1
|
Fan P, Lyu P, Gao F, Li J, Wei C, Du G. A Novel Endoscopic Approach for Treating Breast Cancer: Haigui-1 Hole. Surg Innov 2024; 31:349-354. [PMID: 38867678 DOI: 10.1177/15533506241262563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Abstract
OBJECTIVE Endoscopic surgery is an effective technique for preserving the nipple and areola, as well as for sentinel lymph node biopsy and breast implant reconstruction. However, the technical challenges associated with endoscopic surgery have limited its widespread adoption. METHODS In the normal single-port endoscopic surgery, the ultrasonic knife was accessed through the retractor. In our modified procedure, a tiny 5 mm incision was made at the lateral margin underneath the breast, serving as the second entry port for the ultrasonic scalpel, which was referred to as the "Haigui-1 hole". Preoperative and postoperative indicators such as blood loss, operative time, and postoperative drainage volume were collected. Differences between parameters were compared using Student's t test. RESULTS Endoscopic surgery with the assistance of the "Haigui-1 hole" led to preserved breast aesthetics with minimal scarring. Moreover, "Haigui-1 hole" surgery significantly reduced the operation time, intraoperative bleeding, and postoperative drainage volume compared to normal single-port endoscopic surgery. CONCLUSION The "Haigui-1 hole" procedure, which involves the addition of a second entrance to improve the maneuverability of the ultrasonic knife, is worthy of further promotion.
Collapse
Affiliation(s)
- Pingming Fan
- Department of Breast Surgery, The First Affiliated Hospital of Hainan Medical University, Haikou, China
- Department of Breast Surgery, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Pengfei Lyu
- Department of Breast Surgery, The First Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Fangfang Gao
- Department of Breast Surgery, The First Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Jingtai Li
- Department of Breast Surgery, The First Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Changyuan Wei
- Department of Breast Surgery, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Guankui Du
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, School of Basic Medicine and Life Sciences, Hainan Medical University, Haikou, China
- Department of Biochemistry and Molecular Biology, Hainan Medical University, Haikou, China
| |
Collapse
|
2
|
Khorasani M, Abdurahiman N, Padhan J, Zhao H, Al-Ansari A, Becker AT, Navkar N. Preliminary design and evaluation of a generic surgical scope adapter. Int J Med Robot 2023; 19:e2475. [PMID: 36288569 DOI: 10.1002/rcs.2475] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 08/21/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Robotic scope assistant systems are used to visualise and navigate the operative field during a laparoscopic surgery. The objective of this work is to design a surgical scope adapter that enables control of different scope types (zero-degree, angulated, and articulated), and can be connected to any six degree-of-freedom robotic manipulator for usage as a robotic scope assistant system. METHODS A surgical scope adapter compatible with different camera heads and scope types was designed and prototyped. The technical performance of the scope adapter was evaluated and a user study was conducted to assess the human-in-the-loop control. RESULTS All the subjects were able to navigate the simulated operative field. The scope adapter permits continuous motion to explore the operative field as well as intermittent motion to accurately focus on the targeted anatomical landmarks. CONCLUSION The modular and generic nature of the surgical scope adapter may enable its usage across different minimally invasive surgeries.
Collapse
Affiliation(s)
| | | | | | - Haoran Zhao
- Department of Electrical and Computer Engineering, University of Houston, Houston, Texas, USA
| | | | - Aaron T Becker
- Department of Electrical and Computer Engineering, University of Houston, Houston, Texas, USA
| | - Nikhil Navkar
- Department of Surgery, Hamad Medical Corporation, Doha, Qatar
| |
Collapse
|
3
|
Abdurahiman N, Khorasani M, Padhan J, Baez VM, Al-Ansari A, Tsiamyrtzis P, Becker AT, Navkar NV. Scope actuation system for articulated laparoscopes. Surg Endosc 2023; 37:2404-2413. [PMID: 36750488 PMCID: PMC10017632 DOI: 10.1007/s00464-023-09904-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 01/21/2023] [Indexed: 02/09/2023]
Abstract
BACKGROUND An articulated laparoscope comprises a rigid shaft with an articulated distal end to change the viewing direction. The articulation provides improved navigation of the operating field in confined spaces. Furthermore, incorporation of an actuation system tends to enhance the control of an articulated laparoscope. METHODS A preliminary prototype of a scope actuation system to maneuver an off-the-shelf articulated laparoscope (EndoCAMaleon by Karl Storz, Germany) was developed. A user study was conducted to evaluate this prototype for the surgical paradigm of video-assisted thoracic surgery. In the study, the subjects maneuvered an articulated scope under two modes of operation: (a) actuated mode where an operating surgeon maneuvers the scope using the developed prototype and (b) manual mode where a surgical assistant directly maneuvers the scope. The actuated mode was further assessed for multiple configurations based on the orientation of the articulated scope at the incision. RESULTS The data show the actuated mode scored better than the manual mode on all the measured performance parameters including (a) total duration to visualize a marked region, (a) duration for which scope focus shifts outside a predefined visualization region, and (c) number of times for which scope focus shifts outside a predefined visualization region. Among the different configurations tested using the actuated mode, no significant difference was observed. CONCLUSIONS The proposed articulated scope actuation system facilitates better navigation of an operative field as compared to a human assistant. Secondly, irrespective of the orientation in which an articulated scope's shaft is inserted through an incision, the proposed actuation system can navigate and visualize the operative field.
Collapse
Affiliation(s)
| | | | | | - Victor M Baez
- Department of Electrical Engineering, University of Houston, Houston, TX, USA
| | | | | | - Aaron T Becker
- Department of Electrical Engineering, University of Houston, Houston, TX, USA
| | - Nikhil V Navkar
- Department of Surgery, Hamad Medical Corporation, Doha, Qatar.
- Department of Surgery, Surgical Research Section, Hamad General Hospital, Hamad Medical Corporation, PO Box 3050, Doha, Qatar.
| |
Collapse
|
4
|
Siu ICH, Ng CSH. The future of the uniportal approach. Ann Cardiothorac Surg 2023; 12:46-48. [PMID: 36793980 PMCID: PMC9922767 DOI: 10.21037/acs-2022-urats-16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 11/15/2022] [Indexed: 12/24/2022]
Affiliation(s)
- Ivan C H Siu
- Division of Cardiothoracic Surgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Calvin S H Ng
- Division of Cardiothoracic Surgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| |
Collapse
|
5
|
Xiong R, Wu HR, Wang GX, Sun XH, Liu CQ, Xu GW, Xie MR. Single-Port Video-Assisted Thoracoscopic Lobectomy for Non-small-Cell Lung Cancer—Learning Curve Analysis. Indian J Surg 2021. [DOI: 10.1007/s12262-020-02522-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
|
6
|
Muranishi Y, Sato T, Ueda Y, Yutaka Y, Nakamura T, Date H. A novel suction-based lung-stabilizing device in single-port video-assisted thoracoscopic surgical procedures. Gen Thorac Cardiovasc Surg 2019; 68:503-507. [PMID: 31728836 DOI: 10.1007/s11748-019-01249-6] [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: 08/22/2019] [Accepted: 11/06/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Single-port video-assisted thoracoscopic surgery (SPVATS) has become a subject of interest for thoracic surgeons in recent years; however, it has not been fully accepted partly because the procedure is technically demanding. We speculate that the most critical problem of SPVATS is that significant interferences of the instruments may occur during the procedure because all the instruments share only a single incisional port. The purpose of this study was to evaluate the usability of a new suction-based lung-stabilizing device during SPVATS procedure. METHODS We developed a novel suction-based lung-stabilizing device equipped with three hemispheric silicon suction cups. Ten cases of canine's lower lobectomies were performed. Five cases were performed without this device and designated as the control cases. The remaining cases were performed using this device and were designated as the experimental cases. RESULTS A significantly fewer number of interruption times were noted in the novel lung-stabilizing device group than in the control group (average, 0.4 vs. 4.4; P = 0.0031). Although the differences did not reach statistical significance, the device tended to demonstrate better performance compared with the control group regarding the operation time, organ damage, and accomplishment of SPVATS. CONCLUSION Our study indicates that the novel lung-stabilizing device has potentially useful applications in SPVATS procedures.
Collapse
Affiliation(s)
- Yusuke Muranishi
- Department of Thoracic Surgery, Kyoto City Hospital, Kyoto, Japan
| | - Toshihiko Sato
- Department of General Thoracic Surgery, Breast and Pediatric Surgery, Fukuoka University School of Medicine, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, Japan.
| | - Yuichiro Ueda
- Department of General Thoracic Surgery, Breast and Pediatric Surgery, Fukuoka University School of Medicine, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, Japan
- Department of Thoracic Surgery, Kyoto University Hospital, Kyoto, Japan
- Department of Organ and Tissue Reconstruction, Institute for Frontier Life and Medical Sciences, Kyoto University, Kyoto, Japan
| | - Yojiro Yutaka
- Department of Thoracic Surgery, Kyoto University Hospital, Kyoto, Japan
- Department of Organ and Tissue Reconstruction, Institute for Frontier Life and Medical Sciences, Kyoto University, Kyoto, Japan
| | - Tatsuo Nakamura
- Department of Organ and Tissue Reconstruction, Institute for Frontier Life and Medical Sciences, Kyoto University, Kyoto, Japan
| | - Hiroshi Date
- Department of Thoracic Surgery, Kyoto University Hospital, Kyoto, Japan
| |
Collapse
|
7
|
Kamiyoshihara M, Igai H, Yoshikawa R, Ohsawa F, Yazawa T. Advantages associated with the use of a wound retractor compared to a rigid trocar inserted via the camera port during video-assisted thoracic surgery. J Thorac Dis 2019; 11:S468-S471. [PMID: 30997250 DOI: 10.21037/jtd.2018.11.15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Mitsuhiro Kamiyoshihara
- Department of General Thoracic Surgery, Japanese Red Cross Maebashi Hospital, Maebashi, Japan
| | - Hitoshi Igai
- Department of General Thoracic Surgery, Japanese Red Cross Maebashi Hospital, Maebashi, Japan
| | - Ryohei Yoshikawa
- Department of General Thoracic Surgery, Japanese Red Cross Maebashi Hospital, Maebashi, Japan
| | - Fumi Ohsawa
- Department of General Thoracic Surgery, Japanese Red Cross Maebashi Hospital, Maebashi, Japan
| | - Tomohiro Yazawa
- Department of General Thoracic Surgery, Japanese Red Cross Maebashi Hospital, Maebashi, Japan
| |
Collapse
|
8
|
Siu ICH, Li Z, Ng CSH. Latest technology in minimally invasive thoracic surgery. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:35. [PMID: 30854388 DOI: 10.21037/atm.2018.12.47] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
From the introduction of video-assisted thoracoscopic surgery (VATS) in the 1990s, to performing major lung resections using a uniportal VATS approach, technology has paved the way for the development of minimally invasive thoracic surgery. Natural orifice access to achieve a 'no port' approach, is also on the rise, with advancements in bronchoscopic techniques for diagnosis and therapy, as well as development of soft robotics to achieve desired flexibility, dexterity and stability in future platforms, which may involve in vivo deployment to bring the surgeon totally inside the body. Development of haptic feedback in robotic platforms to enhance the surgical experience is also a major goal, with vibrotactile and mechanical feedback generation, to replicate the traditional touch. In addition, the aid of technology in the form of procedural guidance mechanisms, like augmented reality, will further improve the safety and accuracy of future operations.
Collapse
Affiliation(s)
- Ivan Chi Hin Siu
- Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Zheng Li
- Department of Surgery, Chow Yuk Ho Technology Centre for Innovative Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Calvin S H Ng
- Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| |
Collapse
|