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Eberle A, Turgut F, Somfai GM, Saad A, de Smet MD, Hasler PW, Heussen FM, Becker MD. Comparison of Surgical Times Between Manual and Robot-Assisted Epiretinal Membrane Peeling. Transl Vis Sci Technol 2024; 13:27. [PMID: 39141371 PMCID: PMC11328885 DOI: 10.1167/tvst.13.8.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2024] Open
Abstract
Purpose Epiretinal membranes (ERM) pose a common challenge in vitreoretinal pathology, often causing vision impairment in older adults. The Preceyes Surgical System (PSS) supports the surgical removal of ERM through robot-assisted membrane peeling (RA-MP). This study compares surgical times and iatrogenic hemorrhages between manual membrane peeling (MMP) and RA-MP using PSS. Methods Nine patients underwent RA-MP with PSS, whereas 16 patients (18 eyes) underwent MMP for comparative analysis. Surgical durations were categorized into RA-MP, manual forceps utilization in PSS surgeries (mRA-MP), and traditional MMP. Cumulative manual manipulation duration (cMMP), instrument grasps, and intraoperative hemorrhages were statistically analyzed using the Mann-Whitney U test. Results RA-MP showed significantly longer peeling times compared to MMP (P < 0.001). Flap initiation grasps were similar between methods (P = 0.86), RA-MP demonstrated a significant reduction in peeling grasps (P = 0.01) and mean grasps per minute (P < 0.001). Although RA-MP resulted in fewer hemorrhages, the difference did not reach statistical significance relative to MMP (P = 0.08). Discussion Although RA-MP tended to extend surgical time, it offered advantages in reducing tissue trauma and intraoperative hemorrhages. Further research is needed to explore the learning curve for novice surgeons and evaluate the safety profile of RA-MP. Translational Relevance RA-MP may offer potential advantages over manual surgery, particularly in terms of reduced tissue trauma and intraoperative hemorrhages. Despite its longer duration compared with manual techniques, RA-MP may lead to fewer grasping maneuvers and lower rates of hemorrhages, thereby enhancing the safety and precision of vitreoretinal surgeries.
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Affiliation(s)
- Alexander Eberle
- Department of Ophthalmology, Stadtspital Zürich, Zurich, Switzerland
- Werner H. Spross Foundation for the Advancement of Research and Teaching in Ophthalmology, Zurich, Switzerland
| | - Ferhat Turgut
- Department of Ophthalmology, Stadtspital Zürich, Zurich, Switzerland
- Werner H. Spross Foundation for the Advancement of Research and Teaching in Ophthalmology, Zurich, Switzerland
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
- Gutblick Research, Pfäffikon, Switzerland
| | - Gábor Márk Somfai
- Department of Ophthalmology, Stadtspital Zürich, Zurich, Switzerland
- Werner H. Spross Foundation for the Advancement of Research and Teaching in Ophthalmology, Zurich, Switzerland
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Amr Saad
- Department of Ophthalmology, Stadtspital Zürich, Zurich, Switzerland
- Werner H. Spross Foundation for the Advancement of Research and Teaching in Ophthalmology, Zurich, Switzerland
| | - Marc D de Smet
- Helvetia Retina Associates, Lausanne, Switzerland
- New York Eye and Ear Infirmary of Mt. Sinai, Icahn School of Medicine, New York, NY, USA
| | - Pascal W Hasler
- Department of Ophthalmology, University of Basel, Basel, Switzerland
| | - Florian M Heussen
- Department of Ophthalmology, Stadtspital Zürich, Zurich, Switzerland
- Werner H. Spross Foundation for the Advancement of Research and Teaching in Ophthalmology, Zurich, Switzerland
- Department of Ophthalmology, Bern University Hospital, Bern, Switzerland
| | - Matthias D Becker
- Department of Ophthalmology, Stadtspital Zürich, Zurich, Switzerland
- Werner H. Spross Foundation for the Advancement of Research and Teaching in Ophthalmology, Zurich, Switzerland
- Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
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Gan W, Yang MZ, Tan ZH, Xie CL, Sun TY, Yang HX. Robotic portal resection for mediastinal tumours: a prospective observational study. J Cardiothorac Surg 2024; 19:155. [PMID: 38532497 DOI: 10.1186/s13019-024-02660-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 03/19/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND To demonstrate the effectiveness and feasibility of robotic portal resection (RPR) for mediastinal tumour using a prospectively collected database. METHODS Data from 73 consecutive patients with mediastinal tumours who underwent RPRs were prospectively collected from August 2018 to April 2023. All patients underwent chest and abdominal enhanced computed tomography (CT) and preoperative multidisciplinary team (MDT) discussion. The patients were stratified into two groups based on tumour size: Group A (tumour size < 4 cm) and Group B (tumour size ≥ 4 cm). General clinical characteristics, surgical procedures, and short outcomes were promptly recorded. RESULTS All of the cases were scheduled for RPRs. One patient (1/73, 1.4%) was switched to a small utility incision approach because of extensive pleural adhesion. Two patients (2.8%) converted to sternotomy, however, no perioperative deaths occurred. Most of the tumours were located in the anterior mediastinum (51/73, 69.9%). Thymoma (27/73, 37.0%) and thymic cyst (16/73, 21.9%) were the most common diagnoses. The median diameter of tumours was 3.2 cm (IQR, 2.4-4.5 cm). The median total operative time was 61.0 min (IQR, 50.0-90.0 min). The median intraoperative blood loss was 20 mL (IQR, 5.0-30.0 ml), and only one patient (1.4%) experienced an intraoperative complication. The median length of hospital stay was 3 days (IQR, 2-4 days). Compared with Group A, the median total operative time and console time of Group B were significantly longer (P = 0.006 and P = 0.003, respectively). The volume of drainage on the first postoperative day was greater in group B than in group A (P = 0.013). CONCLUSION RPR is a safe and effective technique for mediastinal tumour treatment, which can expand the application of minimally invasive surgery for the removal of complicated mediastinal tumours.
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Affiliation(s)
- Wei Gan
- Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, No. 651, Dongfeng East Road, Guangzhou City, Guangdong Province, 510060, P.R. China
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, P.R. China
- Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, 510060, P.R. China
| | - Mu-Zi Yang
- Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, No. 651, Dongfeng East Road, Guangzhou City, Guangdong Province, 510060, P.R. China
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, P.R. China
- Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, 510060, P.R. China
| | - Zi-Hui Tan
- Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, No. 651, Dongfeng East Road, Guangzhou City, Guangdong Province, 510060, P.R. China
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, P.R. China
- Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, 510060, P.R. China
| | - Chu-Long Xie
- Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, No. 651, Dongfeng East Road, Guangzhou City, Guangdong Province, 510060, P.R. China
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, P.R. China
- Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, 510060, P.R. China
| | - Tian-Yu Sun
- Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, No. 651, Dongfeng East Road, Guangzhou City, Guangdong Province, 510060, P.R. China
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, P.R. China
- Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, 510060, P.R. China
| | - Hao-Xian Yang
- Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, No. 651, Dongfeng East Road, Guangzhou City, Guangdong Province, 510060, P.R. China.
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, P.R. China.
- Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, 510060, P.R. China.
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Bandara DL, Kanmodi KK, Salami AA, Aladelusi TO, Chandrasiri A, Amzat J, Jayasinghe RD. Quality of life of patients treated with robotic surgery in the oral and maxillofacial region: a scoping review of empirical evidence. BMC Oral Health 2024; 24:276. [PMID: 38408988 PMCID: PMC10895822 DOI: 10.1186/s12903-024-04035-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: 11/08/2023] [Accepted: 02/15/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND There is a blooming trend in the application of robotic surgery in oral and maxillofacial care, and different studies had evaluated the quality of life (QoL) outcomes among patients who underwent robotic surgery in the oral and maxillofacial region. However, empirical evidence on the QoL outcomes from these procedures is yet to be mapped. Thus, this study was conducted to evaluate the available scientific evidence and gaps concerning the QoL outcomes of patients treated with robotic surgery in the oral and maxillofacial region. METHODS This study adopted a scoping review design, and it was conducted and reported based on the Arksey and O'Malley, PRISMA-ScR, and AMSTAR-2 guidelines. SCOPUS, PubMed, CINAHL Complete, and APA PsycINFO were searched to retrieve relevant literature. Using Rayyan software, the retrieved literature were deduplicated, and screened based on the review's eligibility criteria. Only the eligible articles were included in the review. From the included articles, relevant data were charted, collated, and summarized. RESULTS A total of 123 literature were retrieved from the literature search. After deduplication and screening, only 18 heterogeneous original articles were included in the review. A total of 771 transoral robotic surgeries (TORSs) were reported in these articles, and the TORSs were conducted on patients with oropharyngeal carcinomas (OPC), recurrent tonsillitis, and obstructive sleep apnoea (OSA). In total, 20 different QoL instruments were used in these articles to assess patients' QoL outcomes, and the most used instrument was the MD Anderson Dysphagia Inventory Questionnaire (MDADI). Physical functions related to swallowing, speech and salivary functions were the most assessed QoL aspects. TORS was reported to result in improved QOL in patients with OPC, OSA, and recurrent tonsillitis, most significantly within the first postoperative year. Notably, the site of the lesion, involvement of neck dissections and the characteristics of the adjuvant therapy seemed to affect the QOL outcome in patients with OPC. CONCLUSION Compared to the conventional treatment modalities, TORS has demonstrated better QoL, mostly in the domains related to oral functions such as swallowing and speech, among patients treated with such. This improvement was most evident within the initial post-operative year.
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Affiliation(s)
- Dhanushka Leuke Bandara
- Department of Oral Medicine and Periodontology, University of Peradeniya, Peradeniya, Sri Lanka
| | - Kehinde Kazeem Kanmodi
- School of Dentistry, University of Rwanda, Kigali, Rwanda.
- Faculty of Dentistry, University of Puthisastra, Phnom Penh, Cambodia.
- Campaign for Head and Neck Cancer Education (CHANCE) Programme, Cephas Health Research Initiative Inc, Ibadan, Nigeria.
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK.
| | - Afeez Abolarinwa Salami
- Faculty of Dentistry, University of Puthisastra, Phnom Penh, Cambodia
- Campaign for Head and Neck Cancer Education (CHANCE) Programme, Cephas Health Research Initiative Inc, Ibadan, Nigeria
- Department of Oral and Maxillofacial Surgery, University College Hospital, Ibadan, Nigeria
| | | | - Ayodhya Chandrasiri
- Department of Oral and Maxillofacial Surgery, University of Peradeniya, Peradeniya, Sri Lanka
| | - Jimoh Amzat
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
- Department of Sociology, Usmanu Danfodiyo University, Sokoto, Nigeria
- Department of Sociology, University of Johannesburg, Johannesburg, South Africa
| | - Ruwan Duminda Jayasinghe
- Department of Oral Medicine and Periodontology, University of Peradeniya, Peradeniya, Sri Lanka
- Faculty of Dentistry, University of Puthisastra, Phnom Penh, Cambodia
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
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Yim NH, Burns HR, Davis MJ, Selber JC. Robotic Plastic Surgery Education: Developing a Robotic Surgery Training Program Specific to Plastic Surgery Trainees. Semin Plast Surg 2023; 37:157-167. [PMID: 38444955 PMCID: PMC10911909 DOI: 10.1055/s-0043-1771026] [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: 03/07/2024]
Abstract
Over the past two decades, the surgical community has increasingly embraced robotic-assisted surgery (RAS) due to its potential to enhance accuracy and decrease surgical morbidity. Plastic surgery as a field has been historically slow to incorporate RAS, with lack of adequate training posing as one of the most commonly cited barriers. To date, robot technology has been utilized for various reconstructive procedures including flap elevation and inset, pedicle dissection, and microvascular anastomosis. As RAS continues to integrate within plastic surgery procedures, the need for a structured RAS curriculum designed for plastic surgery trainees is rising. This article delineates the essential components of a plastic surgery-specific RAS curriculum and outlines current training models and assessment tools utilized across surgical subspecialties to date.
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Affiliation(s)
- Nicholas H. Yim
- Michael E. DeBakey Department of Surgery, Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
- Division of Plastic Surgery, Texas Children's Hospital, Houston, Texas
| | - Heather R. Burns
- Michael E. DeBakey Department of Surgery, Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
- Division of Plastic Surgery, Texas Children's Hospital, Houston, Texas
| | - Matthew J. Davis
- Michael E. DeBakey Department of Surgery, Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
- Division of Plastic Surgery, Texas Children's Hospital, Houston, Texas
| | - Jesse C. Selber
- Department of Plastic Surgery, Corewell Health, Grand Rapids, Michigan
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Moloney R, Coffey A, Coffey JC, Brien BO. Nurses' perceptions and experiences of robotic assisted surgery (RAS): An integrative review. Nurse Educ Pract 2023; 71:103724. [PMID: 37451167 DOI: 10.1016/j.nepr.2023.103724] [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: 06/07/2023] [Accepted: 07/10/2023] [Indexed: 07/18/2023]
Abstract
AIM To identify and review published literature on the perceptions and experience of nurses working with RAS. BACKGROUND Robotic assisted surgery (RAS) is rapidly becoming accepted as the elite modality for surgery since its introduction in the 1980 s, more recently there has been a rising trend of use with several specialities operating using this technology. The role of nurses in perioperative care has been described as maintaining the momentum of the patient's journey. Patients undergoing RAS require nursing care throughout their journey, therefore knowledge of nurses' experiences and perceptions of RAS is important to identifying nurse education and development needs. DESIGN Integrative literature review DATABASE SOURCES: Databases searched for peer reviewed studies included CINAHL, Academic Search Complete, EMBASE, Scopus, ADA Psycinfo, Medline. REVIEW METHODS A comprehensive database search was conducted following PRISMA guidelines. Six databases were searched with 523 screened for eligibility. Ten studies were included in the review seven qualitative and three quantitative. RESULTS Ten studies were identified, critically appraised and synthesised using thematic analysis. All studies were conducted with nurses in the perioperative environment. Key findings were that nurses education regarding RAS is limited with more emphasis placed on surgeon education and training. There was evidence that nurses experienced a lack of education, training and information as barriers to their role which subsequently raised their stress levels. CONCLUSION Evidence suggests a clear need for education and training for nurses working with RAS. In addition, nurses working with RAS provide care preoperatively, intraoperatively, postoperatively and post discharge in the community. However, no research has been conducted with nurses outside of the perioperative environment. Further research is required to understand the experiences and perceptions of nurses working with RAS patients in all care settings to identify their education and development needs.
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Affiliation(s)
- Rita Moloney
- Department of Nursing and Midwifery, University Hospital Limerick, Limerick, Ireland.
| | - Alice Coffey
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | | | - Brid O Brien
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
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Abstract
The aim of this study was to assess the accuracy of pedicle screw placement, as well as intraoperative factors, radiation exposure, and complication rates in adult patients with degenerative disorders of the thoracic and lumbar spines who have undergone robotic-navigated spinal surgery using a contemporary system. The authors reviewed the prospectively collected data on 196 adult patients who had pedicle screws implanted with robot-navigated assistance (RNA) using the Mazor X Stealth system between June 2019 and March 2022. Pedicle screws were implanted by one experienced spinal surgeon after completion of a learning period. The accuracy of pedicle screw placement was determined using intraoperative 3D fluoroscopy. A total of 1,123 pedicle screws were implanted: 1,001 screws (89%) were placed robotically, 63 (6%) were converted from robotic placement to a freehand technique, and 59 (5%) were planned to be implanted freehand. Of the robotically placed screws, 942 screws (94%) were determined to be Gertzbein and Robbins grade A with median deviation of 0.8 mm (interquartile range 0.4 to 1.6). Skive events were noted with 20 pedicle screws (1.8%). No adverse clinical sequelae were noted in the 90-day follow-up. The mean fluoroscopic exposure per screw was 4.9 seconds (SD 3.8). RNA is highly accurate and reliable, with a low rate of abandonment once mastered. No adverse clinical sequelae occurred after implanting a large series of pedicle screws using the latest generation of RNA. Understanding of patient-specific anatomical features and the real-time intraoperative identification of risk factors for suboptimal screw placement have the potential to improve accuracy further.
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Affiliation(s)
- Frederik Abel
- Department of Spine Surgery, Hospital for Special Surgery, New York, New York, USA
| | - Fedan Avrumova
- Department of Spine Surgery, Hospital for Special Surgery, New York, New York, USA
| | - Samuel N Goldman
- Department of Spine Surgery, Hospital for Special Surgery, New York, New York, USA
| | - Celeste Abjornson
- Department of Spine Surgery, Hospital for Special Surgery, New York, New York, USA
| | - Darren R Lebl
- Department of Spine Surgery, Hospital for Special Surgery, New York, New York, USA
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Turgut F, Somfai GM, Heussen FM, Eberle A, de Smet MD, Becker MD. Robot-Assisted Epiretinal Membrane Peeling: A Prospective Assessment of Pre- and Intra-Operative Times and of Surgeons' Subjective Perceptions. J Clin Med 2023; 12:jcm12082768. [PMID: 37109104 PMCID: PMC10141075 DOI: 10.3390/jcm12082768] [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: 03/05/2023] [Revised: 04/02/2023] [Accepted: 04/06/2023] [Indexed: 04/29/2023] Open
Abstract
PURPOSE The Preceyes Surgical System (PSS) is a robotic assistive device that may enhance surgical precision. This study assessed pre- and intra-operative times and surgeons' perceptions of robot-assisted epiretinal membrane peeling (RA-MP). METHODS We analyzed the time requirement of three main tasks: the preparation of the PSS (I), patient preparation (II), and surgery (III). Following surgery, the surgeons were asked questions about their experience. RESULTS RA-MP was performed in nine eyes of nine patients. Task I required an average time of 12.3 min, initially taking 15 min but decreasing to 6 min in the last surgery. Task II showed a mean time of 47.2 (range of 36-65) min. Task III had a mean time of 72.4 (range of 57-100) min. A mean time of 27.9 (range of 9-46) min was necessary for RA-MP. The responses to the questionnaire revealed a trend towards increasing ease and reduced stress as familiarity with the PSS increased. CONCLUSIONS A substantial reduction in pre- and intra-operative times, decreasing to a total of 115 min, was demonstrated. RA-MP was positively anticipated by the surgeons and led to no hand or arm strain while being more complex than manual MP.
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Affiliation(s)
- Ferhat Turgut
- Department of Ophthalmology, Stadtspital Zurich, 8063 Zurich, Switzerland
- Werner H. Spross Foundation for the Advancement of Research and Teaching in Ophthalmology, 8063 Zurich, Switzerland
- Department of Ophthalmology, Semmelweis University, 1085 Budapest, Hungary
| | - Gábor Márk Somfai
- Department of Ophthalmology, Stadtspital Zurich, 8063 Zurich, Switzerland
- Werner H. Spross Foundation for the Advancement of Research and Teaching in Ophthalmology, 8063 Zurich, Switzerland
- Department of Ophthalmology, Semmelweis University, 1085 Budapest, Hungary
| | - Florian M Heussen
- Department of Ophthalmology, Stadtspital Zurich, 8063 Zurich, Switzerland
- Werner H. Spross Foundation for the Advancement of Research and Teaching in Ophthalmology, 8063 Zurich, Switzerland
- Department of Ophthalmology, Inselspital, University Hospital Bern, 3010 Bern, Switzerland
| | - Alexander Eberle
- Department of Ophthalmology, Stadtspital Zurich, 8063 Zurich, Switzerland
- Werner H. Spross Foundation for the Advancement of Research and Teaching in Ophthalmology, 8063 Zurich, Switzerland
| | - Marc D de Smet
- Helvetia Retina Associates, 1005 Lausanne, Switzerland
- New York Eye and Ear Infirmary of Mt Sinai, Icahn School of Medicine, New York, NY 10029, USA
| | - Matthias D Becker
- Department of Ophthalmology, Stadtspital Zurich, 8063 Zurich, Switzerland
- Werner H. Spross Foundation for the Advancement of Research and Teaching in Ophthalmology, 8063 Zurich, Switzerland
- Department of Ophthalmology, University of Heidelberg, 69117 Heidelberg, Germany
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Redondo-Sáenz D, Cortés-Salas C, Parrales-Mora M. Perioperative Nursing Role in Robotic Surgery: An Integrative Review. J Perianesth Nurs 2023:S1089-9472(22)00594-9. [PMID: 36754770 DOI: 10.1016/j.jopan.2022.11.001] [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: 06/05/2022] [Revised: 09/25/2022] [Accepted: 11/06/2022] [Indexed: 02/10/2023]
Abstract
PURPOSE Robotic surgery is an increasingly popular approach across surgical specialties in several countries. Nurses embedded in this highly-technological environment, however, could excessively center their attention to the robot, deviating their focus from the patient. The Perioperative Patient Focused Model is proposed as a theoretical framework to guide nursing perioperative care towards a patient-centered approach based upon 4 dimensions: Health System, Safety, Behavioral Responses and Physiological Responses. This review aimed to understand the role of perioperative nursing in robotic surgery according to the Perioperative Patient Focused Model. DESIGN An integrative review. METHODS The Whittemore and Knafl methodology guided this review. The following databases were searched: PubMed, Cochrane Library, ProQuest, Scielo, and LILACS. The keywords used were "Robotic Surgical Procedures" and "Nursing" and their equivalents in Spanish, Portuguese, and French, using the Boolean operator "AND," within the time frame of 2010-2021. FINDINGS A total of 1,695 articles were retrieved, of which 26 were retained for the final analysis. The majority (n = 17) were written in English, with a level of evidence between 4 and 5. The main actions performed by nursing professionals were retrieved in the Health Systems, Safety, and Behavioral Responses dimensions, focusing on the intraoperative and postoperative period. However, most of the patient's responses were presented in the postoperative stage, even after discharge. Encompassing these findings, a theoretical framework is proposed. CONCLUSIONS Nursing professional duties are diverse within the course of robotic surgery. It is necessary to expand the Perioperative Nursing specialty towards an extended care, encompassing even the community settings.
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Affiliation(s)
| | | | - Mauricio Parrales-Mora
- Hepato-Pancreato-Biliary (HPB) Surgery Unit, Germans Trias i Pujol University Hospital, Autonomous University of Barcelona, Barcelona, Spain
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Lechien JR, Haddad L, Holsinger FC, Mendelsohn AH, Hans S. Adoption of otolaryngologist-head neck surgeons toward transoral robotic surgery: An international survey. Laryngoscope Investig Otolaryngol 2023; 8:95-102. [PMID: 36846408 PMCID: PMC9948589 DOI: 10.1002/lio2.1003] [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: 11/19/2022] [Revised: 12/14/2022] [Accepted: 12/16/2022] [Indexed: 12/27/2022] Open
Abstract
Objective To investigate perception, adoption and awareness of otolaryngologist-head neck surgeons (OTO-HNS) toward transoral robotic surgery (TORS). Methods An online survey was sent to 1383 OTO-HNS on the perception, adoption and awareness about TORS to members of many otolaryngological societies. The following aspects were assessed: TORS access; training; awareness/perception; indications and advantages/barriers to TORS practice. The responses were presented for the entire cohort and regarding the TORS experience of OTO-HNS. Results A total of 359 completed the survey (26%); including 115 TORS surgeons. TORS-surgeons carry out a mean number of 34.4 annual TORS procedures. The primary barriers to TORS were the cost of the robot (74%) and disposable accessories (69%), and the lack of training opportunity (38%). The 3D view of the surgical field (66%), the postoperative quality of life outcomes (63%) and the shorter hospital stay (56%) were the most important benefits of TORS. TORS-surgeons believed more frequently that TORS is indicated for cT1-T2 oropharyngeal and supraglottic cancers than non-TORS surgeons (p < .005). Participants believed that the priorities for the future consisted of the reduction of the robot arm size and the incorporation of flexible instruments (28%); the integration of laser (25%) or GPS tracking based on imaging (18%), all of them to improve accesses to hypopharynx (24%), supraglottic larynx (23%) and vocal folds (22%). Conclusions The perception, adoption and knowledges toward TORS depend on the access to robot. The findings of this survey may help guide decisions on how improve the dissemination of TORS interest and awareness.
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Affiliation(s)
- Jerome R. Lechien
- Department of Otolaryngology and Head and Neck Surgery, Foch HospitalParis Saclay UniversityParisFrance
- Department of Otolaryngology and Head and Neck Surgery, Division of Broncho‐Esophagology, EpiCURA HospitalUMONS Research Institute for Health Sciences and Technology, University of Mons (UMons)MonsBelgium
- Department of OtolaryngologyElsan polyclinic of PoitiersPoitiersFrance
- Department of Otolaryngology‐Head and Neck SurgeryCHU Saint‐PierreBrusselsBelgium
| | - Leonardo Haddad
- Department of Otolaryngology, Head and Neck SurgeryFederal University of São PauloSão PauloBrazil
| | | | - Abie H. Mendelsohn
- Department of Head and Neck SurgeryDavid Geffen School of Medicine at UCLALos AngelesCaliforniaUSA
| | - Stephane Hans
- Department of Otolaryngology and Head and Neck Surgery, Foch HospitalParis Saclay UniversityParisFrance
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Jin Y, Zhang Y, Cai D, Huang Z, Zhang S, Mao J, Gao Z. Robot-Assisted Resection of Intestinal Duplication in Children. J Laparoendosc Adv Surg Tech A 2022; 32:1288-1292. [PMID: 35904972 DOI: 10.1089/lap.2022.0173] [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: 12/14/2022] Open
Abstract
Background: Intestinal duplication is the most common type of alimentary tract duplications in childhood. Laparoscopic-assisted surgery has become the main surgical procedure, but robot-assisted resection has rarely been reported; the aim of this study was to retrospectively present our experience with robot-assisted intestinal duplication excision using the Da Vinci Xi surgical system and discuss the technical points. Methods: In total, 49 patients who were diagnosed with intestinal duplication and underwent surgery from April 2020 to February 2022 in the Children's Hospital, Zhejiang University School of Medicine, were retrospectively analyzed. The data were collected including the clinical information of the patients, operative details, and postoperative outcomes. Results: Among these 49 patients, a total of 15 underwent robot-assisted surgery and 34 underwent laparoscopic-assisted surgery. For the robot-assisted surgery group, all the cysts were peeled off by complete endoscope, the integrity of the intestine was preserved and intestinal resection and anastomosis were not required. The operation time of 80 minutes for the robot-assisted group was not significantly longer than the 90 minutes for the laparoscopic-assisted surgery group(P > .05), but the mean time to take the liquid diet after surgery and the average length of postoperative hospital stay were significantly shorter (P < .05). Conclusion: Robot-assisted resection of intestinal duplication is safe and feasible and the refinement of the Da Vinci Xi surgical system was much better than that of the conventional laparoscopic equipment, resulting in significantly improved intraoperative and postoperative outcomes.
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Affiliation(s)
- Yi Jin
- Department of General Surgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Yuebin Zhang
- Department of General Surgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Duote Cai
- Department of General Surgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Zongwei Huang
- Department of General Surgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Shuhao Zhang
- Department of General Surgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Jianhua Mao
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Zhigang Gao
- Department of General Surgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
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11
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Bramhe S, Pathak SS. Robotic Surgery: A Narrative Review. Cureus 2022; 14:e29179. [PMID: 36258968 PMCID: PMC9573327 DOI: 10.7759/cureus.29179] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 09/15/2022] [Indexed: 11/05/2022] Open
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Burati M, Tagliabue F, Lomonaco A, Chiarelli M, Zago M, Cioffi G, Cioffi U. Artificial intelligence as a future in cancer surgery. Artif Intell Cancer 2022; 3:11-16. [DOI: 10.35713/aic.v3.i1.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 12/24/2021] [Accepted: 01/17/2022] [Indexed: 02/06/2023] Open
Abstract
Artificial intelligence (AI) is defined as the theory and development of computer systems able to perform tasks normally requiring human intelligence, such as visual perception, speech recognition, and decision-making. Machine learning and deep learning (DL) are subfields of AI that are able to learn from experience in order to complete tasks. AI and its subfields, in particular DL, have been applied in numerous fields of medicine, especially in the cure of cancer. Computer vision (CV) system has improved diagnostic accuracy both in histopathology analyses and radiology. In surgery, CV has been used to design navigation system and robotic-assisted surgical tools that increased the safety and efficiency of oncological surgery by minimizing human error. By learning the basis of AI, surgeons can take part in this revolution to optimize surgical care of oncologic disease.
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Affiliation(s)
- Morena Burati
- Department of Robotic and Emergency Surgery, Ospedale A Manzoni, ASST Lecco, Lecco 23900, Italy
| | - Fulvio Tagliabue
- Department of Robotic and Emergency Surgery, Ospedale A Manzoni, ASST Lecco, Lecco 23900, Italy
| | - Adriana Lomonaco
- Department of Robotic and Emergency Surgery, Ospedale A Manzoni, ASST Lecco, Lecco 23900, Italy
| | - Marco Chiarelli
- Department of Robotic and Emergency Surgery, Ospedale A Manzoni, ASST Lecco, Lecco 23900, Italy
| | - Mauro Zago
- Department of Robotic and Emergency Surgery, Ospedale A Manzoni, ASST Lecco, Lecco 23900, Italy
| | - Gerardo Cioffi
- Department of Sciences and Technologies, Unisannio, Benevento 82100, Italy
| | - Ugo Cioffi
- Department of Surgery, University of Milan, Milano 20122, Italy
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13
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Liang S, Zheng J, Yuan F. Preliminary study on the osseointegration effects of contactless automated implant cavity preparation via femtosecond laser ablation. BIOMEDICAL OPTICS EXPRESS 2022; 13:82-92. [PMID: 35154855 PMCID: PMC8803009 DOI: 10.1364/boe.446602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/25/2021] [Accepted: 11/25/2021] [Indexed: 06/14/2023]
Abstract
Microrobots were used to control the femtosecond laser ablation of bone tissues to prepare implant cavities for dental implant surgery. The method was optimized through depth-of-cut experiments of ex vivo rabbit femurs, and the optimized method was used to prepare implant cavities on the left femurs of eight live rabbits. A power of 10 W and a scanning rate of 4000 mm/s were found to be optimal. After seven days of osteoinduction, the expression of collagen type I was significantly higher in the experimental group than in the control group (manually drilled implant cavities). The bone-implant contacts of the experimental group at 4 and 8 weeks were 9.65% and 23.08%, respectively.
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Affiliation(s)
- Shanshan Liang
- Center of Digital Dentistry/Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing 100081, China
- National Center of Stomatology & National Clinical Research Center for Oral Diseases, Beijing 100081, China
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing 100081, China
- Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
- NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing 100081, China
| | - Jianqiao Zheng
- Center of Digital Dentistry/Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing 100081, China
- National Center of Stomatology & National Clinical Research Center for Oral Diseases, Beijing 100081, China
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing 100081, China
- Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
- NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing 100081, China
| | - Fusong Yuan
- Center of Digital Dentistry/Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing 100081, China
- National Center of Stomatology & National Clinical Research Center for Oral Diseases, Beijing 100081, China
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing 100081, China
- Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
- NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing 100081, China
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14
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Stewart HL, Birch DJS. Fluorescence Guided Surgery. Methods Appl Fluoresc 2021; 9. [PMID: 34399409 DOI: 10.1088/2050-6120/ac1dbb] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 08/16/2021] [Indexed: 01/22/2023]
Abstract
Fluorescence guided surgery (FGS) is an imaging technique that allows the surgeon to visualise different structures and types of tissue during a surgical procedure that may not be as visible under white light conditions. Due to the many potential advantages of fluorescence guided surgery compared to more traditional clinical imaging techniques such as its higher contrast and sensitivity, less subjective use, and ease of instrument operation, the research interest in fluorescence guided surgery continues to grow over various key aspects such as fluorescent probe development and surgical system development as well as its potential clinical applications. This review looks to summarise some of the emerging opportunities and developments that have already been made in fluorescence guided surgery in recent years while highlighting its advantages as well as limitations that need to be overcome in order to utilise the full potential of fluorescence within the surgical environment.
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Affiliation(s)
- Hazel L Stewart
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh BioQuarter, 47 Little France Crescent, Edinburgh, EH16 4TJ, United Kingdom
| | - David J S Birch
- Department of Physics, The Photophysics Research Group, University of Strathclyde, SUPA, John Anderson Building, 107 Rottenrow East, Glasgow G4 0NG, United Kingdom
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Shah K, Tomljenovic-Berube A. A New Dimension of Health Care: The Benefits, Limitations and Implications of Virtual Medicine. JOURNAL OF UNDERGRADUATE LIFE SCIENCES 2021. [DOI: 10.33137/juls.v15i1.37034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background: Virtual medicine has been rapidly evolving over the past several decades. However, obstacles such as data security, inadequate funding and limited technological resources have hindered its seamless incorporation into the health care system. The recent pandemic has induced a widespread adoption of virtual care practices to remove the need for physical meetings between patients and health care practitioners.
Purpose: This literature review aims to examine the current state of virtual medicine amid the COVID-19 pandemic and evaluate the benefits, limitations and implications of continuing technological advancements in the future.
Findings: Most of the available literature suggests that the recent adoption of virtual medicine has allowed practitioners to cut down on costs and secondary expenses while maintaining the quality of medical care services. Due to the growing consumer demand, researchers predict that virtual medicine may be a viable modality for patient care post-pandemic. However, concerns surrounding patient security and digital infrastructure threaten the ability of virtual medicine to provide quality and effective health care. Additionally, rural virtual medicine programs face challenges in expanding services due to the scarcity of information and communication technology specialists and inadequate funding. Comprehensive legislation and governance standards must be implemented to ensure proper data security and privacy. Additional funds may also be required to train staff, reform current digital software and improve the quality of service. The proliferation of advanced technologies and improvements in current platforms will enable more providers to render virtual medical care services.
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