1
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Shiroshita H, Inomata M, Akira S, Kanayama H, Yamaguchi S, Eguchi S, Wada N, Kurokawa Y, Uchida H, Seki Y, Ieiri S, Iwazaki M, Sato Y, Kitamura K, Tabata M, Mimata H, Takahashi H, Uemura T, Akagi T, Taniguchi F, Miyajima A, Hashizume M, Matsumoto S, Kitano S, Watanabe M, Sakai Y. Current Status of Endoscopic Surgery in Japan: The 15th National Survey of Endoscopic Surgery by the Japan Society for Endoscopic Surgery. Asian J Endosc Surg 2022; 15:415-426. [PMID: 34954907 DOI: 10.1111/ases.13012] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In Japan, the first endoscopic surgery, a laparoscopic cholecystectomy, was performed in 1990. Since then, operative procedures have been standardized, and the safety and efficacy of endoscopic surgery have been evaluated. In accordance with the social acceptance of endoscopic surgery as a less invasive type of surgery, the number of endoscopic procedures performed has increased in all surgical domains. The Japan Society for Endoscopic Surgery (JSES) has played an important role in the development of endoscopic surgery in Japan. Notably, a technical skills certification system for surgeons was established by the JSES to train instructors on how to teach safe endoscopic surgery. Furthermore, the JSES has conducted a national survey every 2 years. In 2019, 291,792 patients underwent endoscopic surgery in all surgical domains, such as abdominal, thoracic, mammary and thyroid gland, cardiovascular, obstetrics and gynecology, urologic, orthopedic, and plastic surgery. The 15th National Survey of Endoscopic Surgery conducted by the JSES demonstrated the status of laparoscopic surgery in Japan in 2018-2019.
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Affiliation(s)
- Hidefumi Shiroshita
- Academic Committee of Japan Society for Endoscopic Surgery, Tokyo, Japan.,Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Yufu, Japan
| | - Masafumi Inomata
- Academic Committee of Japan Society for Endoscopic Surgery, Tokyo, Japan.,Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Yufu, Japan
| | - Shigeo Akira
- Academic Committee of Japan Society for Endoscopic Surgery, Tokyo, Japan.,Department of Obstetrics and Gynecology, Nippon Medical School, Tokyo, Japan
| | - Hiroomi Kanayama
- Academic Committee of Japan Society for Endoscopic Surgery, Tokyo, Japan.,Department of Urology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Shigeki Yamaguchi
- Academic Committee of Japan Society for Endoscopic Surgery, Tokyo, Japan.,Department of Surgery, Division of Colorectal Surgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Susumu Eguchi
- Academic Committee of Japan Society for Endoscopic Surgery, Tokyo, Japan.,Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Norihito Wada
- Academic Committee of Japan Society for Endoscopic Surgery, Tokyo, Japan.,Department of Surgery, Shonan Keiiku Hospital, Fujisawa, Japan
| | - Yukinori Kurokawa
- Academic Committee of Japan Society for Endoscopic Surgery, Tokyo, Japan.,Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hiroki Uchida
- Academic Committee of Japan Society for Endoscopic Surgery, Tokyo, Japan.,Department of Surgery, Nakatsu Municipal Hospital, Nakatsu, Japan
| | - Yosuke Seki
- Academic Committee of Japan Society for Endoscopic Surgery, Tokyo, Japan.,Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, Japan
| | - Satoshi Ieiri
- Academic Committee of Japan Society for Endoscopic Surgery, Tokyo, Japan.,Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan
| | - Masayuki Iwazaki
- Academic Committee of Japan Society for Endoscopic Surgery, Tokyo, Japan.,Department of General Thoracic Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Yukio Sato
- Academic Committee of Japan Society for Endoscopic Surgery, Tokyo, Japan.,Department of Thoracic Surgery, University of Tsukuba, Ibaragi, Japan
| | - Kaoru Kitamura
- Academic Committee of Japan Society for Endoscopic Surgery, Tokyo, Japan.,Department of Breast Surgery, Kaizuka Hospital, Fukuoka, Japan
| | - Minoru Tabata
- Academic Committee of Japan Society for Endoscopic Surgery, Tokyo, Japan.,Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan
| | - Hiromitsu Mimata
- Academic Committee of Japan Society for Endoscopic Surgery, Tokyo, Japan.,Department of Urology, Oita University Faculty of Medicine, Yufu, Japan
| | - Hiroshi Takahashi
- Academic Committee of Japan Society for Endoscopic Surgery, Tokyo, Japan.,Department of Orthopedic Surgery, Toho University School of Medicine, Tokyo, Japan
| | - Tetsuji Uemura
- Academic Committee of Japan Society for Endoscopic Surgery, Tokyo, Japan.,Department of Plastic and Reconstructive Surgery, Saga University, Faculty of Medicine, Saga, Japan
| | - Tomonori Akagi
- Academic Committee of Japan Society for Endoscopic Surgery, Tokyo, Japan.,Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Yufu, Japan
| | - Fuminori Taniguchi
- Academic Committee of Japan Society for Endoscopic Surgery, Tokyo, Japan.,Department of Obstetrics and Gynecology, Tottori University Hospital, Yonago, Japan
| | - Akira Miyajima
- Academic Committee of Japan Society for Endoscopic Surgery, Tokyo, Japan.,Department of Urology, Tokai University School of Medicine, Isehara, Japan
| | - Makoto Hashizume
- Academic Committee of Japan Society for Endoscopic Surgery, Tokyo, Japan.,Kitakyushu Koga Hospital, Koga, Japan
| | - Sumio Matsumoto
- Academic Committee of Japan Society for Endoscopic Surgery, Tokyo, Japan.,National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Seigo Kitano
- Academic Committee of Japan Society for Endoscopic Surgery, Tokyo, Japan.,Oita University, Yufu, Japan
| | - Masahiko Watanabe
- Academic Committee of Japan Society for Endoscopic Surgery, Tokyo, Japan.,Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Yoshiharu Sakai
- Academic Committee of Japan Society for Endoscopic Surgery, Tokyo, Japan.,Japanese Red cross Osaka Hospital, Osaka, Japan
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2
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Pandav K, Te AG, Tomer N, Nair SS, Tewari AK. Leveraging 5G technology for robotic surgery and cancer care. Cancer Rep (Hoboken) 2022; 5:e1595. [PMID: 35266317 PMCID: PMC9351674 DOI: 10.1002/cnr2.1595] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 10/09/2021] [Accepted: 11/10/2021] [Indexed: 01/20/2023] Open
Abstract
Background The field of robotic surgery has seen significant advancements in the past few years and it has been adopted in many large hospitals in the United States and worldwide as a standard for various procedures in recent years. However, the location of many hospitals in urban areas and a lack of surgical expertise in the rural areas could lead to increased travel time and treatment delays for patients in need of robotic surgical management, including cancer patients. The fifth generation (5G) networks have been deployed by various telecom companies in multiple countries worldwide. Our aim is to update the readers about the novel technology and the current scenario of surgical procedures performed using 5G technology. In this article, we also discuss how the technology could aid cancer patients requiring surgical management, the future perspectives, the potential challenges, and the limitations, which would need to overcome prior to widespread real‐life use of the technology for cancer care. Recent findings The expansion of 5G technology has enabled some countries to conduct remote surgical procedures, tele‐mentored and real‐time interactive procedures on animal models, cadavers, and humans, demonstrating that 5G networks could offer a potential solution to previously experienced latency and reliability hurdles during the remote surgeries performed in the 2000s. Conclusion New technological advancements could serve as a ground for emerging novel therapeutic applications. While limitations and challenges related to the 5G infrastructure, cost, compatibility, and security exist; researching to overcome the limitations and comprehend the potential benefits of integrating the technology into practice would be imminent before widespread clinical use. Remote and tele‐mentored 5G‐powered procedures could offer a new tool in improving the care of patients requiring robotic surgical management such as prostate cancer patients.
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Affiliation(s)
- Krunal Pandav
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Austen G Te
- Laboratory of Biochemical Genetics and Metabolism, The Rockefeller University, New York, NY, USA
| | - Nir Tomer
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sujit S Nair
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ashutosh K Tewari
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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3
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Analysis and Comparison of Electromagnetic Microrobotic Platforms for Biomedical Applications. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12010456] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Magnetic microrobotics is a promising technology for improving minimally invasive surgery (MIS) with the ambition of enhancing patient care and comfort. The potential benefits include limited incisions, less hemorrhaging and postoperative pain, and faster recovery time. To achieve this, a key issue relies on the design of a proper electromagnetic actuation (EMA) setup which is based on the use of magnetic sources. The magnetic field and its gradient generated by the EMA platform is then used to induce magnetic torque and force for microrobot manipulations inside the human body. Like any control systems, the EMA system must be adapted to the given controlled microrobot and customized for the application. With great research efforts on magnetic manipulating of microrobots, the EMA systems are approaching commercial applications, and their configurations are becoming more suitable to be employed in real medical surgeries. However, most of the proposed designs have not followed any specific rule allowing to take into account the biomedical applications constraints. Through reviewing the different proposed EMA systems in the literature, their various specifications and configurations are comprehensively discussed and analyzed. This study focus on EMA platforms that use electromagnets. From this review and based on the biomedical application specifications, the appropriate EMA system can be determined efficiently.
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4
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Inomata M, Shiroshita H, Uchida H, Bandoh T, Akira S, Yamaguchi S, Kurokawa Y, Seki Y, Eguchi S, Wada N, Takiguchi S, Ieiri S, Endo S, Iwazaki M, Sato Y, Tamaki Y, Kitamura K, Tabata M, Kanayama H, Mimata H, Hasegawa T, Takahashi H, Onishi K, Uemura T, Hashizume M, Matsumoto S, Kitano S, Watanabe M. Current status of endoscopic surgery in Japan: The 14th National Survey of Endoscopic Surgery by the Japan Society for Endoscopic Surgery. Asian J Endosc Surg 2020; 13:7-18. [PMID: 31828925 DOI: 10.1111/ases.12768] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In Japan, the first endoscopic surgery, a laparoscopic cholecystectomy, was performed in 1990. Since then, operative procedures have been standardized, and the safety and efficacy of endoscopic surgery have been evaluated. In accordance with the social acceptance of endoscopic surgery as a less invasive type of surgery, the number of endoscopic procedures performed has increased in all surgical domains. The Japan Society for Endoscopic Surgery (JSES) has played an important role in the development of endoscopic surgery in Japan. Notably, a technical skills certification system for surgeons was established by the JSES to train instructors on how to teach safe endoscopic surgery. Furthermore, the JSES has conducted a national survey every two years to evaluate the status of endoscopic surgery over time. In 2017, 248 743 patients underwent endoscopic surgery in all surgical domains, such as abdominal, thoracic, mammary and thyroid gland, cardiovascular, obstetrics and gynecology, urologic, orthopedic, and plastic surgery. The 14th National Survey of Endoscopic Surgery conducted by the JSES demonstrated the status of laparoscopic surgery in Japan in 2016-2017.
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Affiliation(s)
- Masafumi Inomata
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Yufu, Japan
| | - Hidefumi Shiroshita
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Yufu, Japan
| | - Hiroki Uchida
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Surgery, Kyushu University Beppu Hospital, Beppu, Japan
| | - Toshio Bandoh
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Gastroenterological Surgery, Oita Prefectural Hospital, Oita, Japan
| | - Shigeo Akira
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Obstetrics and Gynecology, Nippon Medical School, Tokyo, Japan
| | - Shigeki Yamaguchi
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Yukinori Kurokawa
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yosuke Seki
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, Japan
| | - Susumu Eguchi
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Norihito Wada
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Shuji Takiguchi
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Gastroenterological Surgery, Nagoya City University Medical School of Medicine, Nagoya, Japan
| | - Satoshi Ieiri
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan
| | - Shunsuke Endo
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of General Thoracic Surgery, Jichi Medical University, Tochigi, Japan
| | - Masayuki Iwazaki
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of General Thoracic Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Yukio Sato
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Thoracic Surgery, University of Tsukuba, Tsukuba, Japan
| | - Yasuhiro Tamaki
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Breast and Endocrine Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Kaoru Kitamura
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Breast Surgery, Kaizuka Hospital, Fukuoka, Japan
| | - Minoru Tabata
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan
| | - Hiroomi Kanayama
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Urology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Hiromitsu Mimata
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Urology, Oita University Faculty of Medicine, Yufu, Japan
| | - Toru Hasegawa
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Orthopedic Surgery, Kawasaki Medical School, Okayama, Japan
| | - Hiroshi Takahashi
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Orthopedic Surgery, Toho University School of Medicine, Tokyo, Japan
| | - Kiyoshi Onishi
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Plastic and Reconstructive Surgery, Toho University School of Medicine, Tokyo, Japan
| | - Tetsuji Uemura
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Plastic and Reconstructive Surgery, Saga University, Faculty of Medicine, Saga, Japan
| | - Makoto Hashizume
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Kitakyushu Central Hospital, Kitakyushu, Japan
| | - Sumio Matsumoto
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Seigo Kitano
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Oita University, Yufu, Japan
| | - Masahiko Watanabe
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Kitasato University Kitasato Institute Hospital, Tokyo, Japan
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5
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Troccaz J, Dagnino G, Yang GZ. Frontiers of Medical Robotics: From Concept to Systems to Clinical Translation. Annu Rev Biomed Eng 2019; 21:193-218. [DOI: 10.1146/annurev-bioeng-060418-052502] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Medical robotics is poised to transform all aspects of medicine—from surgical intervention to targeted therapy, rehabilitation, and hospital automation. A key area is the development of robots for minimally invasive interventions. This review provides a detailed analysis of the evolution of interventional robots and discusses how the integration of imaging, sensing, and robotics can influence the patient care pathway toward precision intervention and patient-specific treatment. It outlines how closer coupling of perception, decision, and action can lead to enhanced dexterity, greater precision, and reduced invasiveness. It provides a critical analysis of some of the key interventional robot platforms developed over the years and their relative merit and intrinsic limitations. The review also presents a future outlook for robotic interventions and emerging trends in making them easier to use, lightweight, ergonomic, and intelligent, and thus smarter, safer, and more accessible for clinical use.
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Affiliation(s)
- Jocelyne Troccaz
- Université Grenoble Alpes, CNRS, Grenoble INP, TIMC-IMAG, F-38000 Grenoble, France
| | - Giulio Dagnino
- The Hamlyn Centre for Robotic Surgery, Imperial College London, London SW7 2AZ, United Kingdom;,
| | - Guang-Zhong Yang
- The Hamlyn Centre for Robotic Surgery, Imperial College London, London SW7 2AZ, United Kingdom;,
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6
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Shiroshita H, Inomata M, Bandoh T, Uchida H, Akira S, Hashizume M, Yamaguchi S, Eguchi S, Wada N, Takiguchi S, Ieiri S, Endo S, Iwazaki M, Tamaki Y, Tabata M, Kanayama H, Mimata H, Hasegawa T, Onishi K, Yanaga K, Morikawa T, Terachi T, Matsumoto S, Yamashita Y, Kitano S, Watanabe M. Endoscopic surgery in Japan: The 13th national survey (2014-2015) by the Japan Society for Endoscopic Surgery. Asian J Endosc Surg 2019; 12:7-18. [PMID: 30681279 DOI: 10.1111/ases.12674] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/01/2018] [Indexed: 01/29/2023]
Abstract
In Japan, the first endoscopic surgery, a laparoscopic cholecystectomy, was performed in 1990. Since then, the operative procedure has been standardized, and the safety and usefulness of endoscopic surgery have been evaluated. In accordance with the social acceptance of endoscopic surgery as a less-invasive surgery, the number of endoscopic procedures has been increasing in all surgical domains. The Japan Society for Endoscopic Surgery (JSES) has played an important role in the development of endoscopic surgery in Japan. For example, JSES established a technical skills certification system for surgeons to train instructors how to teach safe endoscopic surgery, and the organization performs a national survey every 2 years. In 2015, a total of 211 953 patients underwent endoscopic surgery in all surgical domains, including abdominal, thoracic, mammary and thyroid gland, cardiovascular, obstetrics and gynecology, urologic, orthopedic, and plastic surgery. The course of laparoscopic surgery's development and its current status are reported here based on the results of the most recent questionnaire survey conducted by JSES.
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Affiliation(s)
- Hidefumi Shiroshita
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Yufu, Japan
| | - Masafumi Inomata
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Yufu, Japan
| | - Toshio Bandoh
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Gastroenterological Surgery, Oita Prefectural Hospital, Oita, Japan
| | - Hiroki Uchida
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Gastroenterological Surgery, Oita Kouseiren Tsurumi Hospital, Beppu, Japan
| | - Shigeo Akira
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Obstetrics and Gynecology, Nippon Medical School, Tokyo, Japan
| | - Makoto Hashizume
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Advanced Medical Initiatives, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shigeki Yamaguchi
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Susumu Eguchi
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Norihito Wada
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Shuji Takiguchi
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Gastroenterological Surgery, Nagoya City University Medical School of Medicine, Nagoya, Japan
| | - Satoshi Ieiri
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Pediatric Surgery, Kagoshima University Medical School of Medical and Dental Sciences, Kagoshima, Japan
| | - Shunsuke Endo
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of General Thoracic Surgery, Jichi Medical University, Tochigi, Japan
| | - Masayuki Iwazaki
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of General Thoracic Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Yasuhiro Tamaki
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Breast and Endocrine Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Minoru Tabata
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan
| | - Hiroomi Kanayama
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Urology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Hiromitsu Mimata
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Urology, Oita University Faculty of Medicine, Yufu, Japan
| | - Toru Hasegawa
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Orthopedic Surgery, Kawasaki Medical School, Okayama, Japan
| | - Kiyoshi Onishi
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Plastic and Reconstructive Surgery, Toho University School of Medicine, Tokyo, Japan
| | - Katsuhiko Yanaga
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Surgery, Jikei University School of Medicine, Tokyo, Japan
| | - Toshiaki Morikawa
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Surgery, General Tokyo Hospital, Tokyo, Japan
| | - Toshiro Terachi
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Urology, Beppu-Gengendo Shonin Hospital, Beppu, Japan
| | - Sumio Matsumoto
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Yuichi Yamashita
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Fukuseikai Hospital, Fukuoka, Japan
| | - Seigo Kitano
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Oita University, Yufu, Japan
| | - Masahiko Watanabe
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Surgery, Kitasato University School of Medicine, Sagamihara, Japan
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7
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The comparison of surgical outcomes and learning curves of radical hysterectomy by laparoscopy and robotic system for cervical cancer: an experience of a single surgeon. Obstet Gynecol Sci 2018; 61:468-476. [PMID: 30018901 PMCID: PMC6046366 DOI: 10.5468/ogs.2018.61.4.468] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Revised: 10/27/2017] [Accepted: 10/28/2017] [Indexed: 11/08/2022] Open
Abstract
Objective The aim of this study was to compare and determine the feasibility, surgical outcomes, learning curves of robotic radical hysterectomy with lymph node dissection (RRHND) to conventional laparoscopic radical hysterectomy with lymph node dissection (LRHND) performed by a single surgeon, in patients with cervical cancer. Methods Between April 2009 and March 2013, 22 patients underwent LRHND and 19 patients underwent RRHND. Variables such as age, body mass index, International Federation of Gynecology and Obstetrics stage, histological results, number of dissected lymph nodes, operative time, estimated blood loss, days of hospitalization and complications were reviewed. Learning curves of operation time was obtained using cumulative sum (CUSUM) method. Results Both groups showed similar patient and tumor characteristics. In surgical outcome analysis, RRHND (51.8±10.4 minutes) showed longer preparing time than LRHND (42.5±14.1 minutes). In the LRHND group, 8 patients experienced postoperative complications (5 void difficulty, 1 postoperative bleeding, 1 right basal ganglia infarction, 1 fever). On the other hand, in the RRHND group, 4 patients experienced a postoperative complication (2 bleeding, 1 peritonitis, 1 dehiscence of trocar site). Using CUSUM method, the learning curves were obtained by plotting the cumulative sequential differences between each data point and the average operation time, and showed two distinct phases in both type of operations. Conclusion RRHND would be appropriate surgical approach in patients with cervical cancer with favorable outcome of less voiding difficulty. A minimum of 13 cases of robotic radical hysterectomies are required to achieve surgical improvement in the treatment of cervical cancer.
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8
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Bandoh T, Shiraishi N, Yamashita Y, Terachi T, Hashizume M, Akira S, Morikawa T, Kitagawa Y, Yanaga K, Endo S, Onishi K, Takiguchi S, Tamaki Y, Hasegawa T, Mimata H, Tabata M, Yozu R, Inomata M, Matsumoto S, Kitano S, Watanabe M. Endoscopic surgery in Japan: The 12th national survey(2012-2013) by the Japan Society for Endoscopic Surgery. Asian J Endosc Surg 2017; 10:345-353. [PMID: 28980441 DOI: 10.1111/ases.12428] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/28/2017] [Indexed: 12/01/2022]
Abstract
In Japan, the first endoscopic surgery, a laparoscopic cholecystectomy, was performed in 1990. Since then, operative procedures have been standardized, and the safety and usefulness of endoscopic surgery have been evaluated. With the acceptance of endoscopic surgery as less invasive than open surgery, the number of the endoscopic procedures continues to increase in all surgical domains. The Japan Society for Endoscopic Surgery (JSES) has had an important role in the development of endoscopic surgery in Japan. For example, JSES established a technical skills certification system for physicians to train instructors to teach safe endoscopic surgery. Additionally, JSES has performed a national survey every 2 years. In 2013, 178 084 patients underwent endoscopic surgery in all surgical domains, including abdominal, thoracic, mammary and thyroid gland, cardiovascular, obstetrics and gynecology, urologic, orthopedic, and plastic surgery. The development and current status of laparoscopic surgery are reported here based on the results of the most recent questionnaire survey conducted by JSES.
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Affiliation(s)
- Toshio Bandoh
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Gastroenterological Surgery, Oita Prefectural Hospital, Oita, Japan
| | - Norio Shiraishi
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Comprehensive Surgery for Community Medicine, Oita University Faculty of Medicine, Yufu, Japan
| | - Yuichi Yamashita
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Toshiro Terachi
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Urology, Beppu-Gengendo Shonin Hospital, Beppu, Japan
| | - Makoto Hashizume
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Advanced Medical Initiatives, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shigeo Akira
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Obstetrics and Gynecology, Nippon Medical School, Tokyo, Japan
| | - Toshiaki Morikawa
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Surgery, Jikei University School of Medicine, Tokyo, Japan
| | - Yuko Kitagawa
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of General and Gastroenterological Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Katsuhiko Yanaga
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Surgery, Jikei University School of Medicine, Tokyo, Japan
| | - Shunsuke Endo
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of General Thoracic Surgery, Jichi Medical University, Tochigi, Japan
| | - Kiyoshi Onishi
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Plastic and Reconstructive Surgery, Toho University School of Medicine, Tokyo, Japan
| | - Shuji Takiguchi
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Gastroenterological Surgery, Nagoya City University Medical School of Medicine, Nagoya, Japan
| | - Yasuhiro Tamaki
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Breast and Endocrine Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Toru Hasegawa
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Orthopedic Surgery, Kawasaki Medical School, Okayama, Japan
| | - Hiromitsu Mimata
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Urology, Oita University Faculty of Medicine, Yufu, Japan
| | - Minoru Tabata
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan
| | - Ryohei Yozu
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Harajuku Rehabilitation Hospital, Tokyo, Japan
| | - Masafumi Inomata
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Yufu, Japan
| | - Sumio Matsumoto
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Seigo Kitano
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Oita University, Oita, Japan
| | - Masahiko Watanabe
- Academic Committee of Japan Society for Endoscopic Surgery, Japan.,Department of Surgery, Kitasato University School of Medicine, Sagamihara, Japan
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9
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Nozawa H, Watanabe T. Robotic surgery for rectal cancer. Asian J Endosc Surg 2017; 10:364-371. [PMID: 28949102 DOI: 10.1111/ases.12427] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 07/30/2017] [Indexed: 12/20/2022]
Abstract
Laparoscopic surgery has gained acceptance as a less invasive approach in the treatment of colon cancer. However, laparoscopic surgery for rectal cancer, particularly cancer of the lower rectum, is still challenging because of limited accessibility. Robotic surgery overcomes the limitations of laparoscopy associated with anatomy and offers certain advantages, including 3-D imaging, dexterity and ambidextrous capability, lack of tremors, motion scaling, and a short learning curve. Robotic rectal surgery has been reported to reduce conversion rates, particularly in low anterior resection, but it is associated with longer operative times than the conventional laparoscopic approach. Postoperative morbidities are similar between the robotic and conventional laparoscopic approaches, and oncological outcomes such as the quality of the mesorectum and the status of resection margins are also equivalent. The possible superiority of robotic surgery in terms of the preservation of autonomic function has yet to be established in research based on larger numbers of patients. Although robotic rectal surgery is safe, feasible, and appears to overcome some of the technical limitations associated with conventional laparoscopic surgery, the advantages provided by this technical innovation are currently limited. To justify its expensive cost, robotic surgery is more suitable for select patients, such as obese patients, men, those with cancer of the lower rectum, and those receiving preoperative chemoradiotherapy.
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Affiliation(s)
- Hiroaki Nozawa
- Department of Surgical Oncology, The University of Tokyo, Tokyo, Japan
| | - Toshiaki Watanabe
- Department of Surgical Oncology, The University of Tokyo, Tokyo, Japan
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10
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Morel P, Jung M, Cornateanu S, Buehler L, Majno P, Toso C, Buchs NC, Rubbia-Brandt L, Hagen ME. Robotic versus open liver resections: A case-matched comparison. Int J Med Robot 2017; 13. [PMID: 28058770 DOI: 10.1002/rcs.1800] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 10/12/2016] [Accepted: 11/15/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND Most hepatic resections are currently performed using an open approach. Robotic surgery might enable the transition of these procedures to minimally invasive surgery. METHODS Pre-, peri- and post-operative data of all patients who underwent a liver resection from 2009/2012 to 2001/2015, were collected prospectively. All robotic resection patients were matched 1:1 to patients who underwent open surgery. Pre- and perioperative data, up to 30 days, were analyzed. RESULTS Sixteen robotic and open hepatic resections were identified. Fewer complication events and shorter lengths of stay (LOS, 7.9 versus 11 days, P = 0.0603) were observed for robotic resections. Length of stay in the intermediate care unit (IMC) was shorter after the robotic procedure (10 h vs 16.6 h, P = 0.0699). Operating room (OR) time was significantly longer in the robotic resection cohort (352.8 vs 239.6 min, P = 0.0215). All tumor margins were negative. CONCLUSIONS This preliminary comparison demonstrates the general feasibility of minor robotic liver resection in selected cases.
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Affiliation(s)
- Philippe Morel
- Division of Digestive and Transplant Surgery, Department of Surgery, University Hospital Geneva, 4 Rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland
| | - Minoa Jung
- Division of Digestive and Transplant Surgery, Department of Surgery, University Hospital Geneva, 4 Rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland
| | - Sorina Cornateanu
- Division of Digestive and Transplant Surgery, Department of Surgery, University Hospital Geneva, 4 Rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland
| | - Leo Buehler
- Division of Digestive and Transplant Surgery, Department of Surgery, University Hospital Geneva, 4 Rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland
| | - Pietro Majno
- Division of Digestive and Transplant Surgery, Department of Surgery, University Hospital Geneva, 4 Rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland
| | - Christian Toso
- Division of Digestive and Transplant Surgery, Department of Surgery, University Hospital Geneva, 4 Rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland
| | - Nicolas C Buchs
- Division of Digestive and Transplant Surgery, Department of Surgery, University Hospital Geneva, 4 Rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland
| | - Laura Rubbia-Brandt
- Division of Pathology, University Hospital Geneva, 4 Rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland
| | - Monika E Hagen
- Division of Digestive and Transplant Surgery, Department of Surgery, University Hospital Geneva, 4 Rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland
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11
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Degiuli M, De Manzoni G, Di Leo A, D’Ugo D, Galasso E, Marrelli D, Petrioli R, Polom K, Roviello F, Santullo F, Morino M. Gastric cancer: Current status of lymph node dissection. World J Gastroenterol 2016; 22:2875-2893. [PMID: 26973384 PMCID: PMC4779911 DOI: 10.3748/wjg.v22.i10.2875] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 10/09/2015] [Accepted: 01/18/2016] [Indexed: 02/06/2023] Open
Abstract
D2 procedure has been accepted in Far East as the standard treatment for both early (EGC) and advanced gastric cancer (AGC) for many decades. Recently EGC has been successfully treated with endoscopy by endoscopic mucosal resection or endoscopic submucosal dissection, when restricted or extended Gotoda's criteria can be applied and D1+ surgery is offered only to patients not fitted for less invasive treatment. Furthermore, two randomised controlled trials (RCTs) have been demonstrating the non inferiority of minimally invasive technique as compared to standard open surgery for the treatment of early cases and recently the feasibility of adequate D1+ dissection has been demonstrated also for the robot assisted technique. In case of AGC the debate on the extent of nodal dissection has been open for many decades. While D2 gastrectomy was performed as the standard procedure in eastern countries, mostly based on observational and retrospective studies, in the west the Medical Research Council (MRC), Dutch and Italian RCTs have been conducted to show a survival benefit of D2 over D1 with evidence based medicine. Unfortunately both the MRC and the Dutch trials failed to show a survival benefit after the D2 procedure, mostly due to the significant increase of postoperative morbidity and mortality, which was referred to splenopancreatectomy. Only 15 years after the conclusion of its accrual, the Dutch trial could report a significant decrease of recurrence after D2 procedure. Recently the long term survival analysis of the Italian RCT could demonstrate a benefit for patients with positive nodes treated with D2 gastrectomy without splenopancreatectomy. As nowadays also in western countries D2 procedure can be done safely with pancreas preserving technique and without preventive splenectomy, it has been suggested in several national guidelines as the recommended procedure for patients with AGC.
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12
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Current status of robotic gastrectomy for gastric cancer. Surg Today 2015; 46:528-34. [PMID: 26019020 DOI: 10.1007/s00595-015-1190-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 05/11/2015] [Indexed: 02/07/2023]
Abstract
Although over 3000 da Vinci Surgical System (DVSS) devices have been installed worldwide, robotic surgery for gastric cancer has not yet become widely spread and is only available in several advanced institutions. This is because, at least in part, the advantages of robotic surgery for gastric cancer remain unclear. The safety and feasibility of robotic gastrectomy have been demonstrated in several retrospective studies. However, no sound evidence has been reported to support the superiority of a robotic approach for gastric cancer treatment. In addition, the long-term clinical outcomes following robotic gastrectomy have yet to be clarified. Nevertheless, a robotic approach can potentially overcome the disadvantages of conventional laparoscopic surgery if the advantageous functions of this technique are optimized, such as the use of wristed instruments, tremor filtering and high-resolution 3-D images. The potential advantages of robotic gastrectomy have been discussed in several retrospective studies, including the ability to achieve sufficient lymphadenectomy in the area of the splenic hilum, reductions in local complication rates and a shorter learning curve for the robotic approach compared to conventional laparoscopic gastrectomy. In this review, we present the current status and discuss issues regarding robotic gastrectomy for gastric cancer.
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13
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Robotic general surgery: current practice, evidence, and perspective. Langenbecks Arch Surg 2015; 400:283-92. [PMID: 25854502 DOI: 10.1007/s00423-015-1278-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 01/27/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND Robotic technology commenced to be adopted for the field of general surgery in the 1990s. Since then, the da Vinci surgical system (Intuitive Surgical Inc, Sunnyvale, CA, USA) has remained by far the most commonly used system in this domain. The da Vinci surgical system is a master-slave machine that offers three-dimensional vision, articulated instruments with seven degrees of freedom, and additional software features such as motion scaling and tremor filtration. The specific design allows hand-eye alignment with intuitive control of the minimally invasive instruments. As such, robotic surgery appears technologically superior when compared with laparoscopy by overcoming some of the technical limitations that are imposed on the surgeon by the conventional approach. PURPOSE This article reviews the current literature and the perspective of robotic general surgery. CONCLUSIONS While robotics has been applied to a wide range of general surgery procedures, its precise role in this field remains a subject of further research. Until now, only limited clinical evidence that could establish the use of robotics as the gold standard for procedures of general surgery has been created. While surgical robotics is still in its infancy with multiple novel systems currently under development and clinical trials in progress, the opportunities for this technology appear endless, and robotics should have a lasting impact to the field of general surgery.
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