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Auteur : Grafiati
Publié le 14 mars 2023

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1

Kume, Keiichiro, Nobuo Sakai et Toru Ueda. « Development of a Novel Gastrointestinal Endoscopic Robot Enabling Complete Remote Control of All Operations : Endoscopic Therapeutic Robot System (ETRS) ». Gastroenterology Research and Practice 2019 (4 novembre 2019) : 1–5. http://dx.doi.org/10.1155/2019/6909547.

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Background and Objective. The master and slave transluminal endoscopic robot and other flexible endoscopy platforms are designed primarily for the remote control of forceps, with manipulation of the endoscope itself still dependent on conventional techniques. We have developed an endoscopic therapeutic robot system (ETRS) that provides complete remote control of all forceps and endoscope operations. Method. We carried out endoscopic submucosal dissection (ESD) in porcine stomachs using the ETRS. All procedures were completed with the endoscopist seated at the console the entire time. Results. Total en bloc resection was achieved in all 7 cases with no complications. The mean total procedure time was 36.14±14.98 min, the mean size of the resected specimen was 3.39±0.66 cm×3.03±0.63 cm, and the mean dissection time was 14.91±8.61 min. Conclusion. We successfully used the ETRS to perform completely remote-controlled ESD in porcine stomachs.
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Kim, Sang Hyun, Hyuk Soon Choi, Jae Min Lee, Bora Keum, Byung Gon Kim, Daehie Hong, Yoon Tae Jeen et Hoon Jai Chun. « Gastric endoscopic submucosal dissection using a detachable assistant robot. » Journal of Clinical Oncology 40, no 4_suppl (1 février 2022) : 318. http://dx.doi.org/10.1200/jco.2022.40.4_suppl.318.

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318 Background: Effective traction and counter-traction for visualizing the dissection plane in endoscopic submucosal dissection (ESD) is difficult to be achieved with a conventional endoscope. We developed a robotic assistive traction device for flexible endoscopy that provides multi-directional traction during ESD. We compared its safety and efficiency in ESD between experienced and novice endoscopists. Methods: Robotic ESD was performed by experienced and novice endoscopist groups (n = 2, each). The outcomes included time to complete each ESD step, total procedure time, size of the dissected mucosa, rate of en bloc resection, and major adverse events. Furthermore, incision and dissection speeds were compared between groups. Results: Twenty gastric lesions were resected from nine live pigs. The submucosal incision speed was significantly faster in the expert group than in the novice group (P = 0.002). There was no significant difference in the submucosal dissection speed between the groups (P = 0.365). No complications were reported in either group. Conclusions: When the robot was assisting in the ESD procedure, the dissection speed improved significantly, especially in the novice surgeons. Our robotic device can provide simple, effective, and safe multidirectional traction during ESD.
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Kim, Sang Hyun, Bora Keum, Hyuk Soon Choi, Yoon Tae Jeen et Hoon Jai Chun. « Effect of robot-assisted gastric ESD in difficult ESD locations. » Journal of Clinical Oncology 41, no 4_suppl (1 février 2023) : 355. http://dx.doi.org/10.1200/jco.2023.41.4_suppl.355.

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355 Background: Since its introduction, endoscopic submucosal dissection (ESD) has become a standard treatment for early malignant lesions of stomach. However, ESD is technically demanding and it bears a high risk of complication for beginners. The difficulty of the ESD technique tends to depend on the location of the lesion. We compared and analyzed the efficacy of the ESD assistive robot that we developed in the location where stomach ESD is considered difficult. Methods: We have developed an automated simulator that can implement gastric ESD locations. An EndoGel (Sunarrow, Tokyo, Japan) was attached to the simulator to implement a virtual gastric location where ESD is difficult. "Difficult ESD locations" were selected in consideration of the location where a lot of muscle damage and frequent blind dissections occurred when conventional ESD was performed. An experienced endoscopist performed ten robot-assisted ESDs or conventional ESDs in 3 difficult and 3 easy positions, respectively. Results: While there was no significant difference in dissection speed of robot ESD and conventional ESD in easy positions, the submucosal dissection speed was remarkably faster in robotic ESD than in conventional ESD in difficult positions (P < 0.05). In difficult positions, there was significantly more muscle damage in conventional ESD than in robotic ESD. (P < 0.05). Conclusions: Dissection speed was greatly improved when assistive robots aided gastric ESD procedures in difficult locations. Our robotic device can thus provide simple, effective, and safe multidirectional traction during gastric ESD in difficult location.
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Kume, K., T. Kuroki, M. Shingai et M. Harada. « Endoscopic submucosal dissection using the endoscopic operation robot ». Endoscopy 44, S 02 (8 novembre 2012) : E399—E400. http://dx.doi.org/10.1055/s-0032-1310251.

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Lee, Hang Lak. « Endoscopic Submucosal Dissection Using Endoscopic Robot : Endoscopist’s Future Destination ». Gut and Liver 13, no 4 (17 avril 2019) : 381–82. http://dx.doi.org/10.5009/gnl19120.

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Kim, Sang Hyun, Hyuk Soon Choi, Jae Min Lee, Eun Sun Kim, Bora Keum, Yoon Tae Jeen, Hong Sik Lee et al. « Colonic endoscopic submucosal dissection using a novel robotic system. » Journal of Clinical Oncology 40, no 4_suppl (1 février 2022) : 111. http://dx.doi.org/10.1200/jco.2022.40.4_suppl.111.

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111 Background: Appropriate tissue tension and clear visibility of the dissection area using traction are essential for effective and safe endoscopic submucosal dissection (ESD). We developed a robotic assistive traction device for colonoscopy.This is a preclinical animal study to evaluate the performance of colorectal ESD using novel robotic system. Methods: Experienced endoscopist performed ESD on ex vivo porcine colon ten times using a robot and ten times by the conventional method. The outcome measures were operating time (from starting incision to finishing dissection), completeness of resection, procedure-related adverse events, and limitations of arm manipulation in a narrow working space as assessed by counting the frequency of blind cutting.We also conducted an in vivo feasibility study on live pig. Results: Total of twenty colonic lesions were resected from ex vivo porcine colon. The submucosal dissection speed was significantly faster in robotic ESD than in conventional ESD (P = 0.002). Adverse events such as perforation were also significantly higher in the conventional group. In the in vivo feasibility study, robot was attached to the colonoscope and inserted into the proximal colon. ESD was performed successfully. Conclusions: When the robot was assisting in the ESD procedure, the dissection speed improved significantly. Our robotic device can thus provide simple, effective, and safe multidirectional traction during colonic ESD.
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Kim, Sang Hyun, Bora Keum, Hyuk Soon Choi, Yoon Tae Jeen, Hoon Jai Chun et Daehie Hong. « Colorectal endoscopic submucosal dissection using a concealable robotic add-on device : A comparative in vivo feasibility study. » Journal of Clinical Oncology 41, no 4_suppl (1 février 2023) : 128. http://dx.doi.org/10.1200/jco.2023.41.4_suppl.128.

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128 Background: Appropriate tissue tension and clear visibility of the dissection area using traction are essential for effective and safe colonic endoscopic submucosal dissection (ESD). In this preclinical ex vivo and in vivo animal study, we developed a concealable robotic-assisted traction device and evaluated its performance in colorectal ESD. Methods: An experienced endoscopist performed ESD on an ex vivo porcine colon 18 times using our robot and 18 times using the conventional method. The outcome measures were procedure time, dissection speed, procedure-related adverse events, and blind dissection rate. We also conducted an in vivo feasibility study in live pigs. Robotic ESD was performed by experienced and novice endoscopist groups (n = 2, each). The outcomes included time to complete each ESD step, total procedure time, size of the dissected mucosa, rate of en bloc resection, and major adverse events. Results: Thirty-six colonic lesions were resected from ex vivo porcine colon samples. The total procedure time was significantly shorter in robotic ESD (RESD) than in conventional ESD (CESD) (20.1±4.1 vs. 34.3±8.3; P < 0.05). The submucosal dissection speed was significantly higher in the RESD group than in the CESD group (36.8±9.2 vs. 18.1±4.7; P < 0.05). The blind dissection rate was also significantly lower in the robotic group (12.8±3.4% vs. 35.1±3.9%; P < 0.05). In an in vivo feasibility study, the robot was attached to the colonoscope and successfully inserted into the proximal colon without damaging the colonic wall, and ESD was successfully performed. There was no significant difference in the submucosal dissection speed between the groups (P = 0.465). Conclusions: When the concealable robot assisted the colonic ESD procedure, the dissection speed and safety profile improved significantly. Thus, our robotic device can provide a simple, effective, and safe multidirectional traction during colonic ESD. When the robot was assisting in the ESD procedure, the dissection speed improved significantly, especially in the novice endoscopists.
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Kim, Sang-Hyun, Hyuk-Soon Choi, Bora Keum et Hoon-Jai Chun. « Robotics in Gastrointestinal Endoscopy ». Applied Sciences 11, no 23 (30 novembre 2021) : 11351. http://dx.doi.org/10.3390/app112311351.

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Recent advances in endoscopic technology allow clinicians to not only detect digestive diseases early, but also provide appropriate treatment. The development of various therapeutic endoscopic technologies has changed the paradigm in the treatment of gastrointestinal diseases, contributing greatly to improving the quality of life of patients. The application of robotics for gastrointestinal endoscopy improves the maneuverability and therapeutic ability of gastrointestinal endoscopists, but there are still technical limitations. With the development of minimally invasive endoscopic treatment, clinicians need more sophisticated and precise endoscopic instruments. Novel robotic systems are being developed for application in various clinical fields, to ultimately develop into minimally invasive robotic surgery to lower the risk to patients. Robots for endoscopic submucosal dissection, autonomous locomotive robotic colonoscopes, and robotic capsule endoscopes are currently being developed. In this review, the most recently developed innovative endoscopic robots were evaluated according to their operating mechanisms and purpose of use. Robotic endoscopy is an innovative treatment platform for future digestive endoscopy.
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Ho, Khek-Yu. « Robotics in gastrointestinal endoscopy ». Journal of Digestive Endoscopy 03, S 05 (janvier 2012) : 074–76. http://dx.doi.org/10.4103/0976-5042.95039.

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AbstractThe application of robotics in gastrointestinal endoscopy is a much anticipated technological advancement that is attracting an enormous amount of interest from innovators and end-users alike. Emerging robotics-enhanced endoscopy platforms for performance of various endoscopic interventional procedures are already in development and some are expected to be in the pipeline for commercialization in another few years’ time. In particular, the Master And Slave Transluminal Endoscopic Robot (MASTER) developed by a collaboration between the National University of Singapore and the Nanyang Technological University, Singapore is already in human trials for an endoluminal procedure, endoscopic submucosal dissection (ESD). The results on trials performed on five patients with early gastric neoplasia have demonstrated the feasibility and safety of using the system for such procedure, while also shortening the procedure time. This article will highlight the advantages of robotics innovations in gastrointestinal endoscopy, with the MASTER as an example, and explore some of the many possibilities for future applications of robotics-enhanced endoscopy.
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Takeshita, Nobuyoshi, Khek Ho, Soo Phee, Jennie Wong et Philip Chiu. « Feasibility of performing esophageal endoscopic submucosal dissection using master and slave transluminal endoscopic robot ». Endoscopy 49, S 01 (9 janvier 2017) : E27—E28. http://dx.doi.org/10.1055/s-0042-121486.

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Sun, Zhenglong, Rui Yee Ang, Ed Wyn Lim, Zheng Wang, Khek Yu Ho et Soo Jay Phee. « Enhancement of a Master-Slave Robotic System for Natural Orifice Transluminal Endoscopic Surgery ». Annals of the Academy of Medicine, Singapore 40, no 5 (15 mai 2011) : 223–30. http://dx.doi.org/10.47102/annals-acadmedsg.v40n5p223.

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Introduction: A novel robotic platform for Natural Orifice Transluminal Endoscopic Surgery (NOTES) is presented in this paper. It aims to tackle two crucial technical barriers which hinder its smooth transition from animal studies to clinical trials: providing effective instrumentations to perform complex NOTES procedures and maintaining the spatial orientation for endoscopic navigation. Materials and Methods: The technical barriers are overcome by the design of the robotic system considering size, triangulation, dexterity, maneuverability and complexity. It is also shown that haptic feedback and interventional navigation system could solve the problem of off-axis manipulation of the camera angle and loss of spatial orientation upon entering the peritoneal cavity in transgastric NOTES procedure, respectively. Results: Successful ESD (endoscopic submucosal dissection) and wedge hepatic resection have been performed on live pigs with our Master And Slave Transluminal Endoscopic Robot (MASTER) system, showing its capability to perform advanced endoscopic surgical and NOTES procedures. It is found that the MASTER exhibited good grasping and cutting efficiency. And the lesion resection time could be significantly reduced with more practice between the endoscopist and the robot operator. Conclusion: This study evaluates the feasibility of MASTER system as a platform overcoming the barriers to NOTES. It is also demonstrated that the MASTER could effectively mitigate the technical constraints normally encountered in NOTES procedures. Key words: Haptic feedback, Instrumentation design, Interventional Navigation System (INS), Tracking
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Rawal, Sudhir Kumar, Amitabh Singh et Ashish Khanna. « Robot-Assisted Video Endoscopic Inguinal Lymph Node Dissection for Carcinoma Penis ». Journal of Endourology 36, S2 (1 septembre 2022) : S—12—S—17. http://dx.doi.org/10.1089/end.2022.0420.

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Ho, Khek Yu, Louis S. Phee, Zhenglong Sun, Rajat Goel, Pradeep Rebala, Davide Lomanto, Van an Huynh et al. « 875 Endoscopic Submucosal Dissection Using a Computer-Controlled Master- Slave Robot ». Gastrointestinal Endoscopy 73, no 4 (avril 2011) : AB155. http://dx.doi.org/10.1016/j.gie.2011.03.131.

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Nakadate, Ryu, Tsutomu Iwasa, Shinya Onogi, Jumpei Arata, Susumu Oguri, Yasuharu Okamoto, Tomohiko Akahoshi, Masatoshi Eto et Makoto Hashizume. « Surgical Robot for Intraluminal Access : An Ex Vivo Feasibility Study ». Cyborg and Bionic Systems 2020 (5 décembre 2020) : 1–9. http://dx.doi.org/10.34133/2020/8378025.

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Early-stage gastrointestinal cancer is often treated by endoscopic submucosal dissection (ESD) using a flexible endoscope. Compared with conventional percutaneous surgery, ESD is much less invasive and provides a high quality of life for the patient because it does not require a skin incision, and the organ is preserved. However, the operator must be highly skilled because ESD requires using a flexible endoscope with energy devices, which have limited degrees of freedom. To facilitate easier manipulation of these flexible devices, we developed a surgical robot comprising a flexible endoscope and two articulating instruments. The robotic system is based on a conventional flexible endoscope, and an extrapolated motor unit moves the endoscope in all its degrees of freedom. The instruments are thin enough to allow insertion of two instruments into the endoscope channel, and each instrument has a bending section that allows for up–down, right–left, and forward–backward motion. In this study, we performed an ex vivo feasibility evaluation using the proposed robotic system for ESD in a porcine stomach. The procedure was successfully performed by five novice operators without complications. Our findings demonstrated the feasibility of the proposed robotic system and, furthermore, suggest that even operators with limited experience can use this system to perform ESD.
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Ho, Khek-Yu, Soo Jay Phee, Asim Shabbir, Soon Chiang Low, Van An Huynh, Andy Prima Kencana, Kai Yang et al. « Endoscopic submucosal dissection of gastric lesions by using a Master and Slave Transluminal Endoscopic Robot (MASTER) ». Gastrointestinal Endoscopy 72, no 3 (septembre 2010) : 593–99. http://dx.doi.org/10.1016/j.gie.2010.04.009.

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Kim, Byung Gon, Hyuk Soon Choi, Sei Hoon Park, Jun Ho Hong, Jung Min Lee, Seung Han Kim, Hoon Jai Chun, Daehie Hong et Bora Keum. « A Pilot Study of Endoscopic Submucosal Dissection Using an Endoscopic Assistive Robot in a Porcine Stomach Model ». Gut and Liver 13, no 4 (17 avril 2019) : 402–8. http://dx.doi.org/10.5009/gnl18370.

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Min, Geeho, Hyuk Soon Choi, W. O. O. J. U. N. G. KIM, Seong Ji Choi, Jung Min Lee, Jae Min Lee, Seung Han Kim et al. « Sa1891 THE COMPARATIVE STUDY OF ROBOT ASSISTED ENDOSCOPIC SUBMUCOSAL DISSECTION : ANIMAL MODEL STUDY ». Gastrointestinal Endoscopy 87, no 6 (juin 2018) : AB236. http://dx.doi.org/10.1016/j.gie.2018.04.1524.

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Mantovani, Gustavo, Philippe Liverneaux, Jose Carlos Garcia, Stacey H. Berner, Michael S. Bednar et Catherine J. Mohr. « Endoscopic exploration and repair of brachial plexus with telerobotic manipulation : a cadaver trial ». Journal of Neurosurgery 115, no 3 (septembre 2011) : 659–64. http://dx.doi.org/10.3171/2011.3.jns10931.

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Object The aim of this paper was to develop an effective minimally invasive approach to brachial plexus surgery and to determine the feasibility of using telerobotic manipulation to perform a diagnostic dissection and microsurgical repair of the brachial plexus utilizing an entirely endoscopic approach. Methods The authors performed an endoscopic approach using 3 supraclavicular portals in 2 fresh human cadaver brachial plexuses with the aid of the da Vinci telemanipulation system. Dissection was facilitated inflating the area with CO2 at 4 mm Hg pressure. The normal supraclavicular plexus was dissected in its entirety to confirm the feasibility of a complete supraclavicular brachial plexus diagnostic exploration. Subsequently, an artificial lesion to the upper trunk was created, and nerve graft reconstruction was performed. Images and video of the entire procedure were obtained and edited to illustrate the technique. Results All supraclavicular structures of the brachial plexus could be safely dissected and identified, similar to the experience in open surgery. The reconstruction of the upper trunk with nerve graft was successfully completed using an epineural microsurgical suture technique performed exclusively with the aid of the robot. There were no instances of inadvertent macroscopic damage to the vascular and nervous structures involved. Conclusions An endoscopic approach to the brachial plexus is feasible. The use of the robot makes it possible to perform microsurgical procedures in a very small space with telemanipulation and minimally invasive techniques. The ability to perform a minimally invasive procedure to explore and repair a brachial plexus injury may provide a new option in the acute management of these injuries.
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Boškoski, Ivo, Beatrice Orlandini, Luigi Giovanni Papparella, Maria Valeria Matteo, Martina De Siena, Valerio Pontecorvi et Guido Costamagna. « Robotics and Artificial Intelligence in Gastrointestinal Endoscopy : Updated Review of the Literature and State of the Art ». Current Robotics Reports 2, no 1 (1 février 2021) : 43–54. http://dx.doi.org/10.1007/s43154-020-00040-3.

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Abstract Purpose of Review Gastrointestinal endoscopy includes a wide range of procedures that has dramatically evolved over the past decades. Robotic endoscopy and artificial intelligence are expanding the horizons of traditional techniques and will play a key role in clinical practice in the near future. Understanding the main available devices and procedures is a key unmet need. This review aims to assess the current and future applications of the most recently developed endoscopy robots. Recent Findings Even though a few devices have gained approval for clinical application, the majority of robotic and artificial intelligence systems are yet to become an integral part of the current endoscopic instrumentarium. Some of the innovative endoscopic devices and artificial intelligence systems are dedicated to complex procedures such as endoscopic submucosal dissection, whereas others aim to improve diagnostic techniques such as colonoscopy. Summary A review on flexible endoscopic robotics and artificial intelligence systems is presented here, showing the m3ost recently approved and experimental devices and artificial intelligence systems for diagnosis and robotic endoscopy.
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Kim, Sanghyun, Hyuk Soon Choi, Kang Won Lee, Han Jo Jeon, Jae Min Lee, Eun Sun Kim, Bora Keum, Yoon Tae Jeen et Hoon Jai Chun. « ID : 3522803 ENDOSCOPIC SUBMUCOSAL DISSECTION USING DETACHABLE ASSISTANT ROBOT : COMPARATIVE IN VIVO FEASIBILITY STUDY ». Gastrointestinal Endoscopy 93, no 6 (juin 2021) : AB177. http://dx.doi.org/10.1016/j.gie.2021.03.401.

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Wang, Z., S. Phee, D. Lomanto, R. Goel, P. Rebala, Z. Sun, S. Trasti, N. Reddy, J. Wong et K. Ho. « Endoscopic submucosal dissection of gastric lesions by using a master and slave transluminal endoscopic robot : an animal survival study ». Endoscopy 44, no 07 (21 juin 2012) : 690–94. http://dx.doi.org/10.1055/s-0032-1309404.

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Morino, M., E. Forcignanò et A. Arezzo. « Initial clinical experience with a novel flexible endoscopic robot for transanal surgery ». Techniques in Coloproctology 26, no 4 (29 janvier 2022) : 301–8. http://dx.doi.org/10.1007/s10151-022-02577-1.

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Abstract Background The Flex® Robotic System (Medrobotics, Raynham, MA, USA) is the first miniaturised flexible endoscopic robot that aims to allow surgical manoeuvres beyond the area currently reached by transanal endoscopic microsurgery. The aim of this study is to evaluate our initial clinical experience with this novel tool. Methods We prospectively collected all consecutive cases of local excisions of rectal lesions performed with the Flex® Robotic System performed at the Department of Surgical Sciences of the University of Turin between October 2018 and December 2019. Indications were benign, or early rectal lesions judged unsuitable for endoscopic removal, within 20 cm of the anal verge. Debriefing meetings after each procedure allowed technology assessment leading to the modification, development, and implementation of tools according to the clinical experience. We analysed the data in terms of the safety and efficacy of treatment. Results Between October 2018 and February 2020, 26 patients were treated. We performed a full-thickness excision in 14 patients and a submucosal dissection in 12. The median operating time was 115 min (range 45–360 min). In six patients (23.1%), we converted to standard transanal endoscopic operation (TEO®) (Karl Storz, Tuttlingen, Germany) to complete the procedure. The 30-day morbidity rate was 11.5% (3/26). Positive resection margins were detected in 4 (15.4%) patients. At a minimum follow-up of 12 months, 2 (7.7%) local recurrences were observed. Conclusions This first clinical series demonstrates that the Flex® Robotic System is a fascinating technology that deserves further development to increase surgical dexterity, thereby overcoming current technical limitations and improving clinical outcomes.
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Phee, Soo Jay, Nageshwar Reddy, Philip W. Y. Chiu, Pradeep Rebala, Guduru V. Rao, Zheng Wang, Zhenglong Sun, Jennie Y. Y. Wong et Khek–Yu Ho. « Robot-Assisted Endoscopic Submucosal Dissection Is Effective in Treating Patients With Early-Stage Gastric Neoplasia ». Clinical Gastroenterology and Hepatology 10, no 10 (octobre 2012) : 1117–21. http://dx.doi.org/10.1016/j.cgh.2012.05.019.

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Kim, Sang Hyun, Byung Gon Kim, Hyuk Soon Choi, Daehie Hong, Se Hyun Jang, Kihun Hong, Jin Woo Choi et al. « Endoscopic submucosal dissection using a detachable assistant robot : a comparative in vivo feasibility study (with video) ». Surgical Endoscopy 35, no 10 (18 juin 2021) : 5836–41. http://dx.doi.org/10.1007/s00464-021-08510-1.

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Gafford, Joshua B., Hiroyuki Aihara, Christopher C. Thompson, Robert J. Wood et Conor J. Walsh. « Sa1890 ROBOT-ASSISTED ENDOSCOPIC SUBMUCOSAL DISSECTION USING DISPOSABLE TIP-MOUNTED ROBOTIC MODULE : FIRST EX VIVO RESULTS ». Gastrointestinal Endoscopy 87, no 6 (juin 2018) : AB235—AB236. http://dx.doi.org/10.1016/j.gie.2018.04.1523.

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Singh, A., S. Shah, P. Bansal, S. Chatterjee et S. Rawal. « A critical comparative analysis of operative complication and oncological outcome between robot assisted video endoscopic inguinal lymph node dissection and open inguinal lymph node dissection ». European Urology Supplements 16, no 3 (mars 2017) : e1230-e1232. http://dx.doi.org/10.1016/s1569-9056(17)30765-0.

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Singh, A., J. Jaipuria, S. Baidya, R. Kumar, J. Jain et S. Rawal. « Surgical feasibility, and outcome of robot-assisted video endoscopic inguinal lymph node dissection in node positive groin of carcinoma penis patients ». European Urology Supplements 17, no 2 (mars 2018) : e1988. http://dx.doi.org/10.1016/s1569-9056(18)32389-3.

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Takeshita, Nobuyoshi, Soo Jay Phee, Philip WaiYan Chiu et Khek Yu Ho. « Global Evaluative Assessment of Robotic Skills in Endoscopy (GEARS-E) : objective assessment tool for master and slave transluminal endoscopic robot ». Endoscopy International Open 06, no 08 (août 2018) : E1065—E1069. http://dx.doi.org/10.1055/a-0640-3123.

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Abstract Background and study aims The Master and Slave Transluminal Endoscopic Robot (MASTER) is a novel robotic endosurgical system with two operating arms that offer multiple degrees of freedom. We developed a new assessment tool, the Global Evaluative Assessment of Robotic Skills in Endoscopy (GEARS-E), derived from existing tools in laparoscopic and robotic surgery, and evaluated its utility in the performance of procedures using MASTER. Methods This was a pilot study conducted in vivo and ex vivo on animals. Three operators (Novice-1, Novice-2 and Expert) performed a total of five endoscopic submucosal dissections (ESD) using MASTER. Novice operators had no MASTER experience and the expert had previously performed eight MASTER ESDs. Operator performance was assessed by four independent evaluators using GEARS-E, which has a maximum score of 25 for five domains representing various skill-related variables (depth perception, bimanual dexterity, efficiency, tissue handling and autonomy). Results The mean global rating scores for Novice-1 first attempt, Novice-1 second attempt, Novice-2 first attempt, Novice-2 second attempt and Expertʼs cases were 13.0, 16.0, 13.3, 15.5, and 21.5, respectively. The mean scores of each of the five domains were statistically higher for the second attempts compared to the first attempts for both Novice-1 and Novice-2. The mean scores of each of the five domains for the Expertʼs case were consistently higher than those for the two novice operators in both their first and second attempts. Conclusion Results using GEARS-E showed correlations between surgical experience and MASTER ESD. As an assessment tool for evaluation of surgical skills, GEARS-E has great potential for application in MASTER procedures.
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Lee, John Y. K., Bert W. O'Malley, Jason G. Newman, Gregory S. Weinstein, Bradley Lega, Jason Diaz et M. Sean Grady. « Transoral robotic surgery of craniocervical junction and atlantoaxial spine : a cadaveric study ». Journal of Neurosurgery : Spine 12, no 1 (janvier 2010) : 13–18. http://dx.doi.org/10.3171/2009.7.spine08928.

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Object The goal of this study was to determine the potential role and current limitations of the da Vinci surgical robot in transoral decompression of craniocervical junction (CCJ). Methods The da Vinci Surgical System was used in 2 cadaver heads with neck and clavicles intact. Both neurosurgeons and otolaryngologists familiar with the open microscopic procedure, as well as the transoral robotic surgical procedure, undertook dissection and decompression of the CCJ. Results The robotic system provided superb illumination and 3D depth perception even several centimeters deep to the posterior oropharyngeal mucosa. The 30° endoscope improved cephalad visualization, eliminating the need to split the soft palate for exposure of the lower clivus. The “intuitive” nature of the da Vinci surgical robot arms provided an advantage in allowing the ability to suture the dura mater in a deep, dark corridor. Because visualization was excellent, tremor-free closure was possible. Conclusions The authors' findings suggest that transoral robotic surgery, with the da Vinci robot system, holds great potential for decompression of the CCJ as well as resection of both extra- and intradural tumors of this region. Further instrument development is necessary and continued investigation is warranted.
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Dev, P., Y. Tb, S. Waigankar et A. Pednekar. « Robot assisted simultaneous bilateral video endoscopic inguinal lymph node dissection (VEIL) with preservation of both saphenous veins. Is it feasible ? A video demonstration ». European Urology Open Science 19 (juillet 2020) : e2417. http://dx.doi.org/10.1016/s2666-1683(20)34272-5.

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Khanna, A., A. Singh, J. Jaipuria, S. Gupta, P. Kasaraneni et S. Rawal. « Robot assisted video endoscopic inguinal lymph node dissection in carcinoma penis with palpable inguinal lymphadenopathy : Our technique and long term functional and oncological outcomes ». European Urology 79 (juin 2021) : S1766. http://dx.doi.org/10.1016/s0302-2838(21)01617-1.

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Veerwal, A., T. B. Yuvaraja, S. Waigankar, A. M. Shah, S. Kamath et A. Pednekar. « Comparing perioperative outcomes after Robot Assisted Video Endoscopic Inguinal Lymphadenectomy (RAVEIL) with Open Inguinal Lymph Node Dissection (O-ILND) using propensity score match analysis ». European Urology 83 (février 2023) : S909. http://dx.doi.org/10.1016/s0302-2838(23)00687-5.

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Turiani Hourneaux de Moura, Diogo, Hiroyuki Aihara, Pichamol Jirapinyo, Galileu Farias, Kelly E. Hathorn, Ahmad Bazarbashi, Amit Sachdev et Christopher C. Thompson. « Robot-assisted endoscopic submucosal dissection versus conventional ESD for colorectal lesions : outcomes of a randomized pilot study in endoscopists without prior ESD experience (with video) ». Gastrointestinal Endoscopy 90, no 2 (août 2019) : 290–98. http://dx.doi.org/10.1016/j.gie.2019.03.016.

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Singh, A., A. Khanna, V. Vasudev, S. K. Pratihar, N. Saurabh et S. Rawal. « Comparison of long term functional and oncological outcomes of robot assisted video endoscopic inguinal lymph node dissection between clinically non-palpable and palpable inguinal lymphadenopathy ». European Urology 83 (février 2023) : S910. http://dx.doi.org/10.1016/s0302-2838(23)00688-7.

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Cheng, Qiangli, et Yajun Dong. « Da Vinci Robot-Assisted Video Image Processing under Artificial Intelligence Vision Processing Technology ». Computational and Mathematical Methods in Medicine 2022 (30 avril 2022) : 1–10. http://dx.doi.org/10.1155/2022/2752444.

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This research was aimed to explore the application value of intelligent algorithm-based digital images in Da Vinci robot-assisted treatment of patients with gastric cancer surgery. 154 patients were included as the research objects, with 89 cases in the control group underwent laparoscopic surgery, and 65 cases in the experimental group underwent robotic surgery. According to the propensity score, the patients in two groups were pair matched (1: 1), of which 104 cases (52 cases in each group) were successfully matched. The general data of patients, the changes in the images before and after the algorithm processing, the intraoperative and postoperative conditions, the pathological examination results, and the follow-up information were observed after matching. Compared with the original images, the images processed by the thread image edge detection algorithm had the significantly improved clarity, as well as highly reduced artifacts and noises. The sensitivity, specificity, and accuracy of image-assisted diagnosis were improved remarkably, showing the differences of statistical significance ( P < 0.05 ). The total time of surgery, intraoperative bleeding, CRP (1d and 3d after surgery), and postoperative total abdominal drainage showed the significant differences as well ( P < 0.05 ). The surgeries of patients in both groups met R0 resection (no tumor infiltration within 1 mm of the surgical margin), but there was a significant difference in the number of lymph node dissections ( P < 0.05 ). The overall survival rates of patients in the experimental group and the control group were 83.0% and 76.1%, respectively, 2 years after surgery, with no significant difference ( P > 0.05 ). The thread image edge detection algorithm produced a better processing effect on the images, which greatly improved the diagnostic sensitivity, specificity, and accuracy. Compared with endoscopic surgery, robotic surgery has better postoperative recovery, safety and reliability, and obvious advantages of minimally invasive surgery.
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Rasanen, Jari. « PS01.030 : ROBOTIC LAPAROSCOPIC HELLER-DOR FOR ACHALASIA : SINGLE INSTITUTION’S EXPERIENCE ON 89 FIRST PATIENTS ». Diseases of the Esophagus 31, Supplement_1 (1 septembre 2018) : 58. http://dx.doi.org/10.1093/dote/doy089.ps01.030.

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Abstract Background Robotics allows precise dissection during the Heller-Dor. We wanted clarify whether this has produced good results in achalasia treatment of our patients in our institution. Methods We reviewed eighty-nine patients who were treated with robot-assisted laparoscopic Heller-Dor between October 2010 and January 2018 at Helsinki University Hospital. They all underwent laparoscopic myotomy for achalasia extending 8 cm onto esophagus and 3 cm onto proximal stomach with partial Dor fundoplication by two surgeons. Diagnosis of achalasia was confirmed by radiography, endoscopy, and manometry. Success of the myotomy was verified by intraoperative EGD, postoperative contrast radiography, and subjective postoperative symptom recording. Results There were 44 men and 45 women, with a mean age 43 + /- 15 years. Thirty-three percent of patients reported weight loss and 95% of patients experienced dysphagia at least once every week preoperatively. Mean operative time was 124 + /- 34 minutes. There were no conversions. Intraoperatively there were 6 patients with minor tears in mucosa of esophagus and 1 patient with minor tear in the mucosa of stomach. They were all recognized and repaired intraoperatively without any significant consequences to the patients (no deaths or ICU admissions). Median hospitalization was 4 days (2 - 17). Postoperatively 93% of patients reported significant improvement in dysphagia. All 6 patients with intra-operative mucosal tear experienced good or excellent symptom relief. Three of patients experienced significant pain in their esophagus even after surgery. All patients but 3 rated their overall symptom control either excellent or good after median follow-up of 31 months. Conclusion Robotic-assisted laparoscopic Heller-Dor is feasible with good median term results although some patients may experience intraoperative mucosal tears during the learning curve Disclosure All authors have declared no conflicts of interest.
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Robles-Medranda, Carlos. « Endoscopic submucosal dissection ». Gastroenterology Insights 4, no 1 (29 mai 2012) : 10. http://dx.doi.org/10.4081/gi.2012.e10.

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Fernández-Esparrach, Gloria, Ángel Calderón, Joaquín de la Peña, José Díaz Tasende, José Esteban, Antonio Gimeno-García, Alberto Herreros de Tejada et al. « Endoscopic Submucosal Dissection ». Endoscopy 46, no 04 (26 mars 2014) : 361–70. http://dx.doi.org/10.1055/s-0034-1364921.

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Zhong, Dan-Dan, et Jian-Ting Cai. « Endoscopic Submucosal Dissection ». Diseases of the Colon & ; Rectum 55, no 8 (août 2012) : e320. http://dx.doi.org/10.1097/dcr.0b013e31825b9073.

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Maple, John T., Barham K. Abu Dayyeh, Shailendra S. Chauhan, Joo Ha Hwang, Sri Komanduri, Michael Manfredi, Vani Konda, Faris M. Murad, Uzma D. Siddiqui et Subhas Banerjee. « Endoscopic submucosal dissection ». Gastrointestinal Endoscopy 81, no 6 (juin 2015) : 1311–25. http://dx.doi.org/10.1016/j.gie.2014.12.010.

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Fukami, Norio. « Endoscopic Submucosal Dissection ». Gastrointestinal Endoscopy Clinics of North America 24, no 2 (avril 2014) : xv—xvi. http://dx.doi.org/10.1016/j.giec.2014.01.001.

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Suzuki, N., et B. P. Saunders. « PWE-018 Endoscopic submucosal dissection and hybrid endoscopic submucosal dissection piecemeal endoscopic mucosal resection ». Gut 59, Suppl 1 (avril 2010) : A92.1—A92. http://dx.doi.org/10.1136/gut.2009.208942n.

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Hoteya, Shu, Toshiro Iizuka, Daisuke Kikuchi et Naohisa Yahagi. « ENDOSCOPIC SUBMUCOSAL DISSECTION FOR GASTRIC SUBMUCOSAL TUMOR, ENDOSCOPIC SUB-TUMORAL DISSECTION ». Digestive Endoscopy 21, no 4 (octobre 2009) : 266–69. http://dx.doi.org/10.1111/j.1443-1661.2009.00905.x.

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Lomanto, Davide, Sujith Wijerathne, Lawrence Khek Yu Ho et Louis Soo Jay Phee. « Flexible endoscopic robot ». Minimally Invasive Therapy & ; Allied Technologies 24, no 1 (2 janvier 2015) : 37–44. http://dx.doi.org/10.3109/13645706.2014.996163.

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Godse, Neal Rajan, et Umamaheswar Duvvuri. « Robot-assisted neck dissection ». Operative Techniques in Otolaryngology-Head and Neck Surgery 32, no 3 (septembre 2021) : 169–73. http://dx.doi.org/10.1016/j.otot.2021.10.004.

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Yang, Jin-Lin, Tao Gan, Lin-Lin Zhu, Yi-Ping Wang, Li Yang et Jun-Chao Wu. « Endoscopic Submucosal Tunnel Dissection ». Diseases of the Colon & ; Rectum 60, no 8 (août 2017) : 866–71. http://dx.doi.org/10.1097/dcr.0000000000000805.

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Figueirôa, Gonçalo, Pedro Pimentel-Nunes, Mário Dinis-Ribeiro et Diogo Libânio. « Gastric endoscopic submucosal dissection ». European Journal of Gastroenterology & ; Hepatology 31, no 10 (octobre 2019) : 1234–46. http://dx.doi.org/10.1097/meg.0000000000001542.

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Caicedo, Emiro. « Endoscopic sinonasal dissection guide ». Head & ; Neck 35, no 6 (2 novembre 2012) : 910. http://dx.doi.org/10.1002/hed.23177.

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Wormald, Peter-John. « Endoscopic sinonasal dissection guide ». Laryngoscope 123, no 2 (9 juillet 2012) : 553. http://dx.doi.org/10.1002/lary.23445.

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Shimamura, Yuto. « Repeat endoscopic submucosal dissection for recurrent gastric cancers after endoscopic submucosal dissection ». World Journal of Gastrointestinal Endoscopy 5, no 12 (2013) : 600. http://dx.doi.org/10.4253/wjge.v5.i12.600.

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