Τετάρτη 27 Ιανουαρίου 2021

Research on Spatial Motion Safety Constraints and Cooperative Control of Robot‐Assisted Craniotomy: Beagle model experiment verification

xlomafota13 shared this article with you from Inoreader

Abstract:

Background

Traditional craniotomy depends primarily on the experience of the surgeon. However, the accuracy of manual operation is limited and carries certain surgical risks. The interaction method of current robot‐assisted craniotomy is unnatural and inadaptive to the operating style of the surgeon. In this research, we built a hands‐on synergistic robotics craniotomy system with human‐machine collaboration. Safe isometric surfaces and virtual restraint methods are combined to achieve highly accurate, efficient, minimally invasive, and safe craniotomy.

Materials and methods

Fifteen 3D‐printed beagle skull models were used to evaluate system accuracy and the related image guidance process. It mainly includes: the design of the surgical plan, the adopted strategy based on motion constraint and safe isometric surface, and the impedance control method based on the position inner loop experiment via the human‐machine collaboration method. The trajectory tracking experiment was performed by applying human‐machine collaboration, and completing an experiment on the 3D printed beagle skull models involving drilling and milling of the skull performed by the robot, and evaluation of accuracy via computed tomographic (CT) scanning verification after the operation.

Results

The 3D‐printed beagle skull model experiment shows that the average errors for the top surface and the bottom surface, and the angle error were 0.81 ± 0.15 mm, 0.89 ± 0.12 mm, and 1.74 ± 0.16 degrees, respectively. The average milling position errors for the top and bottom surfaces were 0.87 ± 0.19 mm and 0.93 ± 0.22 mm, respectively.

Conclusion

The performance of the robot system was evaluated and verified using a 3D printed beagle model experiment. The proposed collaborative surgical robot system is feasible and can complete a craniotomy, with improved accuracy and surgical safety.

This article is protected by copyright. All rights reserved.

View on the web

Development of a novel deployable arm for natural orifice transluminal endoscopic surgery(NOTES)

xlomafota13 shared this article with you from Inoreader

Abstract:

Background

NOTES is aided by the instrument channel of an endoscope. Limited by the diameter of the endoscope, the construction of the operation triangle is affected. This paper presents a deployable arm that can increase the distance between the arms.

Methods

The manipulation arm is composed of a continuum arm and a deployable arm. The deployable arm can be locked by a stay cable and a mechanical structure. The angle between the end‐effectors and the common workspace of the two manipulation arms are comprehensively analyzed. Through experiments, the design parameters are validated and justified.

Results

The experiment shows that the deployment arm can maintain the deformation within 3.5 mm under a 300 g load, and the angle between the two end‐effectors can be maintained within the range of [88o ,110o].

Conclusions

The novel deployment arms enlarge the angle between the end effectors, which significantly improves the flexibility of the arms.

This article is protected by copyright. All rights reserved.

View on the web

Fluorescence‐guided D3 lymphadenectomy in robotic right colectomy with complete mesocolic excision

xlomafota13 shared this article with you from Inoreader

Abstract

Background

In robotic right hemicolectomy for cancer, appropriate lymphadenectomy is essential. Visualization of draining lymph nodes and blood flow with near‐infrared (NIR) fluorescence DaVinci® imaging system is a recent development. We present the technique of robotic right colectomy with complete mesocolic excision (CME) and D3 lymphadenectomy using Indocyanine Green (ICG) endoscopic submucosal injection to intraoperatively identify tumour lymphatic basin.

Methods

The day before surgery, in patients scheduled for robotic right colectomy an endoscopic submucosal injection of 3 mg of ICG solution around the tumor is realized. Robotic right hemicolectomy is performed with suprapubic trocars layout and "bottom to up dissection", realizing a CME with central vessel ligation and D3 lymphadenectomy. Site of primary tumor and lymphatic basin are visible with the FireflyTM camera modality.

Results

From July 2016 to July 2020, 85 patients received a robotic right colectomy with CME and D3 lymphadenectomy. In 50 patients, ICG submucosal injection was performed: visualisation of the site of primary tumour and of LN in the D3 area was possible in all cases; in 17/50 patients (34%), LN out from anatomical lymphatic basin were identified. No side effects were observed.

Conclusions

In this series, submucosal ICG injection showed to be feasible and safe. The accuracy in identification of D3 lymphatic basin was high, thus permitting an image‐guided radical lymphadenectomy. Fluorescent technology represents an interesting innovation to ameliorate surgery of colon cancer.

View on the web

Master manipulator optimisation for robot assisted minimally invasive surgery

xlomafota13 shared this article with you from Inoreader

Abstract

Background

In robot‐assisted minimally invasive surgery, the surgeon controls a robot by operating a pair of master manipulators. Thus, the performance of a master manipulator directly affects the work of the surgeon physiologically and psychologically.

Aims

In order to improve the operability and quality of operation, a structure optimisation method of master manipulator is proposed.

Materials & Methods

The optimisation index of workspace and dexterity of main manipulator based on ergonomics and kinematics is established, and the reasonable weight coefficient of optimisation index is determined by using combination weighting method.

Results

Experiments verified that the proposed optimisation method ensures a large workspace and good kinematic performance for the master manipulator.

Conclusion

This improves the comfort of the surgeon and can effectively avoid the problem of cutting off master–slave communication to adjust the position of the master manipulator owing to the small workspace.

View on the web

Urological and sexual function after robotic and laparoscopic surgery for rectal cancer: A systematic review, meta‐analysis and meta‐regression

xlomafota13 shared this article with you from Inoreader

Abstract

Background

This systematic review sought to compare the urogenital functions after laparoscopic (LAP) and robotic (ROB) surgery for rectal cancer.

Methods

This study conformed to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines.

Results

Twenty‐six studies (n = 2709 for ROB, n = 2720 for LAP) were included. There was a lower risk of 30‐day urinary retention in the ROB group (risk ratios 0.78, 95% confidence interval [CI] 0.61–0.99), but the long‐term risk was comparable (p = 0.460). Meta‐regression showed a small, positive relationship between age and risk of 30‐day urinary retention in both the ROB (p = 0.034) and LAP groups (p = 0.004). The International Prostate Symptom Score was better in the ROB group at 3 months (mean difference [MD] −1.58, 95% CI −3.10 to −0.05). The International Index of Erectile Function score was better in the ROB group at 6 months (MD 4.06, 95% CI 2.38 – 5.74).

Conclusion

While robotics may improve urogenital function after rectal surgery, the quality of evidence is low based on the Grading of Recommendations, Assessment, Development and Evaluation approach.

View on the web

Acceptance of patients towards task‐autonomous robotic cochlear implantation: An exploratory study

xlomafota13 shared this article with you from Inoreader

Abstract

Background

Recently, task‐autonomous image‐guided robotic cochlear implantation has been successfully completed in patients. However, no data exist on patients' perspective of this new technology. The aim of this study was to evaluate the acceptance of patients towards task‐autonomous robotic cochlear implantation (TARCI).

Methods

We prospectively surveyed 63 subjects (51 patients and 12 parents of infants) scheduled for manual cochlear implantation. We collected sociodemographic and clinico‐pathological characteristics and their attitude towards TARCI for themselves or their child using a questionnaire. Differences between variables were analysed using one‐way analysis of variance and Spearman's rho was used to test for correlation.

Results

Seventy‐three percent of patients and 84% of parents expressed a high acceptance towards TARCI for themselves, or their child, respectively. Interestingly, patients with a negative attitude towards TARCI were significantly younger.

Conclusion

The attitude of patients and parents likely does not represent a barrier towards application of this new technology.

View on the web

End‐user evaluation of software‐generated intervention planning environment for transrectal magnetic resonance‐guided prostate biopsies

xlomafota13 shared this article with you from Inoreader

Abstract

Background

This study presents user evaluation studies to assess the effect of information rendered by an interventional planning software on the operator's ability to plan transrectal magnetic resonance (MR)‐guided prostate biopsies using actuated robotic manipulators.

Methods

An intervention planning software was developed based on the clinical workflow followed for MR‐guided transrectal prostate biopsies. The software was designed to interface with a generic virtual manipulator and simulate an intervention environment using 2D and 3D scenes. User studies were conducted with urologists using the developed software to plan virtual biopsies.

Results

User studies demonstrated that urologists with prior experience in using 3D software completed the planning less time. 3D scenes were required to control all degrees‐of‐freedom of the manipulator, while 2D scenes were sufficient for planar motion of the manipulator.

Conclusions

The study provides insights on using 2D versus 3D environment from a urologist's perspective for different operational modes of MR‐guided prostate biopsy systems.

View on the web