Robotic Oncological Surgery: Technology That's Here to Stay?

Comparison of FreeHand® robot-assisted with human-assisted laparoscopic fundoplication

Objective: To compare the safety, operative time and feasibilty of FreeHand^® robot (FreeHand Ltd, Guildford, United Kingdom) with manual camera control approach for Laparoscopic Fundoplication.Material and methods: A case control study was performed for patients undergoing laparoscopic fundoplication. Primary outcome was operative time; secondary outcomes included length of stay, post-operative morbidity, symptoms at first follow-up and total post-operative out-patient visits.Results: Forty-four patients underwent laparoscopic fundoplication between January 2014 and June 2016. Twenty-six (59%) underwent conventional human-assisted fundoplication while 18 (41%) had FreeHand^® robot assisted procedures. Mean operative time for conventional laparoscopic fundoplication was 165 min compared with 129 min in the robot-assisted group, saving 36 min (p < .001).The median length of stay was 1.5 days in the robot-assisted as compared to two days in the conventional group. Sixteen percent of robot-assisted as opposed to 30% of conventional group patients experienced complications. There was no 30-day mortality. Two patients required more than one post-operative clinic visit in robot-assisted against six in conventional group.Conclusion: Robot-assisted fundoplication is safe, feasible and reduces operative time. Furthermore, this negates need of assistant. Mean operative time for robot-assisted fundoplication was 36 min less than for conventional fundoplication. Advantages also include fewer adverse events, shorter length of stay and less post-operative clinic visits.

Robotic Colorectal Surgery: Our Initial Experience

Robotic colorectal surgery was first performed at our institution in January 2014. The objective of this study is to present our initial experience with robotic colorectal surgery. This is a retrospective review of the prospectively collected data of all patients who underwent robotic colorectal surgery from January 2014 to April 2015. Baseline, perioperative, and postoperative data were obtained for analysis. A total of 101 patients with a mean age of 56 and a body mass index of 31 underwent robotic colorectal surgery between January 2014 and April 2015. The indication for surgery was malignancy in approximately 40 per cent, diverticulitis in 40 per cent, and benign diseases in 20 per cent of the patients. The most common operation was sigmoidectomy (40%) followed by low anterior resection (36%), abdominoperineal resection (7%), right hemicolectomy (6%), rectopexy (6%), total colectomy (4%), and left hemicolectomy (1%). The mean operative and docking time was 226 (range, 104–496) minutes and 3 (range, 1–18) minutes, respectively. The median number of lymph nodes harvested was 19 (range, 0–34). The median length of stay was 3 (range, 1–18) days. Anastomotic leak occurred in one patient and surgical site infection in two patients. Robotic colorectal surgery is safe and technically feasible.

An Infant Development-inspired Approach to Robot Hand-eye Coordination

This paper presents a novel developmental learning approach for hand-eye coordination in an autonomous robotic system. Robotic hand-eye coordination plays an important role in dealing with real-time environments. Under the approach, infant developmental patterns are introduced to build our robot's learning system. The method works by first constructing a brain-like computational structure to control the robot, and then by using infant behavioural patterns to build a hand-eye coordination learning algorithm. This work is supported by an experimental evaluation, which shows that the control system is implemented simply, and that the learning approach provides fast and incremental learning of behavioural competence.

A Quadratic Nonlinear Prediction-Based Heart Motion Model following Control Algorithm in Robotic-Assisted Beating Heart Surgery

Off-pump coronary artery bypass graft surgery outperforms the traditional on-pump surgery because the assisted robotic tools can cancel the relative motion between the beating heart and the robotic tools, which reduces post-surgery complications for patients. The challenge for the robot assisted tool when tracking the beating heart is the abrupt change caused by the nonlinear nature of heart motion and high precision surgery requirements. A characteristic analysis of 3D heart motion data through bi-spectral analysis demonstrates the quadratic nonlinearity in heart motion. Therefore, it is necessary to introduce nonlinear heart motion prediction into the motion tracking control procedures. In this paper, the heart motion tracking problem is transformed into a heart motion model following problem by including the adaptive heart motion model into the controller. Moreover, the model following algorithm with the nonlinear heart motion model embedded inside provides more accurate future reference by the quadratic term of sinusoid series, which could enhance the tracking accuracy of sharp change point and approximate the motion with sufficient detail. The experiment results indicate that the proposed algorithm outperforms the linear prediction-based model following controller in terms of tracking accuracy (root mean square).