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https://www.readbyqxmd.com/read/28203541/anesthetic-considerations-in-robotic-mitral-valve-surgery
#1
Kent H Rehfeldt, J Valery Andre, Matthew J Ritter
The robotic approach to cardiac surgery offers patients numerous potential advantages compared with a traditional sternotomy approach including shorter hospital length of stay, reduced pain, fewer blood transfusions, and a quicker return to normal daily activities. At the same time, robotic cardiac surgery requires that the anesthesiologist employs several subspecialty skillsets in order to provide optimal care for these patients. Multiple different regional anesthesia techniques may be used to improve analgesia, reduce opioid dosages, and facilitate rapid extubation at the conclusion of the case...
January 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28203433/robotic-assisted-double-sleeve-lobectomy
#2
Tong Qiu, Yandong Zhao, Yunpeng Xuan, Wenjie Jiao
Double-sleeve lobectomy, which includes bronchoplasty and pulmonary arterial angioplasty, is required for certain cases of central-type lung cancer. It is usually done by open surgery or video-assisted thoracoscopic surgery (VATS). In recently, da Vinci system and robotic surgery have been applied in such complicated cases. Here we describe the details associated with robotic-assisted double-sleeve lobectomy.
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28195001/design-and-analysis-of-a-tendon-based-computed-tomography-compatible-robot-with-remote-center-of-motion-for-lung-biopsy
#3
Yunpeng Yang, Shan Jiang, Zhiyong Yang, Wei Yuan, Huaisu Dou, Wei Wang, Daguang Zhang, Yuan Bian
Nowadays, biopsy is a decisive method of lung cancer diagnosis, whereas lung biopsy is time-consuming, complex and inaccurate. So a computed tomography-compatible robot for rapid and precise lung biopsy is developed in this article. According to the actual operation process, the robot is divided into two modules: 4-degree-of-freedom position module for location of puncture point is appropriate for patient's almost all positions and 3-degree-of-freedom tendon-based orientation module with remote center of motion is compact and computed tomography-compatible to orientate and insert needle automatically inside computed tomography bore...
February 1, 2017: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/28177327/functional-outcomes-of-supraglottic-squamous-cell-carcinoma-treated-by-transoral-laser-microsurgery-compared-with-horizontal-supraglottic-laryngectomy-in-patients-younger-and-older-than-65-years
#4
C M Chiesa Estomba, F A Betances Reinoso, A I Lorenzo Lorenzo, J L Fariña Conde, J Araujo Nores, C Santidrian Hidalgo
The treatment of supraglottic carcinoma remains a controversial issue. Five accepted surgical and non-surgical oncological treatments have been currently established: standard horizontal supraglottic laryngectomy (HSL), supraglottic CO2 laser microsurgery (TLM), transoral robotic surgery, radiotherapy alone and radiotherapy in combination with chemotherapy. Some studies have shown that complications of head and neck surgeries increase significantly in patients over 65 years compared to younger patients. We designed a retrospective analysis to assess the rate of complications and functional outcomes of patients treated by TLM and HSL in cases of T1-T3 supraglottic squamous cell carcinomas (SCC) in a tertiary University Hospital...
December 2016: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28166107/challenges-in-the-anesthetic-management-for-a-robotic-thymectomy-in-a-patient-with-myasthenia-gravis-a-case-report
#5
Susan M Martinelli, Bilal D Lateef, Jason M Long, David Y Huang, Ameeta Karmarkar, Brian P Barrick
We describe the case of a patient with myasthenia gravis undergoing a robotic-assisted thymectomy complicated by postoperative myasthenic crisis, with a focus on the anesthetic considerations specific to this case. Because myasthenia gravis is an autoimmune disease affecting acetylcholine receptors, caution must be taken with the use of neuromuscular blockade and reversal. Utilizing a robotic-assisted surgical approach makes anesthetic management challenging given the dangers of patient movement while the robot is docked, lung isolation, extubation criteria, and postoperative disposition...
February 3, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28149631/a-decade-of-robotics-in-lung-cancer-surgery
#6
COMMENT
Brian E Louie
No abstract text is available yet for this article.
2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28133758/feasibility-of-robotic-stereotactic-body-radiotherapy-of-lung-tumors-with-kilovoltage-x-ray-beams
#7
Susana V Sánchez-Arreola, Héctor M Garnica-Garza
PURPOSE: Robotic Stereotactic body radiation therapy (SBRT) for lung tumors is treatment modality that, for cases of inoperable lung tumors, has shown excellent treatment outcomes. The typical photon energy when delivering this type of treatments is 6MeV. In this work, using Monte Carlo simulation and realistic patient models we evaluate the characteristics of the absorbed dose distributions that result when x-ray beams of peak spectral energy of 220keV are used to irradiate lung tumors assuming a robotic SBRT delivery mode...
January 30, 2017: Medical Physics
https://www.readbyqxmd.com/read/28109575/nationwide-assessment-of-robotic-lobectomy-for-non-small-cell-lung-cancer
#8
Ravi Rajaram, Sanjay Mohanty, David J Bentrem, Emily S Pavey, David D Odell, Ankit Bharat, Karl Y Bilimoria, Malcolm M DeCamp
BACKGROUND: Robotic lobectomy has been described for non-small cell lung cancer (NSCLC). Our objectives were to (1) evaluate the use of robotic lobectomy over time, (2) identify factors associated with its use, and (3) assess outcomes after robotic lobectomy compared with other surgical approaches. METHODS: Stage I to IIIA NSCLC patients were identified from the National Cancer Data Base (2010 to 2012). Trends in robotic lobectomy were assessed over time, and multivariable logistic regression models were developed to identify factors associated with its use...
January 18, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28099339/pedicle-screw-placement-accuracy-of-bone-mounted-miniature-robot-system
#9
Tai-Hsin Tsai, Rong-Dar Tzou, Yu-Feng Su, Chieh-Hsin Wu, Cheng-Yu Tsai, Chih-Lung Lin
This article describes factors affecting the accuracy of transpedicle screw placements performed with the Renaissance robot-guided system and reviews the relevant literature. Between January 2013 and January 2015, Renaissance robot-guided spinal surgery was performed in 125 patients at Kaohsiung Medical University Hospital in Kaohsiung, Taiwan. The surgeries included 662 transpedicle screw implants and 49 Kirschner wire (K-wire) reimplants performed by intraoperative repositioning. The lead author evaluated the accuracy of all K-wire insertions and classified their accuracy into 3 categories relative to the preoperative plan for transpedicle screw placement...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28089192/commissioning-monte-carlo-algorithm-for-robotic-radiosurgery-using-cylindrical-3d-array-with-variable-density-inserts
#10
D Dechambre, V Baart, S Cucchiaro, C Ernst, N Jansen, P Berkovic, C Mievis, P Coucke, A Gulyban
INTRODUCTION: To commission the Monte Carlo (MC) algorithm based model of CyberKnife robotic stereotactic system (CK) and evaluate the feasibility of patient specific QA using the ArcCHECK cylindrical 3D-array (AC) with Multiplug inserts (MP). RESULTS: Four configurations were used for simple beam setup and two for patient QA, replacing water equivalent inserts by lung. For twelve collimators (5-60mm) in simple setup, mean (SD) differences between MC and RayTracing algorithm (RT) of the number of points failing the 3%/1mmgamma criteria were 1(1), 1(3), 1(2) and 1(2) for the four MP configurations...
January 2017: Physica Medica: PM
https://www.readbyqxmd.com/read/28066670/image-guided-thoracoscopic-surgery-with-dye-localization-in-a-hybrid-operating-room
#11
Shun-Mao Yang, Wei-Chun Ko, Mong-Wei Lin, Hsao-Hsun Hsu, Chih-Yang Chan, I-Hui Wu, Yeun-Chung Chang, Jin-Shing Chen
BACKGROUND: The rate of detection of small pulmonary nodules (SPNs) has increased. Thoracoscopic resection following image-guided localization had been a reliable alternative in their treatment. We present our experience with image-guided dye localization using robotic C-arm computed tomography (CT) followed by immediate video-assisted thoracoscopic surgery (VATS) for SPNs in a hybrid operating room (OR). METHODS: From July 2015 to July 2016, 25 consecutive patients with SPNs smaller than 2 cm underwent robotic C-arm CT-guided blue dye tattooing followed by immediate VATS in a hybrid OR...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28059973/long-term-survival-based-on-the-surgical-approach-to-lobectomy-for-clinical-stage-i-nonsmall-cell-lung-cancer-comparison-of-robotic-video-assisted-thoracic-surgery-and-thoracotomy-lobectomy
#12
Hao-Xian Yang, Kaitlin M Woo, Camelia S Sima, Manjit S Bains, Prasad S Adusumilli, James Huang, David J Finley, Nabil P Rizk, Valerie W Rusch, David R Jones, Bernard J Park
OBJECTIVE: To compare the long-term outcomes among robotic, video-assisted thoracic surgery (VATS), and open lobectomy in stage I nonsmall cell lung cancer (NSCLC). BACKGROUND: Survival comparisons between robotic, VATS, and open lobectomy in NSCLC have not yet been reported. Some studies have suggested that survival after VATS is superior, for unclear reasons. METHODS: Three cohorts (robotic, VATS, and open) of clinical stage I NSCLC patients were matched by propensity score and compared to assess overall survival (OS) and disease-free survival (DFS)...
2017: Annals of Surgery
https://www.readbyqxmd.com/read/28048402/su-f-t-569-implementation-of-a-patient-specific-qa-method-using-ebt-xd-for-cyberknife-srs-sbrt-plans
#13
K Zerouali, J Aubry, R Doucet
PURPOSE: To implement the new EBT-XD Gafchromic films for accurate dosimetric and geometric validation of stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT) CyberKnife (CK) patient specific QA. METHODS: Film calibration was performed using a triplechannel film analysis on an Epson 10000XL scanner. Calibration films were irradiated using a Varian Clinac 21EX flattened beam (0 to 20 Gy), to ensure sufficient dose homogeneity. Films were scanned to a resolution of 0...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048315/su-f-t-650-the-comparison-of-robotic-partial-breast-stereotactic-irradiation-using-mlc-vs-iris-cone
#14
C Ding, R Timmerman, S Jiang, A Rahimi
PURPOSE: To evaluate the dosimetric impact on treatment planning for partial breast stereotactic irradiation using Cyberknife with MLC versus Iris Cone. METHODS: Ten patients whom underwent lumpectomy for DCIS or stage I invasive non-lobular epithelial breast cancer were included in this study. All patients were previously treated on the Cyberknife using Iris cone with the prescription dose of 37.5Gy in 5 fractions covering at least 95% of PTV on our phase I SBRT 5 fraction partial breast irradiation trial...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047703/su-f-p-31-dosimetric-effects-of-roll-and-pitch-corrections-using-robotic-table
#15
M Mamalui, Z Su, S Flampouri, Z Li
PURPOSE: To quantify the dosimetric effect of roll and pitch corrections being performed by two types of robotic tables available at our institution: BrainLabTM 5DOF robotic table installed at VERO (BrainLab&MHI) dedicated SBRT linear accelerator and 6DOF robotic couch by IBA Proton Therapy with QFixTM couch top. METHODS: Planning study used a thorax phantom (CIRSTM), scanned at 4DCT protocol; targets (IGTV, PTV) were determined according to the institutional lung site-specific standards...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046265/su-f-t-546-a-radiobiological-comparative-study-of-robotic-and-linac-based-lung-sbrt
#16
T Roth, L Rankine, E Schreiber, S Das, P Mavroidis
PURPOSE: To expand the dosimetric comparison of CyberKnife and Elekta Versa HD regarding their capability to perform SBRT in lung cases by including radiobiological measures, which can estimate the clinical impact of the observed differences. METHODS: This study analyzes treatment data of 10 patients, who were treated with SBRT on Elekta Versa HD and replanned using CyberKnife. The original structure sets from the RayStation treatment plans were transferred to MultiPlan and were used for planning, with the exception of the PTV...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046239/su-f-t-575-verification-of-a-monte-carlo-small-field-srs-sbrt-dose-calculation-system
#17
A Sudhyadhom, C McGuinness, M Descovich
PURPOSE: To develop a methodology for validation of a Monte-Carlo dose calculation model for robotic small field SRS/SBRT deliveries. METHODS: In a robotic treatment planning system, a Monte-Carlo model was iteratively optimized to match with beam data. A two-part analysis was developed to verify this model. 1) The Monte-Carlo model was validated in a simulated water phantom versus a Ray-Tracing calculation on a single beam collimator-by-collimator calculation. 2) The Monte-Carlo model was validated to be accurate in the most challenging situation, lung, by acquiring in-phantom measurements...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046225/mo-ab-bra-03-development-of-novel-real-time-in-vivo-epid-treatment-verification-for-brachytherapy
#18
G Fonseca, M Podesta, B Reniers, F Verhaegen
PURPOSE: High Dose Rate (HDR) brachytherapy treatments are employed worldwide to treat a wide variety of cancers. However, in vivo dose verification remains a challenge with no commercial dosimetry system available to verify the treatment dose delivered to the patient. We propose a novel dosimetry system that couples an independent Monte Carlo (MC) simulation platform and an amorphous silicon Electronic Portal Imaging Device (EPID) to provide real time treatment verification. METHODS: MC calculations predict the EPID response to the photon fluence emitted by the HDR source by simulating the patient, the source dwell positions and times, and treatment complexities such as tissue compositions/densities and different applicators...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/27924200/effect-of-recruitment-maneuver-on-arterial-oxygenation-in-patients-undergoing-robot-assisted-laparoscopic-prostatectomy-with-intraoperative-15-cmh2o-positive-end-expiratory-pressure
#19
Sowoon Ahn, Sung Hye Byun, Haeyoon Chang, Young Bin Koo, Jong Chan Kim
BACKGROUND: This randomized, controlled study was designed to compare the effects of recruitment maneuvers (RMs) with a 15 cmH2O positive end-expiratory pressure (PEEP) on the systemic oxygenation and lung compliance of patients with healthy lungs following robot-assisted laparoscopic prostatectomy (RALP). METHODS: Sixty patients undergoing a RALP with an intraoperative 15 cmH2O PEEP were randomly allocated to an RM or a Control group. The patients in the RM group received a single RM through the application of a continuous positive airway pressure of 40 cmH2O for 40 s 15 min after being placed in the Trendelenburg position...
December 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27915431/time-dependent-postmortem-redistribution-of-morphine-and-its-metabolites-in-blood-and-alternative-matrices-application-of-ct-guided-biopsy-sampling
#20
Sandra N Staeheli, Dominic Gascho, Lars C Ebert, Thomas Kraemer, Andrea E Steuer
Interpretation of postmortem morphine concentrations in forensic toxicology provides several pitfalls such as missing information on tolerance, analyte stability, or postmortem redistribution (PMR). Recently, it had been shown that computed tomography (CT)-guided collection of biopsies using a robotic arm (virtobot) provides a valuable strategy for systematic studies on time-dependent PMR. Using this technique, time-dependent PMR of morphine and its metabolites was investigated in 12 cases. At admission to the institute (t1), femoral and heart blood (right ventricle) as well as biopsies from the right lung, the right kidney, liver, spleen, and muscle tissue were collected...
March 2017: International Journal of Legal Medicine
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