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Chen G, Jin S, Xia Q, Wang Z, Shi Z, Chen G, Hong Y, Fan X, Lin H. Insight into the history and trends of surgical simulation training in education: a bibliometric analysis. Int J Surg 2023; 109:2204-2213. [PMID: 37204478 PMCID: PMC10442119 DOI: 10.1097/js9.0000000000000468] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/01/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND Surgical simulation training enables surgeons to acquire clinical experience or skills from the operating room to the simulation environment. Historically, it has changed with advances in science and technology. Moreover, no previous study has analyzed this field from the bibliometric analysis dimension. The study aimed to review changes in surgical simulation training worldwide using bibliometric software. MATERIALS AND METHODS Two searches were performed on the core collection database, Web of Science, regarding data from 1991 to the end of 2020 using three topic words (surgery, training, and simulation). From 1 January 2000, to 15 May 2022, the keyword 'robotic' was added for the hotspot exploration. The data were chiefly analyzed by publication date, country, author(s), and keywords using bibliometric software. RESULTS A total of 5285 articles were initially analyzed, from which it was clear that laparoscopic skill, three-dimensional printing, and virtual reality were the main focuses during those study periods. Subsequently, 348 publications on robotic surgery training were identified. CONCLUSION This study systematically summarizes the current status in the field of surgical simulation training and provides insights into the research focuses and future hotspot in a global context.
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Affiliation(s)
- Guoqiao Chen
- Department of General Surgery
- Department of Emergency Medicine, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University
| | | | | | - Zhifei Wang
- Department of General Surgery, Zhejiang Province People’s Hospital
| | | | | | - Yucai Hong
- Department of Emergency Medicine, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University
| | | | - Hui Lin
- Department of General Surgery
- College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China
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2
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Tiberkak A, Hentout A, Belkhir A. WebRTC-based MOSR remote control of mobile manipulators. INTERNATIONAL JOURNAL OF INTELLIGENT ROBOTICS AND APPLICATIONS 2023; 7:304-320. [PMID: 37266512 PMCID: PMC10129311 DOI: 10.1007/s41315-023-00281-3] [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: 03/11/2022] [Accepted: 04/11/2023] [Indexed: 06/03/2023]
Abstract
This article describes a contribution to the field of telerobotics via the Internet through the development of a web-based platform allowing the remote control of robots by multiple users, simultaneously. It also deals with minimizing the execution times of tasks by reducing connection and interaction delays. For this purpose, the Web Real-Time Communication (WebRTC) technology is utilized. The developed remote manipulation system allows the operators to visualize the robot, its surroundings and the data incoming from its sensors, and to carry out basic tasks, either independently by the manipulator or by the mobile robot, or jointly by both mechanical sub-systems. In addition, to ensure the control of the remote robot by several operators simultaneously, a priority system managing parallel tasks and a chat system between the operators have been proposed. Besides, many teams are able to exploit the robot, concurrently. The WebRTC-based Multiple Operator Single Robot (MOSR) telerobotic platform is validated on the emulator of the RobuTER/ULM mobile manipulator through various scenarios of primitive tasks over the Internet.
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Affiliation(s)
- Allal Tiberkak
- Department of Mathematics and Computer Science, Faculty of Sciences, University Dr. Yahia Fares of Medea, Boulevard de l’ALN, Ain D’heb, 26000 Medea, Algeria
| | - Abdelfetah Hentout
- Division of Robotics and Industrial Automation (DPR), Centre for Development of Advanced Technologies (CDTA), BP 17, 16303 Baba Hassen, Algiers Algeria
| | - Abdelkader Belkhir
- Computer Systems Laboratory, Faculty of Electronics and Computer Science, University of Sciences and Technology Houari Boumediene (USTHB), BP 32, 16111 Bab Ezzouar, Algiers Algeria
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3
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Das R, Baishya NJ, Bhattacharya B. A review on tele-manipulators for remote diagnostic procedures and surgery. CSI TRANSACTIONS ON ICT 2023. [PMCID: PMC10040908 DOI: 10.1007/s40012-023-00373-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
With modern medicine and healthcare services improving in leaps and bounds, the integration of telemedicine has helped in expanding these specialised healthcare services to remote locations. Healthcare telerobotic systems form a component of telemedicine, which allows medical intervention from a distance. It has been nearly 40 years since a robotic technology, PUMA 560, was introduced to perform a stereotaxic biopsy in the brain. The use of telemanipulators for remote surgical procedures began around 1995, with the Aesop, the Zeus, and the da Vinci robotic surgery systems. Since then, the utilisation of robots has steadily increased in diverse healthcare disciplines, from clinical diagnosis to telesurgery. The telemanipulator system functions in a master–slave protocol mode, with the doctor operating the master system, aided by audio-visual and haptic feedback. Based on the control commands from the master, the slave system, a remote manipulator, interacts directly with the patient. It eliminates the requirement for the doctor to be physically present in the spatial vicinity of the patient by virtually bringing expert-guided medical services to them. Post the Covid-19 pandemic, an exponential surge in the utilisation of telerobotic systems has been observed. This study aims to present an organised review of the state-of-the-art telemanipulators used for remote diagnostic procedures and surgeries, highlighting their challenges and scope for future research and development.
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Affiliation(s)
- Ratnangshu Das
- grid.417965.80000 0000 8702 0100Department of Mechanical Engineering, Indian Institute of Technology, Kanpur, Kalyanpur, Kanpur, Uttar Pradesh 208016 India
| | - Nayan Jyoti Baishya
- grid.417965.80000 0000 8702 0100Department of Mechanical Engineering, Indian Institute of Technology, Kanpur, Kalyanpur, Kanpur, Uttar Pradesh 208016 India
| | - Bishakh Bhattacharya
- grid.417965.80000 0000 8702 0100Department of Mechanical Engineering, Indian Institute of Technology, Kanpur, Kalyanpur, Kanpur, Uttar Pradesh 208016 India
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4
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The Availability, Cost, Limitations, Learning Curve and Future of Robotic Systems in Urology and Prostate Cancer Surgery. J Clin Med 2023; 12:jcm12062268. [PMID: 36983269 PMCID: PMC10053304 DOI: 10.3390/jcm12062268] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 03/10/2023] [Accepted: 03/12/2023] [Indexed: 03/17/2023] Open
Abstract
Robot-assisted surgical systems (RASS) have revolutionised the management of many urological conditions over the last two decades with robot-assisted radical prostatectomy (RARP) now being considered by many to be the preferred surgical approach. Intuitive Surgical has dominated the market during this time period with successive iterations of the da Vinci model. The expiration of patents has opened the RASS market and several new contenders have become available or are currently in development. This comprehensive narrative review aims to explore the merits of each robotic system as well as the evidence and barriers to their use. The newly developed RASS have increased the versality of robotic surgical systems to a wider range of settings through advancement in technology. The increased competition may result in an overall reduction in cost, broadening the accessibility of RASS. Learning curves and training remain a barrier to their use, but the situation appears to be improving through dedicated training programmes. Outcomes for RARP have been well investigated and tend to support improved early functional outcomes. Overall, the rapid developments in the field of robot-assisted surgery indicate the beginning of a promising new era to further enhance urological surgery.
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5
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Gupta R, Chopra D, Hemal AK, Mukherjee S, Rogers CG, Sundaram CP, Tewari AK. The first SURS World Congress of Robotic Surgery at Mount Sinai Hospital in New York City: A tribute to the past and the future of robotic urologic surgery. BJUI COMPASS 2023; 4:243-245. [PMID: 37025466 PMCID: PMC10071073 DOI: 10.1002/bco2.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/06/2023] [Indexed: 02/16/2023] Open
Affiliation(s)
- Raghav Gupta
- Department of Urology Icahn School of Medicine at Mount Sinai New York New York USA
| | | | - Ashok K. Hemal
- Department of Urology Wake Forest University School of Medicine Winston‐Salem North Carolina USA
| | - Siddhartha Mukherjee
- Department of Medicine Columbia University Irving Medical Center New York New York USA
| | - Craig G. Rogers
- Department of Urology Henry Ford Health System Detroit Michigan USA
| | - Chandru P. Sundaram
- Department of Urology Indiana University School of Medicine Indianapolis Indiana USA
| | - Ashutosh K. Tewari
- Department of Urology Icahn School of Medicine at Mount Sinai New York New York USA
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6
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Lazar JF, Hwalek AE. A Review of Robotic Thoracic Surgery Adoption and Future Innovations. Thorac Surg Clin 2023; 33:1-10. [DOI: 10.1016/j.thorsurg.2022.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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7
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Seleem IA, El-Hussieny H, Ishii H. Recent Developments of Actuation Mechanisms for Continuum Robots: A Review. INTERNATIONAL JOURNAL OF CONTROL, AUTOMATION, AND SYSTEMS 2023; 21:1592-1609. [PMID: 37151813 PMCID: PMC10153025 DOI: 10.1007/s12555-022-0159-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 06/08/2022] [Accepted: 06/14/2022] [Indexed: 05/09/2023]
Abstract
Traditional rigid robots face significant challenges in congested and tight environments, including bulky size, maneuverability, and safety limitations. Thus, soft continuum robots, inspired by the incredible capabilities of biological appendages such as octopus arms, starfish, and worms, have shown promising performance in complex environments due to their compliance, adaptability, and safety. Different actuation techniques are implemented in soft continuum robots to achieve a smoothly bending backbone, including cable-driven actuators, pneumatic actuators, and hydraulic actuation systems. However, designing and developing efficient actuation mechanisms, motion planning approaches, and control algorithms are challenging due to the high degree of redundancy and non-linearity of soft continuum robots. This article profoundly reviews the merits and drawbacks of soft robots' actuation systems concerning their applications to provide the readers with a brief review reference to explore the recent development of soft robots' actuation mechanisms technology. Moreover, the authors have surveyed the recent review studies in controller design of continuum robots as a guidance for future applications.
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Affiliation(s)
- Ibrahim A. Seleem
- Department of Modern Mechanical Engineering, Faculty of Science and Engineering, Waseda University, Tokyo, Japan
- Present Address: Industrial Electronics and Control Engineering Department, Menoufia University, Shibin Al Kawm, Egypt
| | - Haitham El-Hussieny
- Department of Mechatronics and Robotics Engineering, Egypt-Japan University of Science and Technology, Al Gadida City, Egypt
- Present Address: Electrical Engineering Department, Faculty of Engineering (Shoubra), Benha University, Banha, Egypt
| | - Hiroyuki Ishii
- Department of Modern Mechanical Engineering, Faculty of Science and Engineering, Waseda University, Tokyo, Japan
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8
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Surgeon perception of factors affecting the efficiency of conventional and robotic laparoscopy: A Pan India study. Heliyon 2022; 8:e12561. [PMID: 36619437 PMCID: PMC9813728 DOI: 10.1016/j.heliyon.2022.e12561] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 11/09/2022] [Accepted: 12/14/2022] [Indexed: 12/25/2022] Open
Abstract
Background Laparoscopic surgery, being minimally invasive, offers many benefits including faster patient recovery, reduced scarring and lower mortality rate. It is, however, technically challenging and requires a long learning curve. These issues can be overcome by Robot-Assisted Surgery (RAS) systems, which incorporate computer-controlled motions enabling enhanced precision and accuracy. Methods This study involves identifying and verifying various difficulties related to laparoscopy and the role of RAS in their mitigation. It involved 93 surgeons across India, covering a range of demographics, medical specialties and experience. They were interviewed to understand the current status and to compare RAS with conventional laparoscopy. The questionnaire developed for the purpose tests a set of hypotheses related to instruments, comfort, and other factors derived from the available literature as well as inputs from leading laparoscopy surgeons and domain experts. Results A grading system was adopted to evaluate the hypotheses based on the surgeons' responses. A statistical method based on T-test was employed to gain useful inferences from the study. The results showed that early-career surgeons preferred haptic enabled systems. As the experience of the surgeon increases, tissue identification becomes easier, thereby reducing the need for haptic feedback-enabled instruments. Conclusions The surgeons from across the demographics were strongly in the favour of the need for articulated instruments with surgeon-controlled camera systems. They reported a reduction in physical and mental discomfort during surgical procedures using RAS. They also confirmed the similarity in patient outcomes for both conventional laparoscopy and RAS. These insights are expected to be interesting and useful for further research and development in this field.
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9
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Measuring interaction forces in surgical telemanipulation using conventional instruments. ROBOTICA 2022. [DOI: 10.1017/s0263574722001758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Abstract
Minimally invasive surgery (MIS) has been an essential tool in the surgical sector for many years due to its crucial advantages compared to open surgery. To overcome remaining limitations, teleoperated MIS experienced a strong emergence. However, the widespread usage of such systems is hindered by the enormous financial hurdle. The use of standard components and conventional tools for teleoperated MIS can facilitate integration into existing hospital workflows and can be a cost-efficient and versatile approach for research purposes. To compensate for the lack of haptic feedback, some teleoperation setups inherit a sensor system allowing them to record interaction forces and display them at the user interface. In research and in commercially available systems, different positions for the sensor can be found. In this paper, mechanical interfaces for the guidance and actuation of non-wristed and wristed standard instruments are presented. Furthermore, a method for the extracorporeal measurement of interaction forces is presented, characterized, and discussed. The overall mean relative error of the magnitude of the interaction force is 9.4%, while the overall mean absolute error of the force vector is 14.4
$^{\circ }$
, both below the respective human differential perception threshold. The presented measurement method is a simple, yet sufficiently accurate approach to measure interaction forces in surgical telemanipulation.
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10
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Kossowsky H, Farajian M, Nisky I. The Effect of Kinesthetic and Artificial Tactile Noise and Variability on Stiffness Perception. IEEE TRANSACTIONS ON HAPTICS 2022; 15:351-362. [PMID: 35271449 DOI: 10.1109/toh.2022.3158386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Robot-assisted minimally invasive surgeries (RAMIS) have many benefits. A disadvantage, however, is the lack of haptic feedback. Haptic feedback is comprised of kinesthetic and tactile information, and we use both to form stiffness perception. Applying both kinesthetic and tactile feedback can enable more precise feedback than kinesthetic feedback alone. However, during remote surgeries, haptic noises and variations can be present. Therefore, toward designing haptic feedback for RAMIS, it is important to understand the effect of haptic manipulations on stiffness perception. We assessed the effect of two manipulations using stiffness discrimination tasks in which participants received force feedback and artificial skin stretch. In Experiment 1, we added sinusoidal noise to the artificial tactile signal, and found that the noise did not affect participants' stiffness perception or uncertainty. In Experiment 2, we varied either the kinesthetic or the artificial tactile information between consecutive interactions with an object. We found that the both forms of variability did not affect stiffness perception, but kinesthetic variability increased participants' uncertainty. We show that haptic feedback, comprised of force feedback and artificial skin stretch, provides robust haptic information even in the presence of noise and variability, and hence can potentially be both beneficial and viable in RAMIS.
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11
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Eden J, Bräcklein M, Ibáñez J, Barsakcioglu DY, Di Pino G, Farina D, Burdet E, Mehring C. Principles of human movement augmentation and the challenges in making it a reality. Nat Commun 2022; 13:1345. [PMID: 35292665 PMCID: PMC8924218 DOI: 10.1038/s41467-022-28725-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 02/04/2022] [Indexed: 12/23/2022] Open
Abstract
Augmenting the body with artificial limbs controlled concurrently to one's natural limbs has long appeared in science fiction, but recent technological and neuroscientific advances have begun to make this possible. By allowing individuals to achieve otherwise impossible actions, movement augmentation could revolutionize medical and industrial applications and profoundly change the way humans interact with the environment. Here, we construct a movement augmentation taxonomy through what is augmented and how it is achieved. With this framework, we analyze augmentation that extends the number of degrees-of-freedom, discuss critical features of effective augmentation such as physiological control signals, sensory feedback and learning as well as application scenarios, and propose a vision for the field.
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Affiliation(s)
- Jonathan Eden
- Department of Bioengineering, Imperial College of Science, Technology and Medicine, London, UK
| | - Mario Bräcklein
- Department of Bioengineering, Imperial College of Science, Technology and Medicine, London, UK
| | - Jaime Ibáñez
- Department of Bioengineering, Imperial College of Science, Technology and Medicine, London, UK.,BSICoS, IIS Aragón, Universidad de Zaragoza, Zaragoza, Spain.,Department of Clinical and Movement Neurosciences, Institute of Neurology, University College London, London, UK
| | | | - Giovanni Di Pino
- NEXT: Neurophysiology and Neuroengineering of Human-Technology Interaction Research Unit, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Dario Farina
- Department of Bioengineering, Imperial College of Science, Technology and Medicine, London, UK
| | - Etienne Burdet
- Department of Bioengineering, Imperial College of Science, Technology and Medicine, London, UK.
| | - Carsten Mehring
- Bernstein Center Freiburg, University of Freiburg, Freiburg im Breisgau, 79104, Germany.,Faculty of Biology, University of Freiburg, Freiburg im Breisgau, 79104, Germany
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12
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Overview of Artificial Intelligence in Medicine. Artif Intell Med 2022. [DOI: 10.1007/978-981-19-1223-8_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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13
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Asai A, Konno M, Taniguchi M, Vecchione A, Ishii H. Computational healthcare: Present and future perspectives (Review). Exp Ther Med 2021; 22:1351. [PMID: 34659497 PMCID: PMC8515560 DOI: 10.3892/etm.2021.10786] [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: 01/14/2021] [Accepted: 07/19/2021] [Indexed: 12/05/2022] Open
Abstract
Artificial intelligence (AI) has been developed through repeated new discoveries since around 1960. The use of AI is now becoming widespread within society and our daily lives. AI is also being introduced into healthcare, such as medicine and drug development; however, it is currently biased towards specific domains. The present review traces the history of the development of various AI-based applications in healthcare and compares AI-based healthcare with conventional healthcare to show the future prospects for this type of care. Knowledge of the past and present development of AI-based applications would be useful for the future utilization of novel AI approaches in healthcare.
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Affiliation(s)
- Ayumu Asai
- Center of Medical Innovation and Translational Research, Department of Medical Data Science, Graduate School of Medicine, Osaka University, Suita, Osaka 565-0871, Japan.,Artificial Intelligence Research Center, Osaka University, Ibaraki, Osaka 567-0047, Japan.,The Institute of Scientific and Industrial Research, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - Masamitsu Konno
- Center of Medical Innovation and Translational Research, Department of Medical Data Science, Graduate School of Medicine, Osaka University, Suita, Osaka 565-0871, Japan
| | - Masateru Taniguchi
- The Institute of Scientific and Industrial Research, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - Andrea Vecchione
- Department of Clinical and Molecular Medicine, University of Rome 'Sapienza', Santo Andrea Hospital, I-1035-00189 Rome, Italy
| | - Hideshi Ishii
- Center of Medical Innovation and Translational Research, Department of Medical Data Science, Graduate School of Medicine, Osaka University, Suita, Osaka 565-0871, Japan
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14
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Ning G, Zhang X, Liao H. Autonomic Robotic Ultrasound Imaging System Based on Reinforcement Learning. IEEE Trans Biomed Eng 2021; 68:2787-2797. [PMID: 33497322 DOI: 10.1109/tbme.2021.3054413] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE In this paper, we introduce an autonomous robotic ultrasound (US) imaging system based on reinforcement learning (RL). The proposed system and framework are committed to controlling the US probe to perform fully autonomous imaging of a soft, moving and marker-less target based only on single RGB images of the scene. METHODS We propose several different approaches and methods to achieve the following objectives: real-time US probe controlling, soft surface constant force tracking and automatic imaging. First, to express the state of the robotic US imaging task, we proposed a state representation model to reduce the dimensionality of the imaging state and encode the force and US information into the scene image space. Then, an RL agent is trained by a policy gradient theorem based RL model with the single RGB image as the only observation. To achieve adaptable constant force tracking between the US probe and the soft moving target, we propose a force-to-displacement control method based on an admittance controller. RESULTS In the simulation experiment, we verified the feasibility of the integrated method. Furthermore, we evaluated the proposed force-to-displacement method to demonstrate the safety and effectiveness of adaptable constant force tracking. Finally, we conducted phantom and volunteer experiments to verify the feasibility of the method on a real system. CONCLUSION The experiments indicated that our approaches were stable and feasible in the autonomic and accurate control of the US probe. SIGNIFICANCE The proposed system has potential application value in the image-guided surgery and robotic surgery.
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15
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Alip SKL, Koukourikis P, Han WK, Rha KH, Na J. Comparing Revo-i and da Vinci in Retzius-sparing robot-assisted radical prostatectomy: a preliminary propensity score analysis of outcomes. J Endourol 2021; 36:104-110. [PMID: 34375129 DOI: 10.1089/end.2021.0421] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE . This study aims to compare perioperative and oncologic outcomes between matched cohorts of localized Prostate cancer (PCa) operated on by the same surgeon using the DaVinci Si robot and the Revo-i robot. MATERIALS AND METHODS Non-metastatic prostate cancer patients undergoing Retzius-sparing robot-assisted laparoscopic radical prostatectomy (RS-RARP) from January 2016 to December 2020 were matched one-to-one (33:33) to DaVinci Si controls using nearest neighbor propensity score matching according to the following covariates: age, American Society of Anesthesiology (ASA) score, body mass index, previous abdominal and endoscopic surgery, pre-operative prostate specific antigen (PSA), prostate volume, ISUP grade group, tumor stage, and need for pelvic lymphadenectomy. Outcomes of interest were estimated blood loss, length-of-stay, complication rate, operative times, positive surgical margins, and biochemical recurrence at six months. RESULTS Both cohorts were similar in estimated blood loss, rate of margin positivity, and rate of complications. Length of stay was significantly shorter with the Revo-i cohort. The DaVinci showed faster console, suture, total operation times. Positive margin rate and biochemical recurrence at six months were similar in both groups. CONCLUSION Despite the longer suture, console, and operative time compared to the da Vinci in the authors' institution, the Revo-i robot-assisted radical prostatectomy had equivalent short-term oncologic outcomes with the da Vinci standard.
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Affiliation(s)
- Sylvia Karina Lacuna Alip
- University of the Philippines-Philippine General Hospital Department of Surgery, 595255, Urology, Manila, Philippines.,Yonsei University College of Medicine, 37991, Institute of Urology, Seoul, Korea (the Republic of);
| | - Periklis Koukourikis
- Yonsei University College of Medicine, 37991, Institute of Urology, Seoul, Korea (the Republic of);
| | - Woong Kyu Han
- Yonsei University Health System, Yonsei University College of Medicine, Institute of Urology, Seoul, Korea (the Republic of);
| | - Koon Ho Rha
- Yonsei University College of Medicine, Institute of Urology, Seoul, Korea (the Republic of);
| | - Joonchae Na
- Yonsei University College of Medicine, 37991, Institute of Urology, Seoul, Korea (the Republic of);
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16
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Shah AA, Bandari J, Pelzman D, Davies BJ, Jacobs BL. Diffusion and adoption of the surgical robot in urology. Transl Androl Urol 2021; 10:2151-2157. [PMID: 34159097 PMCID: PMC8185660 DOI: 10.21037/tau.2019.11.33] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Over the last two decades, robotic surgery has become a mainstay in hospital systems around the world. Leading this charge has been Intuitive Surgical Inc.’s da Vinci robotic system (Sunnyvale, CA, USA). Through its innovative technology and unique revenue model, Intuitive has installed 4,986 robotic surgical systems worldwide in the last two decades. The rapid rate of adoption and diffusion of the surgical robot has been propelled by many important industry-specific factors. In this review, we propose a model that explains the successful adoption of robotic surgery due to its three core groups: the surgeon, the hospital administrator, and the patient.
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Affiliation(s)
- Anup A Shah
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jathin Bandari
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Daniel Pelzman
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Benjamin J Davies
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Bruce L Jacobs
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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17
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A learning robot for cognitive camera control in minimally invasive surgery. Surg Endosc 2021; 35:5365-5374. [PMID: 33904989 PMCID: PMC8346448 DOI: 10.1007/s00464-021-08509-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 04/07/2021] [Indexed: 12/13/2022]
Abstract
Background We demonstrate the first self-learning, context-sensitive, autonomous camera-guiding robot applicable to minimally invasive surgery. The majority of surgical robots nowadays are telemanipulators without autonomous capabilities. Autonomous systems have been developed for laparoscopic camera guidance, however following simple rules and not adapting their behavior to specific tasks, procedures, or surgeons. Methods The herein presented methodology allows different robot kinematics to perceive their environment, interpret it according to a knowledge base and perform context-aware actions. For training, twenty operations were conducted with human camera guidance by a single surgeon. Subsequently, we experimentally evaluated the cognitive robotic camera control. A VIKY EP system and a KUKA LWR 4 robot were trained on data from manual camera guidance after completion of the surgeon’s learning curve. Second, only data from VIKY EP were used to train the LWR and finally data from training with the LWR were used to re-train the LWR. Results The duration of each operation decreased with the robot’s increasing experience from 1704 s ± 244 s to 1406 s ± 112 s, and 1197 s. Camera guidance quality (good/neutral/poor) improved from 38.6/53.4/7.9 to 49.4/46.3/4.1% and 56.2/41.0/2.8%. Conclusions The cognitive camera robot improved its performance with experience, laying the foundation for a new generation of cognitive surgical robots that adapt to a surgeon’s needs. Supplementary Information The online version contains supplementary material available at 10.1007/s00464-021-08509-8.
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Felsenreich DM, Gachabayov M, Karas J, Rojas A, Bergamaschi R. A meta-analysis of DaVinci Si versus Xi in colorectal surgery. Int J Med Robot 2021; 17:e2222. [PMID: 33624433 DOI: 10.1002/rcs.2222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 12/23/2020] [Accepted: 12/29/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND The aim of this meta-analysis was to evaluate whether adoption of DaVinci Xi® had any impact upon intra- and postoperative metrics in colorectal surgery. METHODS The Pubmed, CINAHL, Cochrane Library and MEDLINE (Ovid) databases were systematically searched. Operating time as well as docking and surgeon console times were the primary endpoints. Conversion and postoperative complication rates were the secondary endpoints. RESULTS Six studies totaling 610 patients (320 Si and 290 Xi) were included. Total operating time [MD (95% CI) = 30.553 (15.071, 46.035); p < 0.001], docking time [MD (95% CI) = 4.178 (2.120, 6.235); p < 0.001] and surgeon console time [MD (95% CI) = 17.246 (-0.479, 34.971); p = 0.056] were longer in DaVinci Si® as compared to DaVinci Xi® . No significant difference was found in conversion (p = 0.816) and postoperative complication rates (p = 0.405). CONCLUSION This meta-analysis found that the adoption of DaVinci Xi® was associated with significantly decreased total operating time as well as docking and surgeon console times. Conversion and complication rates were similar.
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Affiliation(s)
- Daniel Moritz Felsenreich
- Section of Colorectal Surgery, Department of Surgery, Westchester Medical Center, New York Medical College, Valhalla, New York, USA
| | - Mahir Gachabayov
- Section of Colorectal Surgery, Department of Surgery, Westchester Medical Center, New York Medical College, Valhalla, New York, USA
| | - Joshua Karas
- Section of Colorectal Surgery, Department of Surgery, Westchester Medical Center, New York Medical College, Valhalla, New York, USA
| | - Aram Rojas
- Section of Colorectal Surgery, Department of Surgery, Westchester Medical Center, New York Medical College, Valhalla, New York, USA
| | - Roberto Bergamaschi
- Section of Colorectal Surgery, Department of Surgery, Westchester Medical Center, New York Medical College, Valhalla, New York, USA
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Beaman CB, Kaneko N, Meyers PM, Tateshima S. A Review of Robotic Interventional Neuroradiology. AJNR Am J Neuroradiol 2021; 42:808-814. [PMID: 33541906 DOI: 10.3174/ajnr.a6976] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 10/26/2020] [Indexed: 12/20/2022]
Abstract
Robotic interventional neuroradiology is an emerging field with the potential to enhance patient safety, reduce occupational hazards, and expand systems of care. Endovascular robots allow the operator to precisely control guidewires and catheters from a lead-shielded cockpit located several feet (or potentially hundreds of miles) from the patient. This has opened up the possibility of expanding telestroke networks to patients without access to life-saving procedures such as stroke thrombectomy and cerebral aneurysm occlusion by highly-experienced physicians. The prototype machines, first developed in the early 2000s, have evolved into machines capable of a broad range of techniques, while incorporating newly automated maneuvers and safety algorithms. In recent years, preliminary clinical research has been published demonstrating the safety and feasibility of the technology in cerebral angiography and intracranial intervention. The next step is to conduct larger, multisite, prospective studies to assess generalizability and, ultimately, improve patient outcomes in neurovascular disease.
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Affiliation(s)
- C B Beaman
- Department of Neurology (C.B.B.), Columbia University Irving Medical Center, New York, New York
| | - N Kaneko
- Department of Radiological Sciences (N.K., S.T.), David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - P M Meyers
- Department of Radiology and Neurological Surgery (P.M.M.), Columbia University Irving Medical Center, New York, New York
| | - S Tateshima
- Department of Radiological Sciences (N.K., S.T.), David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
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Kong K, Wang S, Li J, Su H. Full-Dimensional Intuitive Motion Mapping Strategy for Minimally Invasive Surgical Robot With Redundant Passive Joints. J Med Device 2021. [DOI: 10.1115/1.4049312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Abstract
Adding redundant passive joints to a robotic arm is an effective way to make the robot overcome the inherent incision constraint of minimally invasive surgery (MIS). However, due to the limited motion accuracy, it is difficult to realize full-dimensional intuitive motion based on traditional multi-axis coordinated control technology in this kind of MIS robots. To solve this problem, a separated position and orientation mapping strategy for MIS robot with redundant passive joints is proposed in the paper. The position and orientation mapping of the strategy are realized by coordinate motion control and joint direct control technique, respectively. To realize the intuitive motion under this condition, an inverse motion mapping method is further proposed. Compared with the existing mapping strategy, the proposed strategy is much more compact as the orientation mapping is greatly simplified. A large number of in vivo trials based on the newly developed prototype have been conducted and results fully verify the effectiveness of the proposed strategy.
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Affiliation(s)
- Kang Kong
- Key Lab of Mechanism Theory and Equipment Design of Ministry of Education, Tianjin University, Tianjin 300354, China
| | - Shuxin Wang
- Key Lab of Mechanism Theory and Equipment Design of Ministry of Education, Tianjin University, Tianjin 300354, China
| | - Jianmin Li
- Key Lab of Mechanism Theory and Equipment Design of Ministry of Education, Tianjin University, Tianjin 300354, China
| | - He Su
- Key Lab of Mechanism Theory and Equipment Design of Ministry of Education, Tianjin University, Tianjin 300354, China
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Abstract
The advent of telerobotic systems has revolutionized various aspects of the industry and human life. This technology is designed to augment human sensorimotor capabilities to extend them beyond natural competence. Classic examples are space and underwater applications when distance and access are the two major physical barriers to be combated with this technology. In modern examples, telerobotic systems have been used in several clinical applications, including teleoperated surgery and telerehabilitation. In this regard, there has been a significant amount of research and development due to the major benefits in terms of medical outcomes. Recently telerobotic systems are combined with advanced artificial intelligence modules to better share the agency with the operator and open new doors of medical automation. In this review paper, we have provided a comprehensive analysis of the literature considering various topologies of telerobotic systems in the medical domain while shedding light on different levels of autonomy for this technology, starting from direct control, going up to command-tracking autonomous telerobots. Existing challenges, including instrumentation, transparency, autonomy, stochastic communication delays, and stability, in addition to the current direction of research related to benefit in telemedicine and medical automation, and future vision of this technology, are discussed in this review paper.
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22
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Banapour P, Yuh B, Chenam A, Shen JK, Ruel N, Han ES, Kim JY, Maghami EG, Pigazzi A, Raz DJ, Singh GP, Wakabayashi M, Woo Y, Fong Y, Lau CS. Readmission and complications after robotic surgery: experience of 10,000 operations at a comprehensive cancer center. J Robot Surg 2020; 15:37-44. [PMID: 32277400 DOI: 10.1007/s11701-020-01077-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 04/02/2020] [Indexed: 01/27/2023]
Abstract
Evaluation of safety is of paramount importance with adoption of novel surgical technology. Although robotic surgery has become widely used in oncologic surgery, analysis of safety is lacking in comparison to traditional techniques. Standardized assessment of robotic surgical outcomes and adverse events following oncologic surgery is necessary for quality improvement with innovative technology. Between 2003 and 2016, 10,013 unique robotic operations were performed in 9,858 patients. Our prospectively maintained database was retrospectively reviewed for hospital readmissions and Clavien-Dindo grade ≥ 2 complications within 30 days. Multivariable logistic regression was used to identify predictors of surgical complications and hospital readmissions. Cases were stratified by discipline: genitourinary (n = 8240), gynecologic (n = 857), thoracic (n = 457), gastrointestinal (n = 322), hepatobiliary (n = 60), ear/nose/throat (n = 44) and general (n = 33). Intraoperative complications occurred in 42 surgeries (0.4%). Postoperative complications occurred in 946 patients [9.4%, highest grade 2 (n = 574), 3 (n = 288), 4 (n = 72), 5 (n = 10)]. Most frequent complications were ileus (154, 16.3%), anemia (91, 9.6%), cardiac arrhythmia (62, 6.6%), deep vein thrombosis/pulmonary embolus (47, 5.0%), wound infection (45, 4.8%) and urinary leak (43, 4.5%). 405 patients (4.0%) required readmission. Most common causes for hospital readmission were ileus (44, 10.9%), urinary leak (23, 5.7%), urinary tract infection (23, 5.7%), intra-abdominal abscess/fluid collection (23, 5.7%), and small bowel obstruction (19, 4.7%). On multivariable analysis, longer operative time and older age predicted complications and readmissions (p ≤ 0.02). Robotic-assisted surgery appears a safe for oncologic surgery with acceptable hospital readmission and complication rates. Older age and longer operative time were associated with complications and readmission.
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Affiliation(s)
- Pooya Banapour
- Department of Surgery, City of Hope National Medical Center, 1500 E. Duarte Rd, MOB L002H, Duarte, CA, 91010, USA.
| | - Bertram Yuh
- Department of Surgery, City of Hope National Medical Center, 1500 E. Duarte Rd, MOB L002H, Duarte, CA, 91010, USA
| | - Avinash Chenam
- Department of Surgery, City of Hope National Medical Center, 1500 E. Duarte Rd, MOB L002H, Duarte, CA, 91010, USA
| | - Jim K Shen
- Department of Surgery, City of Hope National Medical Center, 1500 E. Duarte Rd, MOB L002H, Duarte, CA, 91010, USA
| | - Nora Ruel
- Department of Biostatistics, City of Hope National Medical Center, Duarte, CA, USA
| | - Ernest S Han
- Department of Surgery, City of Hope National Medical Center, 1500 E. Duarte Rd, MOB L002H, Duarte, CA, 91010, USA
| | - Jae Y Kim
- Department of Surgery, City of Hope National Medical Center, 1500 E. Duarte Rd, MOB L002H, Duarte, CA, 91010, USA
| | - Ellie G Maghami
- Department of Surgery, City of Hope National Medical Center, 1500 E. Duarte Rd, MOB L002H, Duarte, CA, 91010, USA
| | - Alessio Pigazzi
- Department of Surgery, City of Hope National Medical Center, 1500 E. Duarte Rd, MOB L002H, Duarte, CA, 91010, USA
| | - Dan J Raz
- Department of Surgery, City of Hope National Medical Center, 1500 E. Duarte Rd, MOB L002H, Duarte, CA, 91010, USA
| | - Gagandeep P Singh
- Department of Surgery, City of Hope National Medical Center, 1500 E. Duarte Rd, MOB L002H, Duarte, CA, 91010, USA
| | - Mark Wakabayashi
- Department of Surgery, City of Hope National Medical Center, 1500 E. Duarte Rd, MOB L002H, Duarte, CA, 91010, USA
| | - Yanghee Woo
- Department of Surgery, City of Hope National Medical Center, 1500 E. Duarte Rd, MOB L002H, Duarte, CA, 91010, USA
| | - Yuman Fong
- Department of Surgery, City of Hope National Medical Center, 1500 E. Duarte Rd, MOB L002H, Duarte, CA, 91010, USA
| | - Clayton S Lau
- Department of Surgery, City of Hope National Medical Center, 1500 E. Duarte Rd, MOB L002H, Duarte, CA, 91010, USA
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Yip HM, Wang Z, Navarro-Alarcon D, Li P, Cheung TH, Greiffenhagen C, Liu YH. A collaborative robotic uterine positioning system for laparoscopic hysterectomy: Design and experiments. Int J Med Robot 2020; 16:e2103. [PMID: 32163664 DOI: 10.1002/rcs.2103] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 03/03/2020] [Accepted: 03/10/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Uterus manipulation is a lengthy and tedious task that is usually performed by a human assistant during laparoscopic hysterectomy. Note that the performance of the assistant may decrease with time. Moreover, under this approach, the primary surgeon does not have direct control over the uterus position. He/she can only verbally request the assistant to place it on a particular configuration. METHODS A robotic system composed of a 3 degrees-of-freedom uterine positioner is developed to assist in changing configuration of the uterus during laparoscopic hysterectomy. The developed system has a remote centre of motion structure; independently controlling the uterus motion with one joint at the time is allowed. RESULTS From the lab experiments, it is found that the robot shows better performance in retaining the uterus position and shows quicker response to the surgeon's instruction. Cadaver studies have been conducted to evaluate the feasibility of the robot. The robot was also applied to real patients in a clinical study. CONCLUSIONS The robot is capable of assisting in uterus manipulation during laparoscopic hysterectomy. However, its user friendliness can be improved by simplifying the docking procedure. Furthermore, a more ergonomic user interface is desired.
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Affiliation(s)
- Hiu Man Yip
- The Chinese University of Hong Kong, Shatin, Hong Kong.,The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Zerui Wang
- The Chinese University of Hong Kong, Shatin, Hong Kong
| | | | - Peng Li
- Harbin Institute of Technology, Shenzhen, China
| | | | | | - Yun-Hui Liu
- The Chinese University of Hong Kong, Shatin, Hong Kong
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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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25
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Ma Q, Kobayashi E, Wang J, Hara K, Suenaga H, Sakuma I, Masamune K. Development and preliminary evaluation of an autonomous surgical system for oral and maxillofacial surgery. Int J Med Robot 2019; 15:e1997. [PMID: 30900789 DOI: 10.1002/rcs.1997] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 02/27/2019] [Accepted: 03/06/2019] [Indexed: 11/12/2022]
Abstract
BACKGROUND Human-related factors affect the accuracy and safety of the oral and maxillofacial surgery (OMS). This study proposed an autonomous surgical system aiming to conduct the OMS under the assistance and surveillance of the surgeon. METHODS A markerless navigation module and a compact OMS robot were seamlessly integrated into this system. The specifications of each module and the working concept of the system were elaborated in this paper. A drilling experiment was conducted on five 3D-printed mandible models to test the pose detecting capability and evaluate the operational performance. RESULTS The experiment showed that this system could successfully guide the robot finishing the operation regardless of the mandible pose. The accuracy of software and hardware are acceptable and potential performance improvement can be achieved in positioning accuracy. CONCLUSION This system proposed a novel concept and a practical solution to decrease the human-related factors on the OMS, which may change the role of the surgeon in the future operating room and finally benefit the outcomes of OMS.
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Affiliation(s)
- Qingchuan Ma
- Graduate School of Engineering, The University of Tokyo, Tokyo, Japan
| | - Etsuko Kobayashi
- Institute of Advanced BioMedical Engineering and Science, Tokyo Women's Medical University, Tokyo, Japan
| | - Junchen Wang
- School of Mechanical Engineering and Automation, Beihang University, Beijing, China
| | - Kazuaki Hara
- Graduate School of Engineering, The University of Tokyo, Tokyo, Japan
| | - Hideyuki Suenaga
- Department of Oral-Maxillofacial Surgery and Orthodontics, The University of Tokyo Hospital, Tokyo, Japan
| | - Ichiro Sakuma
- Graduate School of Engineering, The University of Tokyo, Tokyo, Japan
| | - Ken Masamune
- Institute of Advanced BioMedical Engineering and Science, Tokyo Women's Medical University, Tokyo, Japan
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26
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Connelly TM, Malik Z, Sehgal R, Byrnes G, Coffey JC, Peirce C. The 100 most influential manuscripts in robotic surgery: a bibliometric analysis. J Robot Surg 2019; 14:155-165. [PMID: 30949890 DOI: 10.1007/s11701-019-00956-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Accepted: 03/28/2019] [Indexed: 01/18/2023]
Abstract
Since the first robotic assisted surgery in 1985, the number of procedures performed annually has steadily increased. Bibliometric analysis highlights the key studies that have influenced current practice in a field of interest. We use bibliometric analysis to evaluate the 100 most cited manuscripts on robotic surgery and discuss their content and influence on the evolution of the platform. The terms 'robotic surgery,' 'robot assisted surgery' and 'robot-assisted surgery' were used to search Thomson Reuters Web of Science database for full length, English language manuscripts. The top 100 cited manuscripts were analyzed by manuscript type, surgical specialty, first and last author, institution, year and journal of publication. 14,980 manuscripts were returned. Within the top 100 cited manuscripts, the majority featured urological surgery (n = 28), followed by combined results from multiple surgical subspecialties (n = 15) and colorectal surgery (n = 13). The majority of manuscripts featured case series/reports (n = 42), followed by comparative studies (n = 24). The most cited paper authored by Nelson et al. (432 citations) reviewed technological advances in the field. The year and country with the greatest number of publications were 2009 (n = 15) and the USA (n = 68). The Johns Hopkins University published the most top 100 manuscripts (n = 18). The 100 most cited manuscripts reflect the progression of robotic surgery from a basic instrument-holding platform to today's articulated instruments with 3D technology. From feasibility studies to multicenter trials, this analysis demonstrates how robotic assisted surgery has gained acceptance in urological, colorectal, general, cardiothoracic, orthopedic, maxillofacial and neuro surgery.
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Affiliation(s)
- Tara M Connelly
- Department of Colorectal Surgery, University Hospital Limerick, Dooradoyle, Limerick, Ireland.
| | - Zoya Malik
- Department of Colorectal Surgery, University Hospital Limerick, Dooradoyle, Limerick, Ireland
| | - Rishabh Sehgal
- Department of Colorectal Surgery, University Hospital Limerick, Dooradoyle, Limerick, Ireland
| | - Gerrard Byrnes
- Department of Colorectal Surgery, University Hospital Limerick, Dooradoyle, Limerick, Ireland
| | - J Calvin Coffey
- Department of Colorectal Surgery, University Hospital Limerick, Dooradoyle, Limerick, Ireland
- Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - Colin Peirce
- Department of Colorectal Surgery, University Hospital Limerick, Dooradoyle, Limerick, Ireland
- Graduate Entry Medical School, University of Limerick, Limerick, Ireland
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Tan X, Chng CB, Su Y, Lim KB, Chui CK. Robot-Assisted Training in Laparoscopy Using Deep Reinforcement Learning. IEEE Robot Autom Lett 2019. [DOI: 10.1109/lra.2019.2891311] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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28
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Qian L, Deguet A, Kazanzides P. ARssist: augmented reality on a head-mounted display for the first assistant in robotic surgery. Healthc Technol Lett 2018; 5:194-200. [PMID: 30800322 PMCID: PMC6372092 DOI: 10.1049/htl.2018.5065] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 08/20/2018] [Indexed: 11/23/2022] Open
Abstract
In robot-assisted laparoscopic surgery, the first assistant (FA) is responsible for tasks such as robot docking, passing necessary materials, manipulating hand-held instruments, and helping with trocar planning and placement. The performance of the FA is critical for the outcome of the surgery. The authors introduce ARssist, an augmented reality application based on an optical see-through head-mounted display, to help the FA perform these tasks. ARssist offers (i) real-time three-dimensional rendering of the robotic instruments, hand-held instruments, and endoscope based on a hybrid tracking scheme and (ii) real-time stereo endoscopy that is configurable to suit the FA's hand-eye coordination when operating based on endoscopy feedback. ARssist has the potential to help the FA perform his/her task more efficiently, and hence improve the outcome of robot-assisted laparoscopic surgeries.
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Affiliation(s)
- Long Qian
- Johns Hopkins University, Baltimore, Maryland, USA
| | - Anton Deguet
- Johns Hopkins University, Baltimore, Maryland, USA
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Miura S, Tsuda N, Parque V, Miyashita T. Spiral Folded Adhesive Plaster Optimization for Laparoscopic Surgery. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2018; 2018:151-154. [PMID: 30440361 DOI: 10.1109/embc.2018.8512247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Laparoscopic surgery has the advantage of the minimally invasive for patients. However, the surgery is technically difficult for surgeon because high dexterity is required for suturing in the narrow patient's body. This paper presents a sealing method to locate the adhesive plaster at the incision instead of suturing. The objective is to optimize the plaster material and structure. We made the plaster with the thermally cross-linked gelatin film in a spiral fold because thermally cross-linked gelatin film has the high biocompatibility and tackiness, and a spiral fold has great storage efficiency. In 3 experiments, we measured expansion rate, expansion tension, peeling force, and sealing pressure in a variety of gelatin volume and concentration, and the films diameter. From these experimental results, we optimized the films using response surface method. As a result, the plaster is optimal at gelatin volume 10 mL, gelatin concentration 4 wt %, and films diameters 75 mm. We concluded that the optimized spiral folded adhesive plaster is sufficient in terms of the expansion, tackiness, and sealing properties.
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31
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Hirose K, Aoki T, Furukawa T, Fukushima S, Niioka H, Deguchi S, Hashimoto M. Coherent anti-Stokes Raman scattering rigid endoscope toward robot-assisted surgery. BIOMEDICAL OPTICS EXPRESS 2018; 9:387-396. [PMID: 29552380 PMCID: PMC5854045 DOI: 10.1364/boe.9.000387] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 12/16/2017] [Accepted: 12/18/2017] [Indexed: 05/16/2023]
Abstract
Label-free visualization of nerves and nervous plexuses will improve the preservation of neurological functions in nerve-sparing robot-assisted surgery. We have developed a coherent anti-Stokes Raman scattering (CARS) rigid endoscope to distinguish nerves from other tissues during surgery. The developed endoscope, which has a tube with a diameter of 12 mm and a length of 270 mm, achieved 0.91% image distortion and 8.6% non-uniformity of CARS intensity in the whole field of view (650 μm diameter). We demonstrated CARS imaging of a rat sciatic nerve and visualization of the fine structure of nerve fibers.
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Affiliation(s)
- K. Hirose
- Graduate School of Engineering Science, Osaka University, Osaka,
Japan
| | - T. Aoki
- Graduate School of Engineering Science, Osaka University, Osaka,
Japan
| | - T. Furukawa
- Faculty of Engineering, Yokohama National University, Yokohama,
Japan
| | - S. Fukushima
- Graduate School of Engineering Science, Osaka University, Osaka,
Japan
| | - H. Niioka
- Graduate School of Engineering Science, Osaka University, Osaka,
Japan
| | - S. Deguchi
- Graduate School of Engineering Science, Osaka University, Osaka,
Japan
| | - M. Hashimoto
- Graduate School of Information Science and Technology, Hokkaido University, Hokkaido,
Japan
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32
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Bernardo A. The Changing Face of Technologically Integrated Neurosurgery: Today's High-Tech Operating Room. World Neurosurg 2018; 106:1001-1014. [PMID: 28985655 DOI: 10.1016/j.wneu.2017.06.159] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Over the last decade, surgical technology in planning, mapping, optics, robotics, devices, and minimally invasive techniques has changed the face of modern neurosurgery. We explore the current advances in clinical technology across all neurosurgical subspecialties, examine how clinical practice is being shaped by this technology, and suggest what the operating room of tomorrow may look like.
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Affiliation(s)
- Antonio Bernardo
- Department of Neurological Surgery, Skull Base Laboratory, Weill Cornell Medical College, New York, New York, USA.
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33
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Wei L, Xue T, Tao KS, Zhang G, Zhao GY, Yu SQ, Cheng L, Yang ZX, Zheng MJ, Li F, Wang Q, Han Y, Shi YQ, Dong HL, Lu ZH, Wang Y, Yang H, Ma XD, Liu SJ, Liu HX, Xiong LZ, Chen BL. Modified human uterus transplantation using ovarian veins for venous drainage: the first report of surgically successful robotic-assisted uterus procurement and follow-up for 12 months. Fertil Steril 2017; 108:346-356.e1. [PMID: 28778283 DOI: 10.1016/j.fertnstert.2017.05.039] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 05/31/2017] [Accepted: 05/31/2017] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To report the 12-month results of the first human uterus transplantation case using robot-assisted uterine retrieval. This type of transplantation may become a treatment for permanent uterine factor infertility. DESIGN Case study. SETTING University hospital. PATIENT(S) A 22-year-old woman with complete müllerian agenesis who underwent a previous surgery for vaginal reconstruction. The live uterine donor was her mother. INTERVENTION(S) The uterus transplantation procedure consisted of robot-assisted uterine procurement, orthotopic replacement and fixation of the retrieved uterus, revascularization, and end-to-side anastomoses of bilateral hypogastric arteries and ovarian-uterine vein to the bilateral external iliac arteries and veins. MAIN OUTCOME MEASURE(S) Data from preoperative investigations, surgery, and follow-up (12 months). RESULT(S) The duration of the donor and recipient surgeries were 6 and 8 hours, 50 minutes, respectively. No immediate perioperative complications occurred in the recipient or donor. The recipient experienced menarche 40 days after transplant surgery, and she has had 12 menstrual cycles since the surgery. No rejection episodes occurred in the recipient. CONCLUSION(S) These results demonstrate the feasibility of live-donor uterine transplantation with a low-dose immunosuppressive protocol and the role of DaVinci robotic assistance during human uterine procurement. CLINICAL TRIAL REGISTRATION NUMBER XJZT12Z06.
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Affiliation(s)
- Li Wei
- Department of Obstetrics and Gynecology, Xijing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China
| | - Tao Xue
- Department of Otorhinolaryngology, Xijing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China
| | - Kai-Shan Tao
- Department of Hepatic and Splenic Surgery, Department of Organ Transplant Centers, Xijing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China
| | - Geng Zhang
- Department of Urinary Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China
| | - Guang-Yue Zhao
- Department of Osteology, Xijing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China
| | - Shi-Qiang Yu
- Department of Cardiac Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China
| | - Liang Cheng
- Department of Cardiac Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China
| | - Zhao-Xu Yang
- Department of Hepatic and Splenic Surgery, Department of Organ Transplant Centers, Xijing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China
| | - Min-Juan Zheng
- Department of Ultrasound Diagnosis, Xijing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China
| | - Fei Li
- Department of Cardiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China
| | - Qiong Wang
- Department of Cardiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China
| | - Ying Han
- Department of Gastroenterology, Xijing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China
| | - Yong-Quan Shi
- Department of Gastroenterology, Xijing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China
| | - Hai-Long Dong
- Department of Anesthesiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China
| | - Zhi-Hong Lu
- Department of Anesthesiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China
| | - Yun Wang
- Department of Ultrasound Diagnosis, Xijing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China
| | - Hong Yang
- Department of Obstetrics and Gynecology, Xijing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China
| | - Xiang-Dong Ma
- Department of Obstetrics and Gynecology, Xijing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China
| | - Shu-Juan Liu
- Department of Obstetrics and Gynecology, Xijing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China
| | - Hai-Xia Liu
- Department of Obstetrics and Gynecology, Xijing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China
| | - Li-Ze Xiong
- Department of Anesthesiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China
| | - Bi-Liang Chen
- Department of Obstetrics and Gynecology, Xijing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China.
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Kim M, Lee C, Hong N, Kim YJ, Kim S. Development of stereo endoscope system with its innovative master interface for continuous surgical operation. Biomed Eng Online 2017. [PMID: 28646865 PMCID: PMC5483295 DOI: 10.1186/s12938-017-0376-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background Although robotic laparoscopic surgery has various benefits when compared with conventional open surgery and minimally invasive surgery, it also has issues to overcome and one of the issues is the discontinuous surgical flow that occurs whenever control is swapped between the endoscope system and the operating robot arm system. This can lead to problems such as collision between surgical instruments, injury to patients, and increased operation time. To achieve continuous surgical operation, a wireless controllable stereo endoscope system is proposed which enables the simultaneous control of the operating robot arm system and the endoscope system. Methods The proposed system consists of two improved novel master interfaces (iNMIs), a four-degrees of freedom (4-DOFs) endoscope control system (ECS), and a simple three-dimensional (3D) endoscope. In order to simultaneously control the proposed system and patient side manipulators of da Vinci research kit (dVRK), the iNMIs are installed to the master tool manipulators of dVRK system. The 4-DOFs ECS consists of four servo motors and employs a two-parallel link structure to provide translational and fulcrum point motion to the simple 3D endoscope. The images acquired by the endoscope undergo stereo calibration and rectification to provide a clear 3D vision to the surgeon as available in clinically used da Vinci surgical robot systems. Tests designed to verify the accuracy, data transfer time, and power consumption of the iNMIs were performed. The workspace was calculated to estimate clinical applicability and a modified peg transfer task was conducted with three novice volunteers. Results The iNMIs operated for 317 min and moved in accordance with the surgeon’s desire with a mean latency of 5 ms. The workspace was calculated to be 20378.3 cm3, which exceeds the reference workspace of 549.5 cm3. The novice volunteers were able to successfully execute the modified peg transfer task designed to evaluate the proposed system’s overall performance. Conclusions The experimental results verify that the proposed 3D endoscope system enables continuous surgical flow. The workspace is suitable for the performance of numerous types of surgeries. Therefore, the proposed system is expected to provide much higher safety and efficacy for current surgical robot systems.
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Affiliation(s)
- Myungjoon Kim
- Interdisciplinary Program for Bioengineering, Graduate School, Seoul National University, Seoul, 03080, South Korea
| | - Chiwon Lee
- Korea Electrotechnology Research Institute, Ansan, 15588, South Korea
| | - Nhayoung Hong
- Interdisciplinary Program for Bioengineering, Graduate School, Seoul National University, Seoul, 03080, South Korea
| | - Yoon Jae Kim
- Interdisciplinary Program for Bioengineering, Graduate School, Seoul National University, Seoul, 03080, South Korea
| | - Sungwan Kim
- Institute of Medical and Biological Engineering, Seoul National University, Seoul, 08826, South Korea. .,Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, 03080, South Korea.
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Lee H, Kim KG, Seo JH, Sohn DK. Natural orifice transluminal endoscopic surgery with a snake-mechanism using a movable pulley. Int J Med Robot 2017; 13. [PMID: 28271600 DOI: 10.1002/rcs.1816] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 01/16/2017] [Accepted: 01/19/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND Natural orifice transluminal endoscopic surgery is an emerging technique. We aimed to develop an advanced surgical robot mechanism for natural orifice surgery. METHODS We propose the active-controlled overtube-type platform with multiple channels for an endoscopic camera and surgical tools. To make such a platform, we suggest an advanced snake mechanism comprising movable pulleys to make a snake mechanism with multiple degrees of freedom and high operating force. RESULTS The stiffness and maneuverability of the active-controlled platform appeared satisfactory. Using prototypes and ex vivo experiments, we confirmed that the mechanism was suitable for a snake-like robotic platform for natural orifice surgery. CONCLUSIONS The suggested snake mechanism using movable pulleys has the advantages of stiffness and maneuverability. This new mechanism can be an alternative platform for natural orifice surgery.
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Affiliation(s)
- Hoyul Lee
- Biomedical Engineering Branch, Research Institute and Hospital, National Cancer Center, Republic of Korea.,Biomedical Engineering Research Center, Asan Medical Center, Republic of Korea
| | - Kwang Gi Kim
- Biomedical Engineering Branch, Research Institute and Hospital, National Cancer Center, Republic of Korea
| | - Jong Hyun Seo
- Biomedical Engineering Branch, Research Institute and Hospital, National Cancer Center, Republic of Korea
| | - Dae Kyung Sohn
- Biomedical Engineering Branch, Research Institute and Hospital, National Cancer Center, Republic of Korea
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36
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Kim M, Lee C, Park WJ, Suh YS, Yang HK, Kim HJ, Kim S. A development of assistant surgical robot system based on surgical-operation-by-wire and hands-on-throttle-and-stick. Biomed Eng Online 2016; 15:58. [PMID: 27206350 PMCID: PMC4875655 DOI: 10.1186/s12938-016-0189-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 05/11/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Robot-assisted laparoscopic surgery offers several advantages compared with open surgery and conventional minimally invasive surgery. However, one issue that needs to be resolved is a collision between the robot arm and the assistant instrument. This is mostly caused by miscommunication between the surgeon and the assistant. To resolve this limitation, an assistant surgical robot system that can be simultaneously manipulated via a wireless controller is proposed to allow the surgeon to control the assistant instrument. METHODS The system comprises two novel master interfaces (NMIs), a surgical instrument with a gripper actuated by a micromotor, and 6-axis robot arm. Two NMIs are attached to master tool manipulators of da Vinci research kit (dVRK) to control the proposed system simultaneously with patient side manipulators of dVRK. The developments of the surgical instrument and NMI are based on surgical-operation-by-wire concept and hands-on-throttle-and-stick concept from the earlier research, respectively. Tests for checking the accuracy, latency, and power consumption of the NMI are performed. The gripping force, reaction time, and durability are assessed to validate the surgical instrument. The workspace is calculated for estimating the clinical applicability. A simple peg task using the fundamentals of laparoscopic surgery board and an in vitro test are executed with three novice volunteers. RESULTS The NMI was operated for 185 min and reflected the surgeon's decision successfully with a mean latency of 132 ms. The gripping force of the surgical instrument was comparable to that of conventional systems and was consistent even after 1000 times of gripping motion. The reaction time was 0.4 s. The workspace was calculated to be 8397.4 cm(3). Recruited volunteers were able to execute the simple peg task within the cut-off time and successfully performed the in vitro test without any collision. CONCLUSIONS Various experiments were conducted and it is verified that the proposed assistant surgical robot system enables collision-free and simultaneous operation of the dVRK's robot arm and the proposed assistant robot arm. The workspace is appropriate for the performance of various kinds of surgeries. Therefore, the proposed system is expected to provide higher safety and effectiveness for the current surgical robot system.
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Affiliation(s)
- Myungjoon Kim
- />Interdisciplinary Program for Bioengineering, Graduate School, Seoul National University, Seoul, 110-744 South Korea
| | - Chiwon Lee
- />Institute of Medical and Biological Engineering, Seoul National University, Seoul, 151-742 South Korea
| | - Woo Jung Park
- />Interdisciplinary Program for Bioengineering, Graduate School, Seoul National University, Seoul, 110-744 South Korea
| | - Yun Suhk Suh
- />Department of Surgery, Seoul National University College of Medicine, Seoul, 110-799 South Korea
| | - Han Kwang Yang
- />Department of Surgery, Seoul National University College of Medicine, Seoul, 110-799 South Korea
| | - H. Jin Kim
- />Department of Mechanical & Aerospace Engineering, Seoul National University College of Engineering, Seoul, 151-742 South Korea
| | - Sungwan Kim
- />Institute of Medical and Biological Engineering, Seoul National University, Seoul, 151-742 South Korea
- />Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, 110-799 South Korea
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A new forecasting kinematic algorithm of automatic navigation for a laparoscopic minimally invasive surgical robotic system. ROBOTICA 2016. [DOI: 10.1017/s0263574715001137] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
SUMMARYThis paper presents a novel forecasting kinematic algorithm for autonomously navigating the 3D visual window of laparoscopic minimally invasive surgical robotic system (LMISRS). By the application of the proposed technique, a constant distribution area ratio of the micro devices can be guaranteed in the visual window; real-time concurrency motion of the visual window of the laparoscope and the mark points of the instruments is realized, i.e. the visual window can keep tracking the movement of the marks automatically, so that the user does not have to switch between the master-slave controlling targets. The implementation of the new technique is summarized as follows: the robotic kinematics and space analytic geometry are thoroughly analyzed and modeled, and a “following kinematic algorithm” is proposed for the visual window of the laparoscope, which tracks the mark points of the instrument arms; a “forecasting kinematic algorithm” is established by using a combination of the “following kinematic algorithm”, the basic visual parameters of 3D visual field, the Verhulst Grey Model and the filtered amendment method. The proposed technique is verified by a series of simulations by using two groups of marks' motion trails with different sampling times, indicating that the technique is accurate, feasible and robust.
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38
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Zhang LH, Zhao JX, Zhao Z, Su XY, Zhang LC, Zhao YP, Tang PF. Computer-aided pelvic reduction frame for anatomical closed reduction of unstable pelvic fractures. J Orthop Res 2016. [PMID: 26212594 DOI: 10.1002/jor.22987] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Traditional closed reductions of unstable pelvic fractures are mainly performed by surgeons using manual manipulation and subjective verification based on intra-operative roentgenography. It is difficult to perform an accurate closed reduction because of a lack of adequate knowledge of the displacement patterns and an inability to apply the reduction in correct direction. Using the concept of the remote center of motion mechanism and computer-aided design software, we developed a pelvic reduction frame for use in anatomical closed reductions of unstable pelvic fractures. With three-dimensional reconstruction technique and the matrix algorithm, the spatial orientation of the displaced hemipelvis can be calculated and deconstructed into several rotational and translational movements that can be completed with the frame. To verify the accuracy of this system, the rotations were repeated 10 times in arbitrary degrees and directions. After the matrix is calculated, the displaced hemipelvis can be reduced to the anatomical position using our frame. The maximum residual translational and rotational displacements were less than 5 mm and 4 degrees, which indicated the accuracy of this system. The maximum average residual translation and rotation were 1.87 mm in Z-axis (ranging: 4.63-0.1 mm) and 1.1 degrees around Y-axis (ranging: 3.81-0.13 degrees), respectively. Only the Z-axial translation showed a statistically significant difference (p < 0.05). In conclusion, the proposed pelvic reduction frame could be a useful tool for the anatomical reduction of unstable pelvic fractures.
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Affiliation(s)
- Li-Hai Zhang
- Department of Orthopaedics, Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, People's Republic of China
| | - Jing-Xin Zhao
- Department of Orthopaedics, Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, People's Republic of China
| | - Zhe Zhao
- Department of Orthopaedics, Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, People's Republic of China.,Department of Orthopaedics, Beijing Tsinghua Chang Gung Hospital, No. 1 Block Tiantongyuan North, Beijing, 102218, People's Republic of China
| | - Xiu-Yun Su
- Department of Orthopaedics, Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, People's Republic of China.,Department of Orthopaedics, Affiliated Hospital of the Academy of Military Medical Sciences, No. 8 Dongdajie Road, Beijing, 100071, People's Republic of China
| | - Li-Cheng Zhang
- Department of Orthopaedics, Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, People's Republic of China
| | - Yan-Peng Zhao
- Department of Orthopaedics, Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, People's Republic of China
| | - Pei-Fu Tang
- Department of Orthopaedics, Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, People's Republic of China
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Affiliation(s)
- Raquel Bravo
- Servicio de Cirugía Gastrointestinal, Hospital Clínic, Barcelona, España.
| | - Antonio M Lacy
- Servicio de Cirugía Gastrointestinal, Hospital Clínic, Barcelona, España
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40
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An experimental study about haptic feedback in robotic surgery: may visual feedback substitute tactile feedback? J Robot Surg 2015; 10:57-61. [PMID: 26559538 DOI: 10.1007/s11701-015-0541-0] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 10/26/2015] [Indexed: 10/22/2022]
Abstract
The aim of this study is to demonstrate the hypothesis that the experience of the surgeon is sufficient to partially compensate for the lack of haptic feedback of the robotic system da Vinci Si HD (Intuitive (®) ). Twenty-five international surgeons belonging to different areas of surgical specialization were divided into two groups of investigation: experts and non-experts in the use of da Vinci Platform. This allocation was made on the basis of the following criteria: the number of performed procedures, the number of robotic working days and the number of true console hours. All participants underwent a specific test to assess their ability to recognize the thickness of custom-made membranes, without the availability of haptic feedback. After the performance of the surgeons, score was given according to an appropriate evaluation system (time, preciseness, force of tension and finding a metallic object). The analysis of the performances of participants provided the following results: an average score of 8.87 for the experts compared to 3.57 of non-experts with significant difference (P < 0.05). Other parameters of interest as the average time to conduct the test showed a result of 28.8 s for experts and 71.3 s of non-experts. After our results, a significant difference between the two groups in terms of performance was found. Our hypothesis that the expertise ability of the experts might partially overcome the lack of haptic feedback was confirmed. Probably visual feedback may play a role.
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Abstract
Within the last two decades the application of minimally invasive surgical technologies has shown significant benefits when it comes to complex surgical procedures. Lower rates of complications and higher patient satisfaction are commonly reported. Until recently these benefits were inaccessible for patients with solid organ transplantation, because conventional laparoscopy was seen as nonapplicable in such technically demanding procedures. The introduction of the da Vinci Robotic Surgical System, with its inherent advantages, has expanded the ability to complete solid organ transplantation in a minimally invasive fashion. Robotic applications in kidney, pancreas, and liver transplantation have been reported. The initial results showed the viability of this technique in the field. The most extensive experience has been described in kidney transplantation. Over 700 donor nephrectomies and more than 70 renal transplants have been performed successfully with the robotic system. The proven advantage of the robotic technique, especially in obese kidney recipients, is a significantly lower rate of surgical site infection, which in these highly immunosuppressed patients is reflected in superior outcomes. The first results in pancreas transplantation and living donor hepatectomy are very promising; however, larger series are needed in order to address the value of the robotic surgery in these areas of solid organ transplantation.
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42
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A grip force model for the da Vinci end-effector to predict a compensation force. Med Biol Eng Comput 2014; 53:253-61. [DOI: 10.1007/s11517-014-1230-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 11/16/2014] [Indexed: 10/24/2022]
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43
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Liu Q, Wang X, Shen B, Zhao L, Zhan Q, Zhao S, Wen C, Deng X, Peng C, Li H. Preliminary experience of the robot-assisted laparoscopic excision of a retroperitoneal mass: A case report. Oncol Lett 2014; 8:2399-2402. [PMID: 25360164 PMCID: PMC4214392 DOI: 10.3892/ol.2014.2533] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Accepted: 08/07/2014] [Indexed: 11/14/2022] Open
Abstract
The aim of the present study was to report the initial clinical experience of adopting the da Vinci Surgical System (Intuitive Surgical, Inc., Sunnyvale, CA, USA) to perform a retroperitoneal tumor resection. The patient was a 56-year-old female who presented with a five-year history of hypertension. Abdominal dynamic computed tomography (CT) and positron emission tomography-CT scans revealed a mass measuring ~6 cm in diameter that was located anterior to the abdominal aorta, and between the abdominal aorta and the inferior vena cava (at the level of the third lumbar vertebra). The tumor was excised via a five-port, robot-assisted, transperitoneal laparoscopic approach. Careful dissection of the tumor away from the abdominal aorta and the inferior vena cava was accomplished without resulting in major vascular injury. There were no complications and the patient was discharged in a good condition on the eleventh postoperative day. Pathological analysis of a tumor specimen demonstrated a benign pheochromocytoma (PHEO). During the three-month follow-up, no recurrence was identified through CT scans or measurement of the patient’s endocrine hormone levels. Thus, the da Vinci robot-assisted laparoscopic system may be safely employed in the treatment of extra-adrenal PHEOs that occur in difficult locations for which a laparoscopic surgical excision may be challenging.
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Affiliation(s)
- Qin Liu
- Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Institute of Digestive Surgery, Shanghai 200025, P.R. China
| | - Xinjing Wang
- Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Institute of Digestive Surgery, Shanghai 200025, P.R. China
| | - Baiyong Shen
- Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Institute of Digestive Surgery, Shanghai 200025, P.R. China
| | - Liangchao Zhao
- Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Institute of Digestive Surgery, Shanghai 200025, P.R. China
| | - Qian Zhan
- Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Institute of Digestive Surgery, Shanghai 200025, P.R. China
| | - Shulin Zhao
- Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Institute of Digestive Surgery, Shanghai 200025, P.R. China
| | - Chenlei Wen
- Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Institute of Digestive Surgery, Shanghai 200025, P.R. China
| | - Xiaxing Deng
- Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Institute of Digestive Surgery, Shanghai 200025, P.R. China
| | - Chenghong Peng
- Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Institute of Digestive Surgery, Shanghai 200025, P.R. China
| | - Hongwei Li
- Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Institute of Digestive Surgery, Shanghai 200025, P.R. China
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Rosiek A, Leksowski K. Technology advances in hospital practices: robotics in treatment of patients. Technol Cancer Res Treat 2014; 14:270-6. [PMID: 25782187 DOI: 10.1177/1533034614546974] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Accepted: 05/15/2014] [Indexed: 11/17/2022] Open
Abstract
Laparoscopic cholecystectomy is widely considered as the treatment of choice for acute cholecystitis. The safety of the procedure and its minimal invasiveness made it a valid treatment option for a patient not responding to antibiotic therapy. Our research shows that patients positively assess this treatment method, but the world's tendency is to turn to a more sophisticated method utilizing robot-assisted surgery as a gold standard. Providing patient with minimally invasive surgical procedures that utilize the state-of-the-art equipment like the da Vinci Robotic Surgical System underscores the commitment to high-quality patient care while enhancing patient safety. The advantages include minimal invasive scarring, less pain and bleeding, faster recovery time, and shorter hospital stay. The move toward less invasive and less morbid procedures and a need to re-create the true open surgical experience have paved the way for the development and application of robotic and computer-assisted systems in surgery in Poland as well as the rest of the world.
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Affiliation(s)
| | - Krzysztof Leksowski
- Department of General, Thoracic and Vascular Surgery Military Clinical Hospital, Bydgoszcz, Poland Public Health Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland
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Lee C, Park WJ, Kim M, Noh S, Yoon C, Lee C, Kim Y, Kim HH, Kim HC, Kim S. Pneumatic-type surgical robot end-effector for laparoscopic surgical-operation-by-wire. Biomed Eng Online 2014; 13:130. [PMID: 25189221 PMCID: PMC4167265 DOI: 10.1186/1475-925x-13-130] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 09/01/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although minimally invasive surgery (MIS) affords several advantages compared to conventional open surgery, robotic MIS systems still have many limitations. One of the limitations is the non-uniform gripping force due to mechanical strings of the existing systems. To overcome this limitation, a surgical instrument with a pneumatic gripping system consisting of a compressor, catheter balloon, micro motor, and other parts is developed. METHOD This study aims to implement a surgical instrument with a pneumatic gripping system and pitching/yawing joints using micro motors and without mechanical strings based on the surgical-operation-by-wire (SOBW) concept. A 6-axis external arm for increasing degrees of freedom (DOFs) is integrated with the surgical instrument using LabVIEW® for laparoscopic procedures. The gripping force is measured over a wide range of pressures and compared with the simulated ideal step function. Furthermore, a kinematic analysis is conducted. To validate and evaluate the system's clinical applicability, a simple peg task experiment and workspace identification experiment are performed with five novice volunteers using the fundamentals of laparoscopic surgery (FLS) board kit. The master interface of the proposed system employs the hands-on-throttle-and-stick (HOTAS) controller used in aerospace engineering. To develop an improved HOTAS (iHOTAS) controller, 6-axis force/torque sensor was integrated in the special housing. RESULTS The mean gripping force (after 1,000 repetitions) at a pressure of 0.3 MPa was measured to be 5.8 N. The reaction time was found to be 0.4 s, which is almost real-time. All novice volunteers could complete the simple peg task within a mean time of 176 s, and none of them exceeded the 300 s cut-off time. The system's workspace was calculated to be 11,157.0 cm3. CONCLUSIONS The proposed pneumatic gripping system provides a force consistent with that of other robotic MIS systems. It provides near real-time control. It is more durable than the existing other surgical robot systems. Its workspace is sufficient for clinical surgery. Therefore, the proposed system is expected to be widely used for laparoscopic robotic surgery. This research using iHOTAS will be applied to the tactile force feedback system for surgeon's safe operation.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Sungwan Kim
- Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul 110-799, South Korea.
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Leonard S, Wu KL, Kim Y, Krieger A, Kim PCW. Smart tissue anastomosis robot (STAR): a vision-guided robotics system for laparoscopic suturing. IEEE Trans Biomed Eng 2014; 61:1305-17. [PMID: 24658254 DOI: 10.1109/tbme.2014.2302385] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This paper introduces the smart tissue anastomosis robot (STAR). Currently, the STAR is a proof-of-concept for a vision-guided robotic system featuring an actuated laparoscopic suturing tool capable of executing running sutures from image-based commands. The STAR tool is designed around a commercially available laparoscopic suturing tool that is attached to a custom-made motor stage and the STAR supervisory control architecture that enables a surgeon to select and track incisions and the placement of stitches. The STAR supervisory-control interface provides two modes: A manual mode that enables a surgeon to specify the placement of each stitch and an automatic mode that automatically computes equally-spaced stitches based on an incision contour. Our experiments on planar phantoms demonstrate that the STAR in either mode is more accurate, up to four times more consistent and five times faster than surgeons using state-of-the-art robotic surgical system, four times faster than surgeons using manual Endo360(°)®, and nine times faster than surgeons using manual laparoscopic tools.
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47
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Sanders L, Stone R, Webb K, Mefford T, Nagatomi J. Mechanical characterization of a bifunctional Tetronic hydrogel adhesive for soft tissues. J Biomed Mater Res A 2014; 103:861-8. [PMID: 25111445 DOI: 10.1002/jbm.a.35310] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 07/16/2014] [Accepted: 08/06/2014] [Indexed: 11/09/2022]
Abstract
Although a number of tissue adhesives and sealants for surgical use are currently available, attaining a useful balance in high strength, high compliance, and low swelling has proven difficult. Recent studies have demonstrated that a four-arm poly(propylene oxide)-poly(ethylene oxide) block copolymer, Tetronic, can be chemically modified to form a hydrogel tissue adhesive (Cho et al., Acta Biomater 2012;8:2223-2232; Barrett et al., Adv Health Mater 2012;1-11; Balakrishnan, Evaluating mechanical performance of hydrogel-based adhesives for soft tissue applications. Clemson University, All Theses, Paper 1574: Tiger Prints; 2013). Building on the success of these studies, this study explored bifunctionalization of Tetronic with acrylates for chemical crosslinking of the hydrogel and N-hydroxysuccinimide (NHS) for reaction with tissue amines. The adhesive bond strengths of various uni and bifunctional Tetronic blends (T1107 ACR: T1107 ACR/NHS) determined by lap shear testing ranged between 8 and 74 kPa, with the 75:25 (T1107 ACR: T1107 ACR/NHS) blend displaying the highest value. These results indicated that addition of NHS led to improvement of tissue bond strength over acrylation alone. Furthermore, ex vivo pressure tests using the rat bladder demonstrated that the bifunctional Tetronic adhesive exhibited high compliance and maintained pressures under hundreds of filling and emptying cycles. Together, the results of this study provided evidence that the bifunctional Tetronic adhesive with a proper blend ratio may be used to achieve an accurate balance in bulk and tissue bond strengths, as well as the compliance and durability for soft tissue such as the bladder.
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Affiliation(s)
- Lindsey Sanders
- Department of Bioengineering, Clemson University, Clemson, South Carolina, 29634
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Atalla MA, Dovey Z, Kavoussi LR. Laparoscopic versus robotic pyeloplasty: man versus machine. Expert Rev Med Devices 2014; 7:27-34. [DOI: 10.1586/erd.09.62] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Azar AT, Eljamel MS. Medical Robotics. ROBOTICS 2013. [DOI: 10.4018/978-1-4666-4607-0.ch054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Medical robotics is an interdisciplinary field that focuses on developing electromechanical devices for clinical applications. The goal of this field is to enable new medical techniques by providing new capabilities to the physician or by providing assistance during surgical procedures. Medical robotics is a relatively young field, as the first recorded medical application occurred in 1985 for a brain biopsy. It has tremendous potential for improving the precision and capabilities of physicians when performing surgical procedures, and it is believed that the field will continue to grow as improved systems become available. This chapter offers a comprehensive overview about medical robotics field and its applications. It begins with an introduction to robotics, followed by a historical review of their use in medicine. Clinical applications in several different medical specialties are discusssed. The chapter concludes with a discussion of technology challenges and areas for future research.
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Abstract
Medical robotics is an interdisciplinary field that focuses on developing electromechanical devices for clinical applications. The goal of this field is to enable new medical techniques by providing new capabilities to the physician or by providing assistance during surgical procedures. Medical robotics is a relatively young field, as the first recorded medical application occurred in 1985 for a brain biopsy. It has tremendous potential for improving the precision and capabilities of physicians when performing surgical procedures, and it is believed that the field will continue to grow as improved systems become available. This chapter offers a comprehensive overview about medical robotics field and its applications. It begins with an introduction to robotics, followed by a historical review of their use in medicine. Clinical applications in several different medical specialties are discusssed. The chapter concludes with a discussion of technology challenges and areas for future research.
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