abreu AL, Gill IS, Artibani W. Consulting 'Dr. Google' for minimally invasive urological oncological surgeries: A contemporary web-based trend analysis. Int J Med Robot 2021; 17:e2250. [PMID: 33667326 DOI: 10.1002/rcs.2250] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/23/2021] [Accepted: 02/25/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE To determine web-based public interest in minimally invasive surgery (MIS) specifically for urological oncological surgical procedures and how interest in robotics and laparoscopy compares over time. MATERIALS AND METHODS Worldwide search-engine trend analysis included electronic Google queries of MIS urologic options from January 2004 to August 2019, worldwide. Join-point regression was performed. Comparison of annual relative search volume (ARSV) and average annual percentage change (AAPC) were analysed to assess loss or gain of interest. Evaluations were made regarding 1) penetrance of interest for MIS in Urology; 2) how MIS urologic procedures compared over time; and 3) which were the top related queries to searches for urologic oncology procedures. RESULTS Increased interest was found for all of the MIS procedures evaluated. Mean ARSV for robotic approach was higher for the search term 'prostatectomy" (44.8 vs. 13.5; p < 0.001) and 'partial nephrectomy" (27.1 vs.11.5; p = 0.02). No statistical difference was found for the search terms 'cystectomy" or 'nephrectomy". The analysis of mean (∆-ARSV) of MIS procedures measured between the first and last 12 months of the study period showed an increased interest with a more pronounced ∆-ARSV for robotic procedures. The top related searches for all surgical procedures were examined showing an increasing inquisitiveness with regards of type of urological cancers, treatment options, type of surgery and prognostic outcomes. CONCLUSIONS People are increasingly searching the web for MIS urological procedures. A growing appeal for robotics is demonstrated, especially for prostatectomy and partial nephrectomy where the robotic approach is gaining traction, suggesting a shift in mind-set amongst people seeking urological healthcare information.
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Affiliation(s)
| | - Marco Sebben
- Department of Urology, University of Verona, Verona, Italy
| | - Alessandro Tafuri
- Urology Institute, University of Southern California, Los Angeles, California, USA.,Department of Urology, University of Verona, Verona, Italy
| | - Nima Nassiri
- Urology Institute, University of Southern California, Los Angeles, California, USA
| | - Andrea Cocci
- Department of Urology, University of Florence, Florence, Italy
| | | | - Andrew Hung
- Urology Institute, University of Southern California, Los Angeles, California, USA
| | | | - Inderbir S Gill
- Urology Institute, University of Southern California, Los Angeles, California, USA
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27
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Gültekin İB, Karabük E, Köse MF. "Hey Siri! Perform a type 3 hysterectomy. Please watch out for the ureter!" What is autonomous surgery and what are the latest developments? J Turk Ger Gynecol Assoc 2021; 22:58-70. [PMID: 33624493 PMCID: PMC7944239 DOI: 10.4274/jtgga.galenos.2021.2020.0187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
As a result of major advances in deep learning algorithms and computer processing power, there have been important developments in the fields of medicine and robotics. Although fully autonomous surgery systems where human impact will be minimized are still a long way off, systems with partial autonomy have gradually entered clinical use. In this review, articles on autonomous surgery classified and summarized, with the aim of informing the reader about questions such as "What is autonomic surgery?" and in which areas studies are progressing.
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Affiliation(s)
- İsmail Burak Gültekin
- Department of Obstetrics and Gynecology, University of Health Sciences, Dr. Sami Ulus Training and Research Hospital, Ankara, Turkey
| | - Emine Karabük
- Department of Obstetrics and Gynecology, Acıbadem University Faculty of Medicine, İstanbul, Turkey
| | - Mehmet Faruk Köse
- Department of Obstetrics and Gynecology, Acıbadem University Faculty of Medicine, İstanbul, Turkey
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Koyanagi K, Kanamori K, Ninomiya Y, Yatabe K, Higuchi T, Yamamoto M, Tajima K, Ozawa S. Progress in Multimodal Treatment for Advanced Esophageal Squamous Cell Carcinoma: Results of Multi-Institutional Trials Conducted in Japan. Cancers (Basel) 2020; 13:cancers13010051. [PMID: 33375499 PMCID: PMC7795106 DOI: 10.3390/cancers13010051] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/23/2020] [Accepted: 12/24/2020] [Indexed: 02/07/2023] Open
Abstract
In Japan, the therapeutic strategies adopted for esophageal carcinoma are based on the results of multi-institutional trials conducted by the Japan Esophageal Oncology Group (JEOG), a subgroup of the Japan Clinical Oncology Group (JCOG). Owing to the differences in the proportion of patients with squamous cell carcinoma among all patients with esophageal carcinoma, chemotherapeutic drugs available, and surgical procedures employed, the therapeutic strategies adopted in Asian countries, especially Japan, are often different from those in Western countries. The emphasis in respect of postoperative adjuvant therapy for patients with advanced esophageal squamous cell carcinoma (ESCC) shifted from postoperative radiotherapy in the 1980s to postoperative chemotherapy in the 1990s. In the 2000s, the optimal timing of administration of perioperative adjuvant chemotherapy returned from the postoperative adjuvant setting to the preoperative neoadjuvant setting. Recently, the JEOG commenced a three-arm randomized controlled trial of neoadjuvant therapies (cisplatin + 5-fluorouracil (CF) vs. CF + docetaxel (DCF) vs. CF + radiation therapy (41.4 Gy) (CRT)) for localized advanced ESCC, and patient recruitment has been completed. Salvage and conversion surgeries for ESCC have been developed in Japan, and the JEOG has conducted phase I/II trials to confirm the feasibility and safety of such aggressive surgeries. At present, the JEOG is conducting several trials for patients with resectable and unresectable ESCC, according to the tumor stage. Herein, we present a review of the JEOG trials conducted for advanced ESCC.
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Intraoperative Feedback and Quality Control in Orbital Reconstruction: The Past, the Present, and the Future. Atlas Oral Maxillofac Surg Clin North Am 2020; 29:97-108. [PMID: 33516542 DOI: 10.1016/j.cxom.2020.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Perceptual uncertainty and action consequences independently affect hand movements in a virtual environment. Sci Rep 2020; 10:22307. [PMID: 33339859 PMCID: PMC7749146 DOI: 10.1038/s41598-020-78378-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 11/20/2020] [Indexed: 01/11/2023] Open
Abstract
When we use virtual and augmented reality (VR/AR) environments to investigate behaviour or train motor skills, we expect that the insights or skills acquired in VR/AR transfer to real-world settings. Motor behaviour is strongly influenced by perceptual uncertainty and the expected consequences of actions. VR/AR differ in both of these aspects from natural environments. Perceptual information in VR/AR is less reliable than in natural environments, and the knowledge of acting in a virtual environment might modulate our expectations of action consequences. Using mirror reflections to create a virtual environment free of perceptual artefacts, we show that hand movements in an obstacle avoidance task systematically differed between real and virtual obstacles and that these behavioural differences occurred independent of the quality of the available perceptual information. This suggests that even when perceptual correspondence between natural and virtual environments is achieved, action correspondence does not necessarily follow due to the disparity in the expected consequences of actions in the two environments.
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Hangai S, Nozaki T, Soma T, Miyashita H, Asoda S, Yazawa M, Sato K, Kawana H, Ohnishi K, Kobayashi E. Development of a microsurgery-assisted robot for high-precision thread traction and tension control, and confirmation of its applicability. Int J Med Robot 2020; 17:e2205. [PMID: 33207394 PMCID: PMC7988610 DOI: 10.1002/rcs.2205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/15/2020] [Accepted: 11/16/2020] [Indexed: 12/17/2022]
Abstract
Background Microsurgery requires high skills for suturing using fragile threads, often within narrow surgical fields. Precise tension is required for good healing and to avoid the risk of thread breakage. Methods To meet the demands, we developed a novel assist robot utilizing high‐precision sensorless haptic technology. The robot adopts a cable‐driven mechanism to maintain a distance from the surgical area and enhances compatibility with surgical equipment such as microscopes. The robot performance was verified through in vitro and in vivo experiments using a rat model. Results The realization of precise tension control was confirmed in both experiments. In particular, in the in vivo experiments, the developed robot succeeded to produce a knot with an accurate tension of 0.66% error. Conclusions The developed robot can realize to control traction force precisely. This technology might open up the window for a full assist robot for microsurgery with haptic feeling.
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Affiliation(s)
- Satoshi Hangai
- Department of System Design Engineering, Keio University, Minato, Tokyo, Japan
| | - Takahiro Nozaki
- Department of System Design Engineering, Keio University, Minato, Tokyo, Japan.,Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Tomoya Soma
- Department of Dentistry and Oral Surgery, Keio University, Minato, Tokyo, Japan
| | - Hidetaka Miyashita
- Department of Dentistry and Oral Surgery, Keio University, Minato, Tokyo, Japan
| | - Seiji Asoda
- Department of Dentistry and Oral Surgery, Keio University, Minato, Tokyo, Japan
| | - Masaki Yazawa
- Department of Plastic and Reconstructive Surgery, Keio University, Minato, Tokyo, Japan
| | - Kazuki Sato
- Institute for Integrated Sports Medicine, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Hiromasa Kawana
- Department of Dentistry and Oral Surgery, Keio University, Minato, Tokyo, Japan.,Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, Yokosuka, Kanagawa, Japan
| | - Kouhei Ohnishi
- Haptics Research Center, Keio University, Yokohama, Japan
| | - Eiji Kobayashi
- Department of Organ Fabrication, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
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Su H, Danioni A, Mira RM, Ungari M, Zhou X, Li J, Hu Y, Ferrigno G, De Momi E. Experimental validation of manipulability optimization control of a 7-DoF serial manipulator for robot-assisted surgery. Int J Med Robot 2020; 17:1-11. [PMID: 33113264 DOI: 10.1002/rcs.2193] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 10/25/2020] [Accepted: 10/26/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE Both safety and accuracy are of vital importance for surgical operation procedures. An efficient way to avoid the singularity of the surgical robot concerning safety issues is to maximize its manipulability in robot-assisted surgery. The goal of this work was to validate a dynamic neural network optimization method for manipulability optimization control of a 7-degree of freedom (DoF) robot in a surgical operation. METHODS Three different paths, a circle, a sinusoid and a spiral were chosen to simulate typical surgical tasks. The dynamic neural network-based manipulability optimization control was implemented on a 7-DoF robot manipulator. During the surgical operation procedures, the manipulability of the robot manipulator and the accuracy of the surgical operation are recorded for performance validation. RESULTS By comparison, the dynamic neural network-based manipulability optimization control achieved optimized manipulability but with a loss of the accuracy of trajectory tracking (the global error was 1 mm compare to the 0.5 mm error of non-optimized method). CONCLUSIONS The method validated in this work achieved optimized manipulability with a loss of error. Future works should be introduced to improve the accuracy of the surgical operation.
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Affiliation(s)
- Hang Su
- Department of Electronics, Information and Bioengineering (DEIB), Politecnico di Milano Piazza Leonardo da Vinci, Milano, Italy
| | - Andrea Danioni
- Department of Electronics, Information and Bioengineering (DEIB), Politecnico di Milano Piazza Leonardo da Vinci, Milano, Italy
| | - Robert Mihai Mira
- Department of Electronics, Information and Bioengineering (DEIB), Politecnico di Milano Piazza Leonardo da Vinci, Milano, Italy
| | - Matteo Ungari
- Department of Electronics, Information and Bioengineering (DEIB), Politecnico di Milano Piazza Leonardo da Vinci, Milano, Italy
| | - Xuanyi Zhou
- State Key Laboratory of High Performance Complicated, Central South University Changsha, Changsha, China
| | - Jiehao Li
- State Key Laboratory of Intelligent Control and Decision of Complex Systems, Beijing Institute of Technology, Beijing, China
| | - Yingbai Hu
- Department of Informatics, Technical University of Munich, Munich, Germany
| | - Giancarlo Ferrigno
- Department of Electronics, Information and Bioengineering (DEIB), Politecnico di Milano Piazza Leonardo da Vinci, Milano, Italy
| | - Elena De Momi
- Department of Electronics, Information and Bioengineering (DEIB), Politecnico di Milano Piazza Leonardo da Vinci, Milano, Italy
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Vaquero-Álvarez E, Cubero-Atienza A, Ruiz-Martínez P, Vaquero-Abellán M, Mecías MDR, Aparicio-Martínez P. Bibliometric Study of Technology and Occupational Health in Healthcare Sector: A Worldwide Trend to the Future. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186732. [PMID: 32947775 PMCID: PMC7558561 DOI: 10.3390/ijerph17186732] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 09/09/2020] [Accepted: 09/13/2020] [Indexed: 12/15/2022]
Abstract
Since the eighties, technological tools have modified how people interact in their environment. At the same time, occupational safety and health measures have been widely applied. The European Agency for Safety and Health at Work considers that information and communication technologies are the main methods to achieve the goals proposed to improve working life and the dissemination of good practices. The principal objective was to determine the trends of publications focused on these technologies and occupational safety in the healthcare sector during the last 30 years. A bibliometric study was carried out. The 1021 documents showed an increased trend per country, especially for the United States (p < 0.001) and year (p < 0.001). The citations per year showed significant differences between citations of articles published before 2007 (p < 0.001). The year was also linked to the increase or decrease of articles (72.2%) and reviews (14.9%) (p < 0.001). The analysis of journal co-citations also showed that the main journals (such as Infection Control and Hospital Epidemiology) were linked to other important journals and had a major part in the clusters formed. All these findings were discussed in the manuscript and conclusions were drawn.
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Affiliation(s)
| | - Antonio Cubero-Atienza
- Departamento Ingeniería Rural, Ed Leonardo da Vinci, Campus de Rabanales, Universidad de Córdoba, 14071 Córdoba, Spain; (A.C.-A.); (M.D.R.M.)
| | - Pilar Ruiz-Martínez
- GC24 Clinical and Molecular Microbiology, Instituto Maimónides, Facultad Medicina y Enfermería, Campus de Menéndez Pidal, Universidad de Córdoba, 14071 Córdoba, Spain;
| | - Manuel Vaquero-Abellán
- GC12 Clinical and Epidemiological Research in Primary Care, Instituto Maimónides, Campus de Menéndez Pidal, Universidad de Córdoba, 14071 Córdoba, Spain;
- Departamento de Enfermería, Fisioterapia y Farmacología, Universidad de Córdoba, Campus de Menéndez Pidal, 14071 Córdoba, Spain
| | - María Dolores Redel Mecías
- Departamento Ingeniería Rural, Ed Leonardo da Vinci, Campus de Rabanales, Universidad de Córdoba, 14071 Córdoba, Spain; (A.C.-A.); (M.D.R.M.)
| | - Pilar Aparicio-Martínez
- GC12 Clinical and Epidemiological Research in Primary Care, Instituto Maimónides, Campus de Menéndez Pidal, Universidad de Córdoba, 14071 Córdoba, Spain;
- Departamento de Enfermería, Fisioterapia y Farmacología, Universidad de Córdoba, Campus de Menéndez Pidal, 14071 Córdoba, Spain
- Correspondence: ; Tel.: +34-679-727-823
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Abstract
minimally invasive surgery (MIS) is the standard approach to performance of several gynecologic procedures, including hysterectomy, gynecologic cancer staging procedures, myomectomy, pelvic organ prolapse repair, and select adnexal procedures. Robotic-assisted surgery, a computer-based MIS approach, has been adopted widely in the United States and several other countries. Robotics may offer technological and ergonomic benefits that overcome limitations associated with conventional laparoscopy; however, it is not clear that reported claims of superiority translate into improved gynecologic patient outcomes compared with other MIS approaches. This review critically appraises the evolving role, benefits, limitations, and controversies of robotic-assisted surgery utilization in benign and oncologic gynecology settings.
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Soldozy S, Young S, Yağmurlu K, Norat P, Sokolowski J, Park MS, Jane JA, Syed HR. Transsphenoidal surgery using robotics to approach the sella turcica: Integrative use of artificial intelligence, realistic motion tracking and telesurgery. Clin Neurol Neurosurg 2020; 197:106152. [PMID: 32858256 DOI: 10.1016/j.clineuro.2020.106152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 08/07/2020] [Accepted: 08/09/2020] [Indexed: 11/27/2022]
Abstract
While full integration of robotic surgery has been achieved in other surgical domains, its transition into neurosurgery has been more prolonged, especially with respect to pituitary surgery. The confined working space and precise maneuvers required in endoscopic endonasal surgery makes development of an efficacious and safe robotic system difficult. Nevertheless, preclinical studies have attempted to demonstrate the feasibility of the da Vinci Surgical System (Intuitive Surgical, Sunnyvale, CA) in both transnasal and transoral approaches. In addition, unique robotics such as the concentric tube robot have been created. This system is optimized specifically for anterior skull base surgery with smaller shaft diameter arms and improved maneuverability in tight corridors. The possible role of concentric tube robotics surgery in skull base pathologies has been explored, and the novel use of telesurgery incorporated into robotic neurosurgery is discussed. An endoscopic endonasal transsphenoidal surgical system has also been developed, integrating computational methods to create a presurgical reconstructive model for surgical planning and automating the line of dissection for an enhanced approach to the sphenoid sinus. While surgical robotics for transsphenoidal surgery remain in its nascency, these preliminary findings are promising and suggest a role for robotic pituitary surgery.
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Affiliation(s)
- Sauson Soldozy
- Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia, United States
| | - Steven Young
- Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia, United States
| | - Kaan Yağmurlu
- Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia, United States
| | - Pedro Norat
- Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia, United States
| | - Jennifer Sokolowski
- Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia, United States
| | - Min S Park
- Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia, United States
| | - John A Jane
- Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia, United States
| | - Hasan R Syed
- Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia, United States.
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BAYRAM A, ESKİİZMİR G, CİNGİ C, HANNA E. Robotic Surgery in Otolaryngology-Head and Neck Surgery: Yesterday, Today and Tomorrow. ENT UPDATES 2020. [DOI: 10.32448/entupdates.780604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Saracino A, Oude-Vrielink TJC, Menciassi A, Sinibaldi E, Mylonas GP. Haptic Intracorporeal Palpation Using a Cable-Driven Parallel Robot: A User Study. IEEE Trans Biomed Eng 2020; 67:3452-3463. [PMID: 32746002 DOI: 10.1109/tbme.2020.2987646] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Intraoperative palpation is a surgical gesture jeopardized by the lack of haptic feedback which affects robotic minimally invasive surgery. Restoring the force reflection in teleoperated systems may improve both surgeons' performance and procedures' outcome. METHODS A force-based sensing approach was developed, based on a cable-driven parallel manipulator with anticipated seamless and low-cost integration capabilities in teleoperated robotic surgery. No force sensor on the end-effector is used, but tissue probing forces are estimated from measured cable tensions. A user study involving surgical trainees (n = 22) was conducted to experimentally evaluate the platform in two palpation-based test-cases on silicone phantoms. Two modalities were compared: visual feedback alone and both visual + haptic feedbacks available at the master site. RESULTS Surgical trainees' preference for the modality providing both visual and haptic feedback is corroborated by both quantitative and qualitative metrics. Hard nodules detection sensitivity improves (94.35 ± 9.1% vs 76.09 ± 19.15% for visual feedback alone), while also exerting smaller forces (4.13 ± 1.02 N vs 4.82 ± 0.81 N for visual feedback alone) on the phantom tissues. At the same time, the subjective perceived workload decreases. CONCLUSION Tissue-probe contact forces are estimated in a low cost and unique way, without the need of force sensors on the end-effector. Haptics demonstrated an improvement in the tumor detection rate, a reduction of the probing forces, and a decrease in the perceived workload for the trainees. SIGNIFICANCE Relevant benefits are demonstrated from the usage of combined cable-driven parallel manipulators and haptics during robotic minimally invasive procedures. The translation of robotic intraoperative palpation to clinical practice could improve the detection and dissection of cancer nodules.
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Wang Z, Kasman M, Martinez M, Rege R, Zeh H, Scott D, Fey AM. A Comparative Human-Centric Analysis of Virtual Reality and Dry Lab Training Tasks on the da Vinci Surgical Platform. ACTA ACUST UNITED AC 2020. [DOI: 10.1142/s2424905x19420078] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
There is a growing, widespread trend of adopting robot-assisted minimally invasive surgery (RMIS) in clinical care. Dry lab robot training and virtual reality simulation are commonly used to train surgical residents; however, it is unclear whether both types of training are equivalent or can be interchangeable and still achieve the same results in terms of training outcomes. In this paper, we take the first step in comparing the effects of physical and simulated surgical training tasks on human operator kinematics and physiological response to provide a richer understanding of exactly how the user interacts with the actual or simulated surgical robot. Four subjects, with expertise levels ranging from novice to expert surgeon, were recruited to perform three surgical tasks — Continuous Suture, Pick and Place, Tubes, with three repetitions — on two training platforms: (1) the da Vinci Si Skills Simulator and (2) da Vinci S robot, in a randomized order. We collected physiological response and kinematic movement data through body-worn sensors for a total of 72 individual experimental trials. A range of expertise was chosen for this experiment to wash out inherent differences based on expertise and only focus on inherent differences between the virtual reality and dry lab platforms. Our results show significant differences ([Formula: see text]-[Formula: see text]) between tasks done on the simulator and surgical robot. Specifically, robotic tasks resulted in significantly higher muscle activation and path length, and significantly lower economy of volume. The individual tasks also had significant differences in various kinematic and physiological metrics, leading to significant interaction effects between the task type and training platform. These results indicate that the presence of the robotic system may make surgical training tasks more difficult for the human operator. Thus, the potentially detrimental effects of virtual reality training alone are an important topic for future investigation.
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Affiliation(s)
- Ziheng Wang
- Department of Mechanical Engineering, University of Texas at Dallas, Richardson, TX 75080, USA
| | - Michael Kasman
- Department of Electrical & Computer Engineering, University of Texas at Dallas, Richardson, TX 75080, USA
| | - Marco Martinez
- Department of Surgery, Naval Medical Center, San Diego, CA 92134, USA
| | - Robert Rege
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Herbert Zeh
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Daniel Scott
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Ann Majewicz Fey
- Department of Mechanical Engineering, University of Texas at Dallas, Richardson, TX 75080, USA
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
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Nebbia M, Yassin NA, Spinelli A. Colorectal Cancer in Inflammatory Bowel Disease. Clin Colon Rectal Surg 2020; 33:305-317. [PMID: 32968366 DOI: 10.1055/s-0040-1713748] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Patients with inflammatory bowel disease (IBD) are at an increased risk for developing colorectal cancer (CRC). However, the incidence has declined over the past 30 years, which is probably attributed to raise awareness, successful CRC surveillance programs and improved control of mucosal inflammation through chemoprevention. The risk factors for IBD-related CRC include more severe disease (as reflected by the extent of disease and the duration of poorly controlled disease), family history of CRC, pseudo polyps, primary sclerosing cholangitis, and male sex. The molecular pathogenesis of inflammatory epithelium might play a critical role in the development of CRC. IBD-related CRC is characterized by fewer rectal tumors, more synchronous and poorly differentiated tumors compared with sporadic cancers. There is no significant difference in sex distribution, stage at presentation, or survival. Surveillance is vital for the detection and subsequently management of dysplasia. Most guidelines recommend initiation of surveillance colonoscopy at 8 to 10 years after IBD diagnosis, followed by subsequent surveillance of 1 to 2 yearly intervals. Traditionally, surveillance colonoscopies with random colonic biopsies were used. However, recent data suggest that high definition and chromoendoscopy are better methods of surveillance by improving sensitivity to previously "invisible" flat dysplastic lesions. Management of dysplasia, timing of surveillance, chemoprevention, and the surgical approaches are all areas that stimulate various discussions. The aim of this review is to provide an up-to-date focus on CRC in IBD, from laboratory to bedside.
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Affiliation(s)
- Martina Nebbia
- Colon and Rectal Surgery Division, Humanitas Clinical and Research Center IRCCS, Rozzano, Milano, Italy
| | - Nuha A Yassin
- Colon and Rectal Surgery Division, Humanitas Clinical and Research Center IRCCS, Rozzano, Milano, Italy
| | - Antonino Spinelli
- Colon and Rectal Surgery Division, Humanitas Clinical and Research Center IRCCS, Rozzano, Milano, Italy.,Deparment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milano, Italy
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Ionna F, Guida A, Califano L, Motta G, Salzano G, Pavone E, Aversa C, Longo F, Villano S, Ponzo LM, Franco P, Losito S, Buonaguro FM, Tornesello ML, Maglione MG. Transoral robotic surgery in head and neck district: a retrospective study on 67 patients treated in a single center. Infect Agent Cancer 2020; 15:40. [PMID: 32549909 PMCID: PMC7296635 DOI: 10.1186/s13027-020-00306-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 06/01/2020] [Indexed: 11/19/2022] Open
Abstract
Background The anatomical complexity of the oropharynx and the difficulty in reaching its distal portion have always conditioned the surgical accessibility. Robotic surgery represents an excellent alternative in the treatment of cervico-facial oncological diseases. Methods This series comprises all patients managed for head and neck cancer by Trans Oral Robotic Surgery TORS. The staging assessment, including neck ultrasound and total body PET/CT scan, was performed in each patient according to the TNM classification. All charts were recorded with the following data: name and surname, age, gender, date of surgery intra or post-operative hemorragia, tumor site, histology, TNM stage, robot set-up time, tumor resection time, whether or not tracheotomy was performed, whether or not neck dissection was performed, insertion of a nasogastric tube or gastrostomy, time to resumption of oral feeding, surgical margins, mean length of hospital stay, adjuvant treatment and follow-up. Results From February 2013 to February 2018, TORS was performed in 67 consecutive patients affected by head and neck tumours. We divided, our sample, in 3 subsites: supraglottic larynx, parapharyngeal space and oropharynx. Pathology reports confimed malignancy in 44 cases: 8 cases lymphomas, 36 cases of Squamous cell carcinoma (SCC), 5 cases of benign salivary glands tumors and 18 miscellaneous cases. Neck dissection was performed in 12 cases. Tracheotomy was perfomed in 3/67 cases for respiratory failures. A nasogastric tube was inserted at the end of the surgical procedure in 21 patients. The mean length of hospital stay was 10 days . Major complications included post-operative bleeding in 3 patients, 1 exitus for massive bleeding 20 days post-surgery and 1 respiratory failure treated with tracheotomy and monitoring in the Intensive Care Unit (ICU) for 3 days. Conclusions Robotic surgery has been considered a valid alternative to traditional open treatment in many specializations with the advantages of an endoscopic procedure, with the same oncological and functional results and with fewer complications. The advantages of this type of surgical technique have been discussed, it is mandatory to focus on the indications and contraindications.
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Affiliation(s)
- Fraco Ionna
- Maxillofacial & ENT surgery Unit, Istituto Nazionale Tumori-IRCCS "Fondazione G. Pascale", via M. Semmola, Naples, Italy
| | - Agostino Guida
- Maxillofacial & ENT surgery Unit, Istituto Nazionale Tumori-IRCCS "Fondazione G. Pascale", via M. Semmola, Naples, Italy
| | - Luigi Califano
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Director and Chair, Maxillofacial Surgery unit, University of Naples "Federico II", Naples, Italy
| | - Gaetano Motta
- Department of Neuroscience, Reproductive and Odontostomatologic Sciences, ENT Unit, University "Federico II", Naples, Italy
| | - Giovanni Salzano
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Director and Chair, Maxillofacial Surgery unit, University of Naples "Federico II", Naples, Italy
| | - Ettore Pavone
- Maxillofacial & ENT surgery Unit, Istituto Nazionale Tumori-IRCCS "Fondazione G. Pascale", via M. Semmola, Naples, Italy
| | - Corrado Aversa
- Maxillofacial & ENT surgery Unit, Istituto Nazionale Tumori-IRCCS "Fondazione G. Pascale", via M. Semmola, Naples, Italy
| | - Francesco Longo
- Maxillofacial & ENT surgery Unit, Istituto Nazionale Tumori-IRCCS "Fondazione G. Pascale", via M. Semmola, Naples, Italy
| | - Salvatore Villano
- Maxillofacial & ENT surgery Unit, Istituto Nazionale Tumori-IRCCS "Fondazione G. Pascale", via M. Semmola, Naples, Italy
| | - Ludovica Marcella Ponzo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Director and Chair, Maxillofacial Surgery unit, University of Naples "Federico II", Naples, Italy
| | - Pierluigi Franco
- Maxillofacial & ENT surgery Unit, Istituto Nazionale Tumori-IRCCS "Fondazione G. Pascale", via M. Semmola, Naples, Italy
| | - Simona Losito
- Departement of Pathology, Istituto Nazionale Tumori-IRCCS "Fondazione G. Pascale", Naples, Italy
| | - Franco Maria Buonaguro
- Molecular Biology and Viral Oncology Unit, Istituto Nazionale Tumori-IRCCS "Fondazione G. Pascale", Naples, Italy
| | - Maria Lina Tornesello
- Molecular Biology and Viral Oncology Unit, Istituto Nazionale Tumori-IRCCS "Fondazione G. Pascale", Naples, Italy
| | - Maria Grazia Maglione
- Maxillofacial & ENT surgery Unit, Istituto Nazionale Tumori-IRCCS "Fondazione G. Pascale", via M. Semmola, Naples, Italy
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Li J, Huang J, Zheng L, Li X. Application of Artificial Intelligence in Diabetes Education and Management: Present Status and Promising Prospect. Front Public Health 2020; 8:173. [PMID: 32548087 PMCID: PMC7273319 DOI: 10.3389/fpubh.2020.00173] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 04/20/2020] [Indexed: 12/22/2022] Open
Abstract
Despite the rapid development of science and technology in healthcare, diabetes remains an incurable lifelong illness. Diabetes education aiming to improve the self-management skills is an essential way to help patients enhance their metabolic control and quality of life. Artificial intelligence (AI) technologies have made significant progress in transforming available genetic data and clinical information into valuable knowledge. The application of AI tech in disease education would be extremely beneficial considering their advantages in promoting individualization and full-course education intervention according to the unique pictures of different individuals. This paper reviews and discusses the most recent applications of AI techniques to various aspects of diabetes education. With the information and evidence collected, this review attempts to provide insight and guidance for the development of prospective, data-driven decision support platforms for diabetes management, with a focus on individualized patient management and lifelong educational interventions.
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Affiliation(s)
- Juan Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Changsha, China.,Department of Metabolism and Endocrinology, The Second Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Metabolic Diseases, Changsha, China
| | - Jin Huang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Changsha, China
| | - Lanbo Zheng
- School of Logistics Engineering, Wuhan University of Technology, Wuhan, China
| | - Xia Li
- Department of Metabolism and Endocrinology, The Second Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Metabolic Diseases, Changsha, China
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Singh R, Suri A. Three-Dimensional Printed Ergonomically Improved Microforceps for Microneurosurgery. World Neurosurg 2020; 141:e271-e277. [PMID: 32434026 DOI: 10.1016/j.wneu.2020.05.105] [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: 01/28/2020] [Revised: 05/11/2020] [Accepted: 05/12/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of this study was to develop and validate an ergonomically improved microforceps, which is a neurosurgical instrument used in microscopic procedures. The distance between tips of microforceps becomes large at high magnification of the operating microscope. This results in tips moving out of view and causes ergonomic discomfort. METHODS The design criteria for ergonomic microforceps were defined, which primarily involved a reduction in the distance between tips and applied force. Computer models of the existing and modified microforceps were created and fabricated using direct metal laser sintering. Ten neurosurgeons validated the developed instrument and provided feedback. In objective validation, video feed of the operating microscope was marked and analyzed by an expert neurosurgeon. RESULTS In subjective validation, most of the neurosurgeons endorsed the ergonomic improvements. The parameters, including microforceps tips moving out of view (P = 0.0005), suture holding attempts (P = 0.001), and needle holding attempts (P = 0.03), were found to be statistically improved (Mann-Whitney U test), whereas the average time taken to tie 1 knot was not statistically improved (P = 0.06). The ergonomic modification also resulted in a reduction of applied force by 47.5%. CONCLUSIONS Validation results show that the developed instrument provides several ergonomic benefits for the microsuturing task under high magnification of the operating microscope.
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Affiliation(s)
- Ramandeep Singh
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Ashish Suri
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
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Hassebrock JD, Makovicka JL, Clarke HD, Spangehl MJ, Beauchamp CP, Schwartz AJ. Frequency, Cost, and Clinical Significance of Incidental Findings on Preoperative Planning Images for Computer-Assisted Total Joint Arthroplasty. J Arthroplasty 2020; 35:945-949.e1. [PMID: 31882348 DOI: 10.1016/j.arth.2019.11.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 11/14/2019] [Accepted: 11/19/2019] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The frequency of incidental findings with computer-assisted total joint arthroplasty (CA TJA) preoperative imaging and their clinical significance are currently unknown. METHODS We reviewed 573 patients who underwent primary CA TJA requiring planning imaging. Incidental findings were defined as reported findings excluding those related to the planned arthroplasty. Secondary outcomes were additional tests or a delay in surgery. Associated charges were obtained from our institution's website. Charge and incidence data were combined with TJA volumes obtained from the 2016 National Inpatient Sample to model costs to the healthcare system. RESULTS Overall, 262 patients (45.7%) had at least 1 incidental finding, 144 patients (25.1%) had 2, and 65 (11.3%) had 3. The most common finding types were musculoskeletal (MSK, 67.7%), digestive (19.5%), cardiovascular (4.9%), and reproductive (4.7%). Also, 9.3% of patients had at least 1 non-MSK incidental finding. Both MSK and non-MSK incidental findings were more common with total hip arthroplasty compared to total knee arthroplasty (67.9% vs 42.2%, P < .0001, and 15.4% vs 8.3%, P < .05, respectively). Further testing was required in 6 cases (1.0%); 1 case required delay in surgery (0.2%). Using the 2016 volume of TJA procedures and assuming a 10%, 15%, and 25%, utilization rate of image-based CA TJA, the annual cost of additional testing was $2.7 million (95% confidence interval, $1.1-$6.3 million), $4.1 million ($1.6-$9.5 million), and $6.9 million (95% confidence interval, $2.7-$15.8 million), respectively. CONCLUSION Incidental findings are relatively common on planning images. Stakeholders should be aware of the hidden costs of incidental findings given the increasing popularity of image-based CA TJA.
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Affiliation(s)
| | | | - Henry D Clarke
- Department of Orthopedics, Mayo Clinic Arizona, Phoenix, AZ
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Armijo PR, Pokala B, Flores L, Hosein S, Oleynikov D. Current state of robotic use in inguinal hernia repair: a survey of minimally invasive hernia surgeons. Updates Surg 2020; 72:179-184. [DOI: 10.1007/s13304-020-00709-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 01/16/2020] [Indexed: 12/12/2022]
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Qian L, Wu JY, DiMaio SP, Navab N, Kazanzides P. A Review of Augmented Reality in Robotic-Assisted Surgery. ACTA ACUST UNITED AC 2020. [DOI: 10.1109/tmrb.2019.2957061] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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46
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Electrically-Evoked Proximity Sensation Can Enhance Fine Finger Control in Telerobotic Pinch. Sci Rep 2020; 10:163. [PMID: 31932709 PMCID: PMC6957695 DOI: 10.1038/s41598-019-56985-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 12/19/2019] [Indexed: 11/24/2022] Open
Abstract
For teleoperation tasks requiring high control accuracy, it is essential to provide teleoperators with information on the interaction between the end effector and the remote environment. Real-time imaging devices have been widely adopted, but it delivers limited information, especially when the end effectors approach the target following the line-of-sight. In such situations, teleoperators rely on the perspective at the screen and can apply high force unintentionally at the initial contact. This research proposes to deliver the distance information at teleoperation to the fingertips of teleoperators, i.e., proximity sensation. Transcutaneous electrical stimulation was applied onto the fingertips of teleoperators, with the pulsing frequency inversely proportional to the distance. The efficacy of the proximity sensation was evaluated by the initial contact force during telerobotic pinch in three sensory conditions: vision only, vision + visual assistance (distance on the screen), and vision + proximity sensation. The experiments were repeated at two viewing angles: 30–60° and line-of-sight, for eleven healthy human subjects. For both cases, the initial contact force could be significantly reduced by either visual assistance (20–30%) or the proximity sensation (60–70%), without additional processing time. The proximity sensation is two-to-three times more effective than visual assistance regarding the amount of force reduction.
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Chandawarkar A, Chartier C, Kanevsky J, Cress PE. A Practical Approach to Artificial Intelligence in Plastic Surgery. Aesthet Surg J Open Forum 2020; 2:ojaa001. [PMID: 33791621 PMCID: PMC7671238 DOI: 10.1093/asjof/ojaa001] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Understanding the intersection of technology and plastic surgery has been and will be essential to positioning plastic surgeons at the forefront of surgical innovation. This account of the current and future applications of artificial intelligence (AI) in reconstructive and aesthetic surgery introduces us to the subset of issues amenable to support from this technology. It equips plastic surgeons with the knowledge to navigate technical conversations with peers, trainees, patients, and technical partners for collaboration and to usher in a new era of technology in plastic surgery. From the mathematical basis of AI to its commercially viable applications, topics introduced herein constitute a framework for design and execution of quantitative studies that will better outcomes and benefit patients. Finally, adherence to the principles of quality data collection will leverage and amplify plastic surgeons’ creativity and undoubtedly drive the field forward.
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Affiliation(s)
- Akash Chandawarkar
- Corresponding Author: Dr Akash Chandawarkar, Johns Hopkins University School of Medicine, Department of Plastic and Reconstructive Surgery, 601 N. Caroline Street, Baltimore, MD 21287. E-mail: ; Twitter: @AChandMD
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Patient Perceptions of New Robotic Technologies in Clinical Restorative Dentistry. J Med Syst 2019; 44:33. [PMID: 31848734 DOI: 10.1007/s10916-019-1488-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 10/15/2019] [Indexed: 02/01/2023]
Abstract
Patient perception research has failed to focus on burgeoning technology within the dental field. Specifically, researchers have yet to focus on developing robotic technologies which are being utilized by dentists to help perform certain procedures with added precision and route mapping. The current study attempts to fill the gap created by a lack of intersection between dental technology research, consumer perceptions research, and automation research. The current research takes a two-study approach, with study 1 investigating if gender or price of the procedure affects willingness to undergo a robotic dental procedure. Study 2 further investigates this phenomenon, identifying ten separate types of dental procedures (ranging from minimally invasive to extremely invasive) to further understand consumer perceptions. Results indicate that females are less willing to undergo a robotic dental procedure, and that participants in general are more willing to undergo a procedure if it is half price than if it full price. Willingness is influenced by gender and the type of procedure being performed - participants were less willing to undergo invasive procedures such as gum surgery than noninvasive procedures such as teeth whitening. These results, and their theoretical and practical significance are discussed.
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Affiliation(s)
- Fares S. Haddad
- The Bone & Joint Journal, Professor of Orthopaedic Surgery, University College London Hospitals, The Princess Grace Hospital, and The NIHR Biomedical Research Centre at UCLH, London, UK
| | - S Horriat
- East Kent Hospitals University Foundation Trust, London, UK
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Schreurs R, Dubois L, Ho JPTF, Klop C, Beenen LFM, Habets PEMH, Becking AG, Maal TJJ. Implant-oriented navigation in orbital reconstruction part II: preclinical cadaver study. Int J Oral Maxillofac Surg 2019; 49:678-685. [PMID: 31587822 DOI: 10.1016/j.ijom.2019.09.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 05/31/2019] [Accepted: 09/12/2019] [Indexed: 10/25/2022]
Abstract
In orbital reconstruction, the acquired position of an orbital implant can be evaluated with the aid of intraoperative navigation. Feedback of the navigation system is only obtained after positioning of the implant: the implant's position is not tracked in real time during positioning. The surgeon has to interpret the navigation feedback and translate it to desired adjustments of the implant's position. In a previous study, a real-time implant-oriented navigation approach was introduced and the system's accuracy was evaluated. In this study, this real-time navigation approach was compared to a marker-based navigation approach in a preclinical set-up. Ten cadavers (20 orbital defects) were reconstructed twice, by two surgeons (total: 80 reconstructions). Implant positioning was significantly improved in the real-time implant-oriented approach in terms of roll (2.0° vs. 3.2°, P=0.03), yaw (2.2° vs. 3.4°, P=0.01) and translation (1.3mm vs. 1.8mm, P=0.005). Duration of the real-time navigation procedure was reduced (median 4.5 min vs. 7.5 min). Subjective appreciation of the navigation technique was higher for real-time implant-oriented navigation (mean 7.5 vs. 9.0). Real-time implant-oriented navigation feedback provides real-time, intuitive feedback to the surgeon, which leads to improved implant positioning and shortens duration of the navigation procedure.
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Affiliation(s)
- R Schreurs
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC Location AMC and Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, The Netherlands; Department of Oral and Maxillofacial Surgery, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands.
| | - L Dubois
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC Location AMC and Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, The Netherlands
| | - J P T F Ho
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC Location AMC and Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, The Netherlands
| | - C Klop
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC Location AMC and Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, The Netherlands
| | - L F M Beenen
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - P E M H Habets
- Department of Medical Biology, Section of Clinical Anatomy and Embryology, Amsterdam UMC Location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - A G Becking
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC Location AMC and Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, The Netherlands
| | - T J J Maal
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC Location AMC and Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, The Netherlands; Department of Oral and Maxillofacial Surgery, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands
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