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Şenol Çelik S, Tunçbilek Z, Sarıköse S, Topaktaş G, Canda AE. Roles, experience and views of nurses working in robotic surgery settings: A mixed-methods study. J Perioper Pract 2024; 34:248-256. [PMID: 38606911 DOI: 10.1177/17504589241231100] [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: 04/13/2024]
Abstract
Robotic-assisted surgery has benefits for patients, but there are challenges to working in this field. In Turkey, training is not provided for nurses working in robotic-assisted surgery, and national legislation on nurses' roles in these settings has not been implemented. This study aimed to demonstrate the roles and experiences of nurses in robotic-assisted surgery in Turkey. This study was conducted as a mixed-methods research. The qualitative data were analysed by content analysis. More than half of the nurses had received basic training in robotic-assisted surgery. Qualitative data consisted of five themes, including the effects of robotic surgery, feelings and thoughts on robotic surgery, working as a nurse in robotic surgery settings, responsibilities of nurses and competence of nurses working in robotic surgery settings. Determining the working conditions and roles of nurses working in robotic-assisted surgery settings by policymakers in regulations is crucial for improving the quality of nursing care and the outcomes of patients.
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Affiliation(s)
| | | | | | - Gülsen Topaktaş
- Department of Education and Certification, Ministry of Health, Ankara, Turkey
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2
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Wang Y, Wu Z, Dai J, Morgan TN, Garbens A, Kominsky H, Gahan J, Larson EC. Evaluating robotic-assisted partial nephrectomy surgeons with fully convolutional segmentation and multi-task attention networks. J Robot Surg 2023; 17:2323-2330. [PMID: 37368225 PMCID: PMC10492672 DOI: 10.1007/s11701-023-01657-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 06/17/2023] [Indexed: 06/28/2023]
Abstract
We use machine learning to evaluate surgical skill from videos during the tumor resection and renography steps of a robotic assisted partial nephrectomy (RAPN). This expands previous work using synthetic tissue to include actual surgeries. We investigate cascaded neural networks for predicting surgical proficiency scores (OSATS and GEARS) from RAPN videos recorded from the DaVinci system. The semantic segmentation task generates a mask and tracks the various surgical instruments. The movements from the instruments found via semantic segmentation are processed by a scoring network that regresses (predicts) GEARS and OSATS scoring for each subcategory. Overall, the model performs well for many subcategories such as force sensitivity and knowledge of instruments of GEARS and OSATS scoring, but can suffer from false positives and negatives that would not be expected of human raters. This is mainly attributed to limited training data variability and sparsity.
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Affiliation(s)
- Yihao Wang
- Department of Computer Science, Southern Methodist University, Dallas, USA
| | - Zhongjie Wu
- Department of Computer Science, Southern Methodist University, Dallas, USA
| | - Jessica Dai
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, USA
| | - Tara N. Morgan
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, USA
| | - Alaina Garbens
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, USA
| | - Hal Kominsky
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, USA
| | - Jeffrey Gahan
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, USA
| | - Eric C. Larson
- Department of Computer Science, Southern Methodist University, Dallas, USA
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3
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Wang Y, Dai J, Morgan TN, Elsaied M, Garbens A, Qu X, Steinberg R, Gahan J, Larson EC. Evaluating robotic-assisted surgery training videos with multi-task convolutional neural networks. J Robot Surg 2021; 16:917-925. [PMID: 34709538 DOI: 10.1007/s11701-021-01316-2] [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: 07/02/2021] [Accepted: 10/03/2021] [Indexed: 10/20/2022]
Abstract
We seek to understand if an automated algorithm can replace human scoring of surgical trainees performing the urethrovesical anastomosis in radical prostatectomy with synthetic tissue. Specifically, we investigate neural networks for predicting the surgical proficiency score (GEARS score) from video clips. We evaluate videos of surgeons performing the urethral anastomosis using synthetic tissue. The algorithm tracks surgical instrument locations from video, saving the positions of key points on the instruments over time. These positional features are used to train a multi-task convolutional network to infer each sub-category of the GEARS score to determine the proficiency level of trainees. Experimental results demonstrate that the proposed method achieves good performance with scores matching manual inspection in 86.1% of all GEARS sub-categories. Furthermore, the model can detect the difference between proficiency (novice to expert) in 83.3% of videos. Evaluation of GEARS sub-categories with artificial neural networks is possible for novice and intermediate surgeons, but additional research is needed to understand if expert surgeons can be evaluated with a similar automated system.
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Affiliation(s)
- Yihao Wang
- Department of Computer Science, Southern Methodist University, Dallas, USA
| | - Jessica Dai
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, USA
| | - Tara N Morgan
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, USA
| | - Mohamed Elsaied
- Department of Computer Science, Southern Methodist University, Dallas, USA
| | - Alaina Garbens
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, USA
| | - Xingming Qu
- Department of Computer Science, Southern Methodist University, Dallas, USA
| | - Ryan Steinberg
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, USA
| | - Jeffrey Gahan
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, USA
| | - Eric C Larson
- Department of Computer Science, Southern Methodist University, Dallas, USA.
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Elnikety S, Badr E, Abdelaal A. Surgical training fit for the future: the need for a change. Postgrad Med J 2021; 98:820-823. [PMID: 33941663 PMCID: PMC9613864 DOI: 10.1136/postgradmedj-2021-139862] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/20/2021] [Accepted: 03/30/2021] [Indexed: 12/14/2022]
Abstract
Postgraduate training in surgical specialties is one of the longest training programmes in the medical field. Most of the surgical training programmes require 5–6 years of postgraduate training to become qualified. This is usually followed by 1–2 years of fellowship training in a subspecialised interest. This has been the case for the last 20–30 years with no significant change. The surgical practice is transforming quickly due to the advances in medical technology. This transformation is not matched in the postgraduate training, there is minimal exposure to the new technological advances in early years of postgraduate training. The current postgraduate training in surgical specialties is not fit for the future. Early exposure to robotic and artificial intelligence technologies is required. To achieve this, a significant transformation of surgical training is necessary, which requires a new vision and involves significant investment. We discuss the need for this transformation in the postgraduate surgical specialties training and analyse the threats and opportunities in relation to this transformation.
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Affiliation(s)
- Sherif Elnikety
- College of Medicine and Health Science, Department of Surgery, United Arab Emirates University, Al Ain, UAE
| | - Eman Badr
- Medical Education, University of Buckingham, Buckingham, UK
| | - Ahmed Abdelaal
- Trauma and Orthopaedics Department, University Hospitals of North Midlands NHS Trust, Stoke on Trent, UK
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Abstract
Just as laparoscopic surgery provided a giant leap in safety and recovery for patients over open surgery methods, robotic-assisted surgery (RAS) is doing the same to laparoscopic surgery. The first laparoscopic-RAS systems to be commercialized were the Intuitive Surgical, Inc. (Sunnyvale, CA, USA) da Vinci and the Computer Motion Zeus. These systems were similar in many aspects, which led to a patent dispute between the two companies. Before the dispute was settled in court, Intuitive Surgical bought Computer Motion, and thus owned critical patents for laparoscopic-RAS. Recently, the patents held by Intuitive Surgical have begun to expire, leading to many new laparoscopic-RAS systems being developed and entering the market. In this study, we review the newly commercialized and prototype laparoscopic-RAS systems. We compare the features of the imaging and display technology, surgeons console and patient cart of the reviewed RAS systems. We also briefly discuss the future directions of laparoscopic-RAS surgery. With new laparoscopic-RAS systems now commercially available we should see RAS being adopted more widely in surgical interventions and costs of procedures using RAS to decrease in the near future.
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Nakawala H, De Momi E, Tzemanaki A, Dogramadzi S, Russo A, Catellani M, Bianchi R, De Cobelli O, Sideridis A, Papacostas E, Koupparis A, Rowe E, Persad R, Ascione R, Ferrigno G. Requirements elicitation for robotic and computer-assisted minimally invasive surgery. INT J ADV ROBOT SYST 2019. [DOI: 10.1177/1729881419865805] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The robotic surgical systems and computer-assisted technologies market has seen impressive growth over the last decades, but uptake by end-users is still scarce. The purpose of this article is to provide a comprehensive and informed list of the end-user requirements for the development of new generation robot- and computer-assisted surgical systems and the methodology for eliciting them. The requirements were elicited, in the frame of the EU project SMARTsurg, by conducting interviews on use cases of chosen urology, cardiovascular and orthopaedics procedures, tailored to provide clinical foundations for scientific and technical developments. The structured interviews resulted in detailed requirement specifications which are ranked according to their priorities. Paradigmatic surgical scenarios support the use cases.
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Affiliation(s)
| | - Elena De Momi
- Department of Computer Science, University of Verona, Verona, Italy
| | - Antonia Tzemanaki
- Bristol Robotics Laboratory, University of the West of England, Bristol, UK
| | - Sanja Dogramadzi
- Bristol Robotics Laboratory, University of the West of England, Bristol, UK
| | - Andrea Russo
- Division of Urology, European Institute of Oncology, Milano, Italy
| | | | - Roberto Bianchi
- Division of Urology, European Institute of Oncology, Milano, Italy
| | - Ottavio De Cobelli
- Division of Urology, European Institute of Oncology, Milano, Italy
- Department of Oncology and Hematology-Oncology University of Milan, Milan, Italy
| | | | | | | | - Edward Rowe
- Bristol Urological Institute, North Bristol NHS Trust, Bristol, UK
| | - Raj Persad
- Bristol Urological Institute, North Bristol NHS Trust, Bristol, UK
| | - Raimondo Ascione
- Translational Biomedical Research Centre and Bristol Heart Institute, University of Bristol, Bristol, UK
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Farooq MU, Xu B, Ko SY. A concentric tube-based 4-DOF puncturing needle with a novel miniaturized actuation system for vitrectomy. Biomed Eng Online 2019; 18:46. [PMID: 30999918 PMCID: PMC6472096 DOI: 10.1186/s12938-019-0666-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 04/08/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Vitreoretinal surgeries require precise, dexterous, and steady instruments for operation in delicate parts of the eye. Robotics has presented solutions for many vitreoretinal surgical problems, but, in a few operations, the available tools are still not dexterous enough to carry out procedures with minimum trauma to patients. Vitrectomy is one of those procedures and requires some dexterous instruments to replace straight ones for better navigation to affected sides inside the eyeball. METHOD In this paper, we propose a new vein puncturing solution with a 4-DOF motion to increase the workspace inside the eye. A two-member concentric tube-based 25G needle is proposed whose shape is optimized. To operate the concentric tube needle, a novel and miniaturized actuation system is proposed that uses hollow shaft motors for the first time. The presented prototype of actuation system has a stroke of 100 mm in a small size of 148 × 25 × 65 mm (L × W × H), suitable for approaching distant positions inside the eyeball. RESULTS Experimental results validate that the targeting accuracy of the needle is less than one millimeter and the needle tip can apply a force of 23.51 mN which is enough to perform puncturing. Furthermore, the proposed needle covers maximum workspace of around 128.5° inside the eyeball. For the actuation system, experiments show that it can produce repeatable motions with accuracy in submillimeter. CONCLUSION The proposed needle system can navigate to the sites which are difficult to approach by currently available straight tools requiring reinsertions. Along with the miniaturized actuation system, this work is expected to improve the outcome of vitrectomy with safe and accurate navigation.
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Affiliation(s)
- Muhammad Umar Farooq
- Department of Mechanical Engineering, Chonnam National University, Gwangju, 61186, South Korea
| | - Binxiang Xu
- Department of Mechanical Engineering, Chonnam National University, Gwangju, 61186, South Korea
| | - Seong Young Ko
- Department of Mechanical Engineering, Chonnam National University, Gwangju, 61186, South Korea.
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Ceylan H, Yasa IC, Yasa O, Tabak AF, Giltinan J, Sitti M. 3D-Printed Biodegradable Microswimmer for Theranostic Cargo Delivery and Release. ACS NANO 2019; 13:3353-3362. [PMID: 30742410 PMCID: PMC6728090 DOI: 10.1021/acsnano.8b09233] [Citation(s) in RCA: 203] [Impact Index Per Article: 40.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 02/11/2019] [Indexed: 05/19/2023]
Abstract
Untethered mobile microrobots have the potential to leverage minimally invasive theranostic functions precisely and efficiently in hard-to-reach, confined, and delicate inner body sites. However, such a complex task requires an integrated design and engineering, where powering, control, environmental sensing, medical functionality, and biodegradability need to be considered altogether. The present study reports a hydrogel-based, magnetically powered and controlled, enzymatically degradable microswimmer, which is responsive to the pathological markers in its microenvironment for theranostic cargo delivery and release tasks. We design a double-helical architecture enabling volumetric cargo loading and swimming capabilities under rotational magnetic fields and a 3D-printed optimized 3D microswimmer (length = 20 μm and diameter = 6 μm) using two-photon polymerization from a magnetic precursor suspension composed from gelatin methacryloyl and biofunctionalized superparamagnetic iron oxide nanoparticles. At normal physiological concentrations, we show that matrix metalloproteinase-2 (MMP-2) enzyme could entirely degrade the microswimmer in 118 h to solubilized nontoxic products. The microswimmer rapidly responds to the pathological concentrations of MMP-2 by swelling and thereby boosting the release of the embedded cargo molecules. In addition to delivery of the drug type of therapeutic cargo molecules completely to the given microenvironment after full degradation, microswimmers can also release other functional cargos. As an example demonstration, anti-ErbB 2 antibody-tagged magnetic nanoparticles are released from the fully degraded microswimmers for targeted labeling of SKBR3 breast cancer cells in vitro toward a potential future scenario of medical imaging of remaining cancer tissue sites after a microswimmer-based therapeutic delivery operation.
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Affiliation(s)
- Hakan Ceylan
- Physical
Intelligence Department, Max Planck Institute
for Intelligent Systems, 70569 Stuttgart, Germany
| | - Immihan Ceren Yasa
- Physical
Intelligence Department, Max Planck Institute
for Intelligent Systems, 70569 Stuttgart, Germany
| | - Oncay Yasa
- Physical
Intelligence Department, Max Planck Institute
for Intelligent Systems, 70569 Stuttgart, Germany
| | - Ahmet Fatih Tabak
- Physical
Intelligence Department, Max Planck Institute
for Intelligent Systems, 70569 Stuttgart, Germany
- Mechatronics
Engineering Department, Bahcesehir University, 34353 Istanbul, Turkey
| | - Joshua Giltinan
- Physical
Intelligence Department, Max Planck Institute
for Intelligent Systems, 70569 Stuttgart, Germany
| | - Metin Sitti
- Physical
Intelligence Department, Max Planck Institute
for Intelligent Systems, 70569 Stuttgart, Germany
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Ortega S, Fabelo H, Iakovidis DK, Koulaouzidis A, Callico GM. Use of Hyperspectral/Multispectral Imaging in Gastroenterology. Shedding Some⁻Different⁻Light into the Dark. J Clin Med 2019; 8:E36. [PMID: 30609685 PMCID: PMC6352071 DOI: 10.3390/jcm8010036] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 12/14/2018] [Accepted: 12/26/2018] [Indexed: 01/27/2023] Open
Abstract
Hyperspectral/Multispectral imaging (HSI/MSI) technologies are able to sample from tens to hundreds of spectral channels within the electromagnetic spectrum, exceeding the capabilities of human vision. These spectral techniques are based on the principle that every material has a different response (reflection and absorption) to different wavelengths. Thereby, this technology facilitates the discrimination between different materials. HSI has demonstrated good discrimination capabilities for materials in fields, for instance, remote sensing, pollution monitoring, field surveillance, food quality, agriculture, astronomy, geological mapping, and currently, also in medicine. HSI technology allows tissue observation beyond the limitations of the human eye. Moreover, many researchers are using HSI as a new diagnosis tool to analyze optical properties of tissue. Recently, HSI has shown good performance in identifying human diseases in a non-invasive manner. In this paper, we show the potential use of these technologies in the medical domain, with emphasis in the current advances in gastroenterology. The main aim of this review is to provide an overview of contemporary concepts regarding HSI technology together with state-of-art systems and applications in gastroenterology. Finally, we discuss the current limitations and upcoming trends of HSI in gastroenterology.
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Affiliation(s)
- Samuel Ortega
- Institute for Applied Microelectronics (IUMA), University of Las Palmas de Gran Canaria (ULPGC), Las Palmas de Gran Canaria 35017, Spain.
| | - Himar Fabelo
- Institute for Applied Microelectronics (IUMA), University of Las Palmas de Gran Canaria (ULPGC), Las Palmas de Gran Canaria 35017, Spain.
| | - Dimitris K Iakovidis
- Dept. of Computer Science and Biomedical Informatics, University of Thessaly, 35131 Lamia, Greece.
| | | | - Gustavo M Callico
- Institute for Applied Microelectronics (IUMA), University of Las Palmas de Gran Canaria (ULPGC), Las Palmas de Gran Canaria 35017, Spain.
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Yamin M. IT applications in healthcare management: a survey. INTERNATIONAL JOURNAL OF INFORMATION TECHNOLOGY : AN OFFICIAL JOURNAL OF BHARATI VIDYAPEETH'S INSTITUTE OF COMPUTER APPLICATIONS AND MANAGEMENT 2018; 10:503-509. [PMID: 32289102 PMCID: PMC7111554 DOI: 10.1007/s41870-018-0203-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 05/28/2018] [Indexed: 11/28/2022]
Abstract
Healthcare management is currently undergoing substantial changes, and reshaping our perception of the medical field. One spectrum is that of the considerable changes that we see in surgical machines and equipment, and the way the procedures are performed. Computing power, Internet and associated technologies are transforming surgical operations into model based procedures. The other spectrum is the management side of healthcare, which is equally critical to the medical profession. In particular, recent advances in the field of Information Technology (IT) is assisting in better management of health appointments and record management. With the proliferation of IT and management, data is now playing a vital role in diagnostics, drug administration and management of healthcare services. With the advancement in data processing, large amounts of medical data collected by medical centres and providers, can now be mined and analysed to assist in planning and making appropriate decisions. In this article, we shall provide an overview of the role of IT that have been reshaping the healthcare management, hospital, health profession and industry.
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Affiliation(s)
- Mohammad Yamin
- Department of MIS, Faculty of Economics and Admin, King Abdulaziz University, Jeddah, Saudi Arabia
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11
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Abstract
Recent advances and review of literature
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Affiliation(s)
| | - Joydeep Sinha
- King's College Hospital , London ; Joint CAG Leader, King's Health Partners, King's College London
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Díaz CE, Fernández R, Armada M, García F. A research review on clinical needs, technical requirements, and normativity in the design of surgical robots. Int J Med Robot 2017; 13. [PMID: 28105687 DOI: 10.1002/rcs.1801] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 11/04/2016] [Accepted: 11/21/2016] [Indexed: 12/14/2022]
Abstract
Nowadays robots play an important role in society, mainly due to the significant benefits they provide when utilized for assisting human beings in the execution of dangerous or repetitive tasks. Medicine is one of the fields in which robots are gaining greater use and development, especially those employed in minimally invasive surgery (MIS). However, due to the particular conditions of the human body where robots have to act, the design of these systems is complex, not only from a technical point of view, but also because the clinical needs and the normativity aspects are important considerations that have to be taken into account in order to achieve better performances and more secure systems for patients and surgeons. Thus, this paper explores the clinical needs and the technical requirements that will trace the roadmap for the next scientific and technological advances in the field of robotic surgery, the metrics that should be defined for safe technology development and the standards that are being elaborated for boosting the industry and facilitating systems integration.
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Affiliation(s)
- Carlos Eduardo Díaz
- Universidad Tecnológica del Valle de Toluca, Carretera del Departamento del D. F., Lerma, México
| | - Roemi Fernández
- Centre for Automation and Robotics CAR (CSIC-UPM), Madrid, Spain
| | - Manuel Armada
- Centre for Automation and Robotics CAR (CSIC-UPM), Madrid, Spain
| | - Felipe García
- Universidad Tecnológica del Valle de Toluca, Carretera del Departamento del D. F., Lerma, México
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