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https://www.readbyqxmd.com/read/28098574/new-developments-in-robotics-and-single-site-gynecologic-surgery
#1
Catherine A Matthews
Within the last 10 years there have been significant advances in minimal-access surgery. Although no emerging technology has demonstrated improved outcomes or fewer complications than standard laparoscopy, the introduction of the robotic surgical platform has significantly lowered abdominal hysterectomy rates. While operative time and cost were higher in robotic-assisted procedures when the technology was first introduced, newer studies demonstrate equivalent or improved robotic surgical efficiency with increased experience...
January 17, 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28097936/experimental-study-on-tissue-phantoms-to-understand-the-effect-of-injury-and-suturing-on-human-skin-mechanical-properties
#2
Arnab Chanda, Vinu Unnikrishnan, Zachary Flynn, Kim Lackey
Skin injuries are the most common type of injuries occurring in day-to-day life. A skin injury usually manifests itself in the form of a wound or a cut. While a shallow wound may heal by itself within a short time, deep wounds require surgical interventions such as suturing for timely healing. To date, suturing practices are based on a surgeon's experience and may vary widely from one situation to another. Understanding the mechanics of wound closure and suturing of the skin is crucial to improve clinical suturing practices and also to plan automated robotic surgeries...
January 2017: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/28097262/lessons-learned-over-a-decade-of-pediatric-robotic-ureteral-reimplantation
#3
REVIEW
Minki Baek, Chester J Koh
The da Vinci robotic system has improved surgeon dexterity, ergonomics, and visualization to allow for a minimally invasive option for complex reconstructive procedures in children. Over the past decade, robot-assisted laparoscopic ureteral reimplantation (RALUR) has become a viable minimally invasive surgical option for pediatric vesicoureteral reflux (VUR). However, higher-than-expected complication rates and suboptimal reflux resolution rates at some centers have also been reported. The heterogeneity of surgical outcomes may arise from the inherent and underestimated complexity of the RALUR procedure that may justify its reclassification as a complex reconstructive procedure and especially for robotic surgeons early in their learning curve...
January 2017: Investigative and Clinical Urology
https://www.readbyqxmd.com/read/28095555/megasessions-for-robotic-hair-restoration
#4
Joa O Carlos Pereira, Joa O Carlos Pereira Filho, Joa O Pedro Cabrera Pereira
A robotic system can select and remove individual hair follicles from the donor area with great precision and without fatigue. This report describes the use of the robotic system in a megasession for hair restoration. Patients were instructed to cut their hair to 1.0 to 1.2 mm before surgery. The robot selected and removed 600 to 800 grafts per hour so the follicular units (FU)s could be transplanted manually to recipient sites. The robot arm consists of a sharp inner punch and a blunt outer punch which together separate FUs from the sur- rounding tissue...
November 1, 2016: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/28094020/the-wertheim-hysterectomy-development-modifications-and-impact-in-the-present-day
#5
Alexa L Swailes, Allison Gockley, Rébécca Phaëton, Joshua P Kesterson
Ernst Wertheim was a pioneer in the history of the surgical treatment of cervical cancer. His English-language manuscript "The extended abdominal operation for carcinoma uteri (based on 500 operative cases)," which was published in 1912, detailed his standardization of the radical hysterectomy and formed the basis of the current treatment for early stage cervical cancer. We contextualize the Wertheim hysterectomy, emphasizing medical advances that allowed for its development and subsequent modification. We then discuss modifications to the originally proposed procedure, including a maximally extended parametrical resection pioneered by Takayama, and the addition of the Taussig en bloc lymph node dissection by Meigs, both of which afforded an improved mortality profile due to decreased disease recurrence...
January 13, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28090746/development-of-an-in-vivo-visual-robot-system-with-a-magnetic-anchoring-mechanism-and-a-lens-cleaning-mechanism-for-laparoendoscopic-single-site-surgery-less
#6
Haibo Feng, Dinghui Dong, Tengfei Ma, Jinlei Zhuang, Yili Fu, Yi Lv, Liyi Li
BACKGROUND: Surgical robot systems which can significantly improve surgical procedures have been widely used in laparoendoscopic single-site surgery (LESS). For a relative complex surgical procedure, the development of an in vivo visual robot system for LESS can effectively improve the visualization for surgical robot systems. METHODS: In this work, an in vivo visual robot system with a new mechanism for LESS was investigated. A finite element method (FEM) analysis was carried out to ensure the safety of the in vivo visual robot during the movement, which was the most important concern for surgical purposes...
January 16, 2017: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/28090509/innovations-in-surgery-simulation-a-review-of-past-current-and-future-techniques
#7
REVIEW
Ido Badash, Karen Burtt, Carlos A Solorzano, Joseph N Carey
As a result of recent work-hours limitations and concerns for patient safety, innovations in extraclinical surgical simulation have become a desired part of residency education. Current simulation models, including cadaveric, animal, bench-top, virtual reality (VR) and robotic simulators are increasingly used in surgical training programs. Advances in telesurgery, three-dimensional (3D) printing, and the incorporation of patient-specific anatomy are paving the way for simulators to become integral components of medical training in the future...
December 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28089208/the-reconstructive-options-for-oropharyngeal-defects-in-the-transoral-robotic-surgery-framework
#8
Giuseppe Meccariello, Filippo Montevecchi, Rossella Sgarzani, Andrea De Vito, Giovanni D'Agostino, Riccardo Gobbi, Chiara Bellini, Claudio Vicini
Transoral robotic surgery (TORS) is a fascinating new technique that has been proved to be a safe and feasible for selected oropharyngeal cancers. Furthermore, TORS offers several advantages in the treatment of locoregionally advanced cancers. Nevertheless, the careful selection of patients is the keypoint for a successful application of this therapeutic modality. However, the reconstruction of large oropharyngeal defects is challenging due to the restoration of velopharyngeal competency and swallowing. Moreover, the absence of mandibular splitting increases the difficulties faced by reconstructive surgeons...
January 11, 2017: Oral Oncology
https://www.readbyqxmd.com/read/28087244/practice-makes-perfect-correlations-between-prior-experience-in-high-level-athletics-and-robotic-surgical-performance-do-not-persist-after-task-repetition
#9
Kevin Shee, Fady M Ghali, Elias S Hyams
OBJECTIVE: Robotic surgical skill development is central to training in urology as well as in other surgical disciplines. Here, we describe a pilot study assessing the relationships between robotic surgery simulator performance and 3 categories of activities, namely, videogames, musical instruments, and athletics. DESIGN: A questionnaire was administered to preclinical medical students for general demographic information and prior experiences in surgery, videogames, musical instruments, and athletics...
January 10, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28079677/cadaveric-testing-of-robot-assisted-access-to-the-internal-auditory-canal-for-vestibular-schwannoma-removal
#10
Neal P Dillon, Ramya Balachandran, Michael A Siebold, Robert J Webster, George B Wanna, Robert F Labadie
HYPOTHESIS: An image-guided robotic system can safely perform the bulk removal of bone during the translabyrinthine approach to vestibular schwannoma (VS). BACKGROUND: The translabyrinthine approach to VS removal involves extensive manual milling in the temporal bone to gain access to the internal auditory canal (IAC) for tumor resection. This bone removal is time consuming and challenging due to the presence of vital anatomy (e.g., facial nerve) embedded within the temporal bone...
January 10, 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28078822/development-and-testing-of-a-grasper-for-notes-powered-by-variable-stiffness-pneumatic-actuation
#11
Michele Gabrio Antonelli, Pierluigi Beomonte Zobel, Francesco Durante, Fabio Gaj
BACKGROUND: In natural orifice transluminal endoscopic surgery (NOTES) the peritoneal cavity is reached through natural orifices (mouth, rectus and transvaginal duct), by means of little cuttings in the walls of hollow organs. Due to narrow spaces, NOTES needs robotic systems to assure operation/movement precision and patient safety. Variable stiffness actuation (VSA) assures both requirements. METHODS: The authors developed a grasper for NOTES, provided with VSA, to use as an end-effector for snail robot devices...
January 12, 2017: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/28078775/comparison-of-three-surgical-approaches-for-staging-lymphadenectomy-in-high-risk-endometrial-cancer
#12
Katherine J Pulman, Ebernella S Dason, Lauren Philp, Marcus Q Bernardini, Sarah E Ferguson, Stéphane Laframboise, Eshetu G Atenafu, Taymaa May
OBJECTIVE: To compare laparotomy, laparoscopy, and robotic surgical approaches to lymphadenectomy for high-risk endometrial cancer staging. METHODS: A retrospective cohort study enrolled patients who underwent surgery for pathologic high-risk endometrial carcinoma at the University Health Network, Toronto, Canada, between January 1, 2005 and December 31, 2013. The primary outcome, the median number of nodes retrieved, was compared based on surgical technique. The secondary outcome was the detection of metastatic nodes...
December 7, 2016: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28078466/does-stoma-site-specimen-extraction-increase-postoperative-ileostomy-complication-rates
#13
Wanglin Li, Cigdem Benlice, Luca Stocchi, Hermann Kessler, Emre Gorgun, Meagan Costedio
BACKGROUND: Minimizing incisions has the potential to decrease hernia formation and wound complications following laparoscopic surgery. It is currently unknown if using the stoma site for specimen extraction affects outcomes. This study aims to evaluate the impact of stoma site extraction on postoperative complication rates in laparoscopic colorectal surgery. METHODS: After IRB approval, a retrospective comparative review of 738 consecutive patients (405 M) who underwent laparoscopic colorectal surgery with ileostomy between January 2008 and December 2014 was performed...
January 11, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28078455/retention-of-laparoscopic-and-robotic-skills-among-medical-students-a-randomized-controlled-trial
#14
Megan S Orlando, Lauren Thomaier, Melinda G Abernethy, Chi Chiung Grace Chen
BACKGROUND: Although simulation training beneficially contributes to traditional surgical training, there are less objective data on simulation skills retention. OBJECTIVE: To investigate the retention of laparoscopic and robotic skills after simulation training. METHODS: We present the second stage of a randomized single-blinded controlled trial in which 40 simulation-naïve medical students were randomly assigned to practice peg transfer tasks on either laparoscopic (N = 20, Fundamentals of Laparoscopic Surgery, Venture Technologies Inc...
January 11, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28076610/intraoperative-near-infrared-fluorescent-imaging-during-robotic-operations
#15
Antonio Luiz de Vasconcellos Macedo, Vladimir Schraibman
The intraoperative identification of certain anatomical structures because they are small or visually occult may be challenging. The development of minimally invasive surgery brought additional difficulties to identify these structures due to the lack of complete tactile sensitivity. A number of different forms of intraoperative mapping have been tried. Recently, the near-infrared fluorescence imaging technology with indocyanine green has been added to robotic platforms. In addition, this technology has been tested in several types of operations, and has advantages such as safety, low cost and good results...
October 2016: Einstein
https://www.readbyqxmd.com/read/28076489/robotic-surgery-bioethical-aspects
#16
Rodrigo Siqueira-Batista, Camila Ribeiro Souza, Polyana Mendes Maia, Sávio Lana Siqueira
Introduction: The use of robots in surgery has been increasingly common today, allowing the emergence of numerous bioethical issues in this area. Objective: To present review of the ethical aspects of robot use in surgery. Method: Search in Pubmed, SciELO and Lilacs crossing the headings "bioethics", "surgery", "ethics", "laparoscopy" and "robotic". Results: Of the citations obtained, were selected 17 articles, which were used for the preparation of the article...
November 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/28075516/quantifying-severe-urinary-complications-after-radical-prostatectomy-the-development-and-validation-of-a-surgical-performance-indicator-using-hospital-administrative-data
#17
A Sujenthiran, S C Charman, M Parry, J Nossiter, A Aggarwal, P Dasgupta, H Payne, N W Clarke, P Cathcart, J van der Meulen
OBJECTIVES: To develop and validate a surgical performance indicator based on severe urinary complications that require an intervention within two years after radical prostatectomy (RP) identified in hospital administrative data. PATIENTS AND METHODS: Men who underwent RP between 2008 and 2012 in England were identified using hospital administrative data. A transparent coding-framework based on procedure codes was developed to identify severe urinary complications which were grouped into "stricture", "incontinence" and "other"...
January 11, 2017: BJU International
https://www.readbyqxmd.com/read/28075160/can-we-accomplish-better-oncological-results-with-robot-assisted-radical-prostatectomy
#18
Ali Riza Kural, Can Obek, Tünkut Doğanca
Surgical removal with radical prostatectomy has been a cornerstone for the treatment of prostate cancer and is associated with level one evidence for survival advantage compared to watchful waiting. Since the first structured robotic program was launched in 2000, robot-assisted radical prostatectomy (RARP) has had a rapid diffusion and surpassed its open (ORP) and laparoscopic (LRP) counterparts in the United States and is progressively expanding in other countries. Interestingly, this common acceptance of RARP was initially driven in the paucity of robust clinical evidence...
January 11, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28075157/visual-occlusion-during-minimally-invasive-surgery-a-contemporary-review-of-methods-to-reduce-laparoscopic-and-robotic-lens-fogging-and-other-sources-of-optical-loss
#19
Todd Galvin Manning, Marlon Perera, Daniel Christidis, Ned Kinnear, Shannon McGrath, Richard O'Beirne, Paul Zotov, Damien M Bolton, Nathan Lawrentschuk
Background Maintenance of optimal vision during minimally invasive surgery is crucial to maintaining operative awareness, efficiency and safety. Hampered vision is commonly caused by laparoscopic lens fogging (LLF) which has prompted the development of various anti-fogging fluids and warming devices. However, limited comparative evidence exists in contemporary literature. Despite technological advancements there remains no consensus as to superior methods to prevent LLF or restore visual acuity once LLF has occurred...
January 11, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28073298/extraperitoneal-vs-transperitoneal-robot-assisted-radical-prostatectomy-in-the-setting-of-prior-abdominal-or-pelvic-surgery
#20
David Horovitz, Changyong Feng, Edward M Messing, Jean Volny Joseph
INTRODUCTION: During Robotic-Assisted Radical Prostatectomy (RARP), the prostate may be approached extraperiteoneally (eRARP) or transperitoneally (tRARP). The former avoids the abdominal cavity which might be of benefit in patients who have had prior abdominal or pelvic surgery (PAPS). Our objective was to compare the outcomes of patients with PAPS undergoing either technique. METHODS: A retrospective review of patients treated with RARP from July 1, 2003-Dec. 31, 2014 with a minimum follow-up of 3 months was undertaken...
January 10, 2017: Journal of Endourology
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