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Robotic microsurgery

Sabapathy Giridhar Suren Krishnan, Kandiah Umapathysivam, Craig Lockwood, John-Charles Hodge
The objective of this systematic review is to synthesize the best available evidence regarding the oncological and survival outcomes (as measured by disease control, disease-free survival, disease-specific survival and overall survival) of transoral robotic surgery (TORS) versus transoral laser microsurgery (TLM) in the treatment of oropharyngeal squamous cell carcinoma in adults (aged 18 years or older). Specifically the review questions are:1 Is there a difference in oncological outcomes between a traditional "Halstedian" en bloc tumor resection technique used in TORS versus a modern segmental tumor dissection technique used in TLM?2 Does one surgical approach confer better oncological outcomes with respect to a particular patient subgroup, such as patients with a positive human papilloma virus status or patient's with different tumor T-stages?...
August 2016: JBI Database of Systematic Reviews and Implementation Reports
Alfonso Fiorelli, Salvatore Mazzone, Giuseppe Costa, Mario Santini
Herein, we described a novel method as the use of AcuBlade robotic microsurgery system to manage idiopathic subglottic stenosis in a 73 years old lady. Compared to traditional CO2 lasers, AcuBlade facilitated the scar resection by the generation of different shape of beams (straight, curved, or disk). The same setting used for phonomicrosurgery (1-mm beam length, power of 10 W and pulse duration of 0.05-s) allowed to obtain fast, long, and uniform cuts. In addition, the reduction of the number of laser passes over the same area prevented injury of adjacent tissue and thus reduced the risk of recurrence...
July 27, 2016: Clinical Respiratory Journal
Yaser Maddahi, Kourosh Zareinia, Liu Shi Gan, Christina Sutherland, Sanju Lama, Garnette R Sutherland
The use of robotic technology in the surgical treatment of brain tumour promises increased precision and accuracy in the performance of surgery. Robotic manipulators may allow superior access to narrow surgical corridors compared to freehand or conventional neurosurgery. This paper reports values and ranges of tool-tissue interaction forces during the performance of glioma surgery using an MR compatible, image-guided neurosurgical robot called neuroArm. The system, capable of microsurgery and stereotaxy, was used in the surgical resection of glioma in seven cases...
2016: BioMed Research International
Chengyuan Wang, Summit Kundaria, Juan Fernandez-Miranda, Umamaheswar Duvvuri
OBJECTIVES/HYPOTHESIS: To illustrate detailed anatomy of the extracranial portion of the glossopharyngeal nerve in the parapharyngeal space as encountered during transoral surgery. STUDY DESIGN: Prospective cadaveric dissection. All dissections were performed transorally and confirmed with transcervical dissection. METHODS: Eight color-injected cadaveric heads (16 sides) were dissected to demonstrate the course and anatomy of the glossopharyngeal nerve...
September 2016: Laryngoscope
Jie Shen, Diyu Song, Xiaoyu Wang, Changjiang Wang, Shuming Zhang
OBJECTIVE: To summarize the research progress of peripheral nerve surgery assisted by Da Vinci robotic system. METHODS: The recent domestic and international articles about peripheral nerve surgery assisted by Da Vinci robotic system were reviewed and summarized. RESULTS: Compared with conventional microsurgery, peripheral nerve surgery assisted by Da Vinci robotic system has distinctive advantages, such as elimination of physiological tremors and three-dimensional high-resolution vision...
February 2016: Chinese Journal of Reparative and Reconstructive Surgery
Qi Wang, Guokang Fan
T1 glottic carcinoma is part of early laryngeal carcinoma which involves the vocal cords, including anterior commissure or posterior commissure. We analyzed the treatment options of T1 glottic carcinoma by reviewing the related literatures about T1 glottic carcinoma treated by conservative surgery (open surgery and laser microsurgery), radiotherapy, robot surgery, photodynamic treatment.
January 2016: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
Terence S Fu, Andrew Foreman, David P Goldstein, John R de Almeida
BACKGROUND: Squamous cell carcinoma of the head and neck can present as a cervical metastasis from an unknown primary site. Recently, transoral robotic surgery (TORS) and transoral laser microsurgery (TLM) have been incorporated in the workup of unknown primary tumors. METHODS: We searched MEDLINE, EMBASE, Cochrane, and CINAHL from inception to June 2015 for all English-language studies that utilized TORS, TLM, or lingual tonsillectomy in the approach to an unknown primary...
2016: Journal of Otolaryngology—Head & Neck Surgery
S Wiegand
Surgical treatment of laryngeal cancer has been established for decades. In addition to total laryngectomy, which was first performed in 1873, a large number of organ preservation surgical techniques, like open partial laryngectomy, transoral laser microsurgery and transoral robotic surgery, have been developed. Studies on laryngeal cancer surgery are mainly retrospective case series and cohort studies. The evolution of chemoradiation protocols and their analysis in prospective randomized trials have led to an increasing acceptance of non-surgical treatment procedures...
April 2016: Laryngo- Rhino- Otologie
Berk Gonenc, Peter Gehlbach, Russell H Taylor, Iulian Iordachita
In retinal microsurgery, membrane peeling is a standard procedure requiring the delamination of a thin fibrous membrane adherent to the retina surface by applying very small forces. Robotic devices with combined force-sensing instruments have significant potential to assist this procedure by facilitating membrane delamination through induced micro-vibrations. However, defining the optimal frequency and amplitude for generating such vibrations, and updating these parameters during the procedure is not trivial...
September 2015: Proceedings of the ... IEEE/RSJ International Conference on Intelligent Robots and Systems
Samuel J Lin
No abstract text is available yet for this article.
April 2016: Plastic and Reconstructive Surgery
Joost I P Willems, Alexandra M Shin, Delaney M Shin, Allen T Bishop, Alexander Y Shin
BACKGROUND: Microsurgery can be challenging secondary to orientation of the vessels, accessibility, or depth of the wound. Robotically assisted microsurgery reduces tremors and improves visualization and may improve the quality of anastomosis compared with traditional microsurgery. The purpose of this study was to compare robotically assisted microsurgery to traditional microsurgery in technically challenging situations with respect to time of anastomosis, quality of anastomosis, and Objective Structured Assessment of Technical Skills...
April 2016: Plastic and Reconstructive Surgery
Marc Moisi, R Shane Tubbs, Jeni Page, Alexandra Chapman, Brittni Burgess, Tyler Laws, Haylie Warren, Rod J Oskouian
The operative microscope has been a staple instrument in the neurosurgical operating room over the last 50 years. With advances in optoelectronics, options such as robotically controlled high magnification have become available. Such robotically controlled optoelectronic systems may offer new opportunities in surgical technique and teaching. However, traditionally trained surgeons may find it hard to accept newer technologies due to an inherent bias emerging from their previous background. We, therefore, studied how a medically naïve population in a pilot study would meet set microsurgical goals in a cadaver experiment using either a conventional operative microscope or BrightMatter™ Servo system, ​a robotically controlled optoelectronic system (Synaptive Medical, Toronto, Ontario, Canada)...
2016: Curēus
Vinay Rai, Nitin Mishra
A transanal approach to rectal polyp and cancer excision is often an appropriate alternative to conventional rectal resection, and has a lower associated morbidity. There has been a steady evolution in the techniques of transanal surgery over the past 30 years. It started with traditional transanal excision and was revolutionized by introduction of transanal endoscopic microsurgery in early 1980s. Introduction of transanal minimally invasive surgery made it more accessible to surgeons around the world. Now robotic platforms are being tried in certain institutions...
March 2016: Clinics in Colon and Rectal Surgery
L Vanthournhout, B Herman, J Duisit, F Château, J Szewczyk, B Lengelé, B Raucent
Microanastomosis is a microsurgical gesture that involves suturing two very small blood vessels together. This gesture is used in many operations such as avulsed member auto-grafting, pediatric surgery, reconstructive surgery - including breast reconstruction by free flap. When vessels have diameters smaller than one millimeter, hand tremors make movements difficult to control. This paper introduces our preliminary steps towards robotic assistance for helping surgeons to perform microanastomosis in optimal conditions, in order to increase gesture quality and reliability even on smaller diameters...
August 2015: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Tobia Vendrametto, Jacob S McAfee, Barry E Hirsch, Cameron N Riviere, Giancarlo Ferrigno, Elena De Momi
Micron is a fully handheld active micromanipulator that helps to improve position accuracy and precision in microsurgery by cancelling hand tremor. This work describes adaptation, tuning, and testing of the Micron system for stapedotomy, a microsurgical procedure performed in the middle ear to restore hearing that requires accurate manipulation in narrow spaces. Two end-effectors, a handle, and a brace (or rest) were designed and prototyped. The control system was adapted for the new hardware. The system was tested ex vivo in stapedotomy procedure comparing manually-performed and Micron-assisted surgical tasks...
2015: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Yuki Horise, Xingchi He, Peter Gehlbach, Russell Taylor, Iulian Iordachita
In retinal surgery, microsurgical instruments such as micro forceps, scissors and picks are inserted through the eye wall via sclerotomies. A handheld intraocular light source is typically used to visualize the tools during the procedure. Retinal surgery requires precise and stable tool maneuvers as the surgical targets are micro scale, fragile and critical to function. Retinal surgeons typically control an active surgical tool with one hand and an illumination source with the other. In this paper, we present a "smart" light pipe that enables true bimanual surgery via utilization of an active, robot-assisted source of targeted illumination...
2015: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Albert H Chao, Katie Weimer, Joerg Raczkowsky, Yaokun Zhang, Mirko Kunze, Dianna Cody, Jesse C Selber, Matthew M Hanasono, Roman J Skoracki
Bony free flap reconstruction of the facial skeleton remains a challenging area of reconstructive surgery. Despite technological advances that have aided planning and execution of these procedures, surgical inaccuracy is not insignificant. One source of error that has not been wholly addressed is that attributable to a human operator. In this study, we investigate the feasibility and accuracy of performing osteotomies robotically in pre-programmed fashion for fibula free flap mandible reconstruction as a method to reduce inaccuracies related to human error...
March 2016: Microsurgery
Ajay Vikram Singh, Metin Sitti
Miniature untethered medical robots have been receiving growing attention due to technological advances in microactuation, microsensors, and microfabrication and have significant potential to reduce the invasiveness and improve the accessibility of medical devices into unprecedented small spaces inside the human body. In this review, we discuss therapeutic and diagnostic applications of untethered medical microrobots. Wirelessly controlled milli/microrobots with integrated sensors are revolutionizing micromanipulation based medical interventions and are enabling doctors to perform minimally invasive procedures not possible before...
2016: Current Pharmaceutical Design
James Andrew Smith, Jamil Jivraj, Ronnie Wong, Victor Yang
This review provides an examination of contemporary neurosurgical robots and the developments that led to them. Improvements in localization, microsurgery and minimally invasive surgery have made robotic neurosurgery viable, as seen by the success of platforms such as the CyberKnife and neuromate. Neurosurgical robots can now perform specific surgical tasks such as skull-base drilling and craniotomies, as well as pedicle screw and cochlear electrode insertions. Growth trends in neurosurgical robotics are likely to continue but may be tempered by concerns over recent surgical robot recalls, commercially-driven surgeon training, and studies that show operational costs for surgical robotic procedures are often higher than traditional surgical methods...
April 2016: Annals of Biomedical Engineering
James J Doulgeris, Sabrina A Gonzalez-Blohm, Andreas K Filis, Thomas M Shea, Kamran Aghayev, Frank D Vrionis
BACKGROUND: Advances in technology have pushed the boundaries of neurosurgery. Surgeons play a major role in the neurosurgical field, but robotic systems challenge the current status quo. Robotic-assisted surgery has revolutionized several surgical fields, yet robotic-assisted neurosurgery is limited by available technology. METHODS: The literature on the current robotic systems in neurosurgery and the challenges and compromises of robotic design are reviewed and discussed...
July 2015: Cancer Control: Journal of the Moffitt Cancer Center
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