Articoli di riviste: "Robot-assisted procedure"

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Uzan, Jennifer, Caroline Cornou, Chérazade Bensaid, François Audenet, Charlotte Ngô, Anne-Sophie Bats e Fabrice Lecuru. "Robot-Assisted Laparoscopic Partial Colpectomy and Intracorporeal Ileal Conduit Urinary Diversion (Bricker) for Cervical Adenocarcinoma Recurrence". Case Reports in Obstetrics and Gynecology 2015 (2015): 1–4. http://dx.doi.org/10.1155/2015/241094.

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Ileal conduit urinary diversion (Bricker) is a standard surgical open procedure. The Da Vinci robot allowed precision for this surgical procedure, especially for intracorporeal suturing. Meanwhile, few reports of robot-assisted laparoscopic ileal conduit diversion (Bricker) are described in the literature. We report the case of a 69-year-old patient with a vaginal recurrence of cervical adenocarcinoma associated with vesicovaginal fistula treated by robot-assisted laparoscopic partial colpectomy and ileal conduit urinary diversion (Bricker). The robot-assisted laparoscopic procedure followed all surgical steps of the open procedure. Postoperative period was free of complications.

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Wang, Qing, Yuchao Lu, Henglong Hu, Jiaqiao Zhang, Baolong Qin, Jianning Zhu, Najib Isse Dirie, Zongbiao Zhang e Shaogang Wang. "Management of recurrent ureteral stricture: a retrospectively comparative study with robot-assisted laparoscopic surgery versus open approach". PeerJ 7 (4 dicembre 2019): e8166. http://dx.doi.org/10.7717/peerj.8166.

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Background Management of recurrent ureteral stricture is challenging. Consensus on the best surgical choice has not been demonstrated. In this study, we aim to report our experience in treating recurrent ureteral stricture and demonstrate whether robot-assisted procedure for redo ureteral surgery is as effective as open procedure while remaining less invasive. Methods We retrospectively assessed 41 patients (22 robot-assisted surgeries and 19 open surgeries) who underwent consecutive robot-assisted and open procedures for redo ureteral surgery from January 2014 to 2018 in our institution. Perioperative outcomes, including demographics, operative time, estimated blood loss, complications, pain scores, success rate and cost, were compared between two groups. Results There was no significant intergroup difference in terms of age, body mass index, gender composition and American Society of Anesthesiologists scores. A total of 31 patients underwent redo pyeloplasty and ten underwent redo uretero-ureterostomy. Compared with open group, robot-assisted group showed shorter operative time (124.55 min vs. 185.11 min, p < 0.0001), less estimated blood loss (100.00 mL vs. 182.60 mL, p = 0.008) and higher cost (61161.77¥ vs. 39470.79¥, p < 0.0001). Complication rate and pain scores were similar between two groups. Median follow-up periods were 30 and 48 months for robot-assisted and open group respectively. Success rate in the robot-assisted (85.71%) and the open group (82.35%) was not significantly different. Conclusions Robot-assisted surgery for recurrent stricture after previous ureteral reconstruction is as effective as open procedure and is associated with shorter operative time and less estimated blood loss.

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&NA;. "Robot-Assisted Surgery Shortens Vasectomy Reversal Procedure". Journal of Clinical Engineering 35, n. 2 (aprile 2010): 69. http://dx.doi.org/10.1097/jce.0b013e3181d71c20.

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Singh, Iqbal, e Ashok K. Hemal. "Role of Robot-Assisted Pelvic Surgery". Scientific World JOURNAL 9 (2009): 479–89. http://dx.doi.org/10.1100/tsw.2009.54.

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The purpose of this study was to assess the current role of robot-assisted urological surgery in the female pelvis. The recently published English literature was reviewed to evaluate this role, with special emphasis on reconstructive procedures. These included colposuspension for genuine female stress urinary incontinence, repair of female genitourinary fistulas, ureterosciatic hernias, sacrocolpopexy for vault prolapse, ureterolysis and omental wrap for retroperitoneal fibrosis, ureteric reimplantation, and bladder surgery. To date, a wide spectrum of urogynecological reconstructive procedures have been performed with the assistance of the surgical robot and have been reported worldwide. Currently, a number of female pelvic ablative and reconstructive procedures are technically feasible with the aid of the surgical robot. While the role of robot-assisted surgery for bladder cancer, ureterolysis, ureteric reimplantation, repair of genitourinary fistulas, colposuspension, and sacrocolpopexy is nearly established among urologists, other procedures, such as myomectomy, simple hysterectomy, trachelectomy, and Wertheim's hysterectomy, are still evolving with gynecologists. The advantages of robot assistance include better hand-eye coordination, three-dimensional magnified stereoscopic vision with depth perception, intuitive movements with increased precision, and filtering of hand tremors. For most of the currently performed procedures in selected patients, the robot-assisted surgical outcomes appear to be relatively superior as compared to an open and purely laparoscopic surgical procedure.

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Hermsen, Elizabeth D., Tim Hinze, Harlan Sayles, Lee Sholtz e Mark E. Rupp. "Incidence of Surgical Site Infection Associated with Robotic Surgery". Infection Control & Hospital Epidemiology 31, n. 8 (agosto 2010): 822–27. http://dx.doi.org/10.1086/654006.

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Objective.Robot-assisted surgery is minimally invasive and associated with less blood loss and shorter recovery time than open surgery. We aimed to determine the duration of robot-assisted surgical procedures and the incidence of postoperative surgical site infection (SSI) and to compare our data with the SSI incidence for open procedures according to national data.Design.Retrospective cohort study.Setting.A 689-bed academic medical center.Patients.All patients who underwent a surgical procedure with use of a robotic surgical system during the period from 2000-2007.Methods.SSIs were defined and procedure types were classified according to National Healthcare Safety Network criteria. National data for comparison were from 1992-2004. Because of small sample size, procedures were grouped according to surgical site or wound classification.Results.Sixteen SSIs developed after 273 robot-assisted procedures (5.9%). The mean surgical duration was 333.6 minutes. Patients who developed SSI had longer mean surgical duration than did patients who did not (558 vs 318 minutes; P<.001). The prostate and genitourinary group had 5.74 SSIs per 100 robot-assisted procedures (95% confidence interval [CI], 2.81–11.37), compared with 0.85 SSIs per 100 open procedures from national data. The gynecologic group had 10.00 SSIs per 100 procedures (95% CI, 2.79–30.10), compared with 1.72 SSIs per 100 open procedures. The colon and herniorrhaphy groups had 33.33 SSIs per 100 procedures (95% CI, 9.68–70.00) and 37.50 SSIs per 100 procedures (95% CI, 13.68–69.43), respectively, compared with 5.88 and 1.62 SSIs per 100 open procedures from national data. Patients with a clean-contaminated wound developed 6.1 SSIs per 100 procedures (95% CI, 3.5–10.3), compared with 2.59 SSIs per 100 open procedures. No significant differences in SSI rates were found for other groups.Conclusions.Increased incidence of SSI after some types of robot-assisted surgery compared with traditional open surgery may be related to the learning curve associated with use of the robot.

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Makay, Özer, Esra Yuksel, Asuman Sargin, Murat Ozdemir, Varlik Erol, Osman Bozbiyik, Sezgin Ulukaya e Mahir Akyildiz. "Oral Presentation I". World Journal of Endocrine Surgery 8, n. 1 (2016): 1–7. http://dx.doi.org/10.5005/wjoes-8-1-1.

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ABSTRACT BACKGROUND AND AIMS Minimally invasive surgery of the adrenal gland is widespread. Although reports demonstrate the safety and feasibility of robot-assisted adrenalectomy, the objective benefits are still unclear, compared to those of conventional laparoscopy. Recently, robot-assisted approach has also become possible for pheochromocytoma resection. Since cardiopulmonary changes during robot-assisted dissection of the pheochromocytoma patient has not been studied in detail, we aimed to assess these concerns, compared to the routine laparoscopic technique. METHODS In this case-control study, 19 consecutive robot-assisted adrenal resections were compared with a control group consisting of 14 conventional laparoscopic adrenalectomy. Patient characteristics and intraoperative hemodynamic and respiratory parameters were assessed. Groups were compared using the χ2 test for categorical variables and Student's t-test for continuous variables. Significance was considered p < 0.05. RESULTS The robot-assisted procedure was performed successfully in all patients, except one. The duration of the robot-assisted procedure, compared to the conventional laparoscopy group, was significantly longer (p < 0.05). Intraoperative blood loss was significantly less in the robot-assisted group (p < 0.05). Dissection of pheochromocytoma showed a significant difference between the groups, according to the incidence of intraoperative blood pressure fluctuations (p < 0.05). The robot-assisted approach resulted in less incidents. Other hemodynamic and respiratory parameters did not differ between groups significantly. There were no perioperative deaths. Complication rates and postoperative hospital stays were not significantly different. CONCLUSION Robot-assisted adrenalectomy is a safe and technically feasible procedure for a pheochromocytoma patient. Robot-assisted resection of pheochromocytoma minimized the occurrence of intraoperative blood pressure fluctuations and blood loss.

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De Benedictis, Alessandro, Andrea Trezza, Andrea Carai, Elisabetta Genovese, Emidio Procaccini, Raffaella Messina, Franco Randi et al. "Robot-assisted procedures in pediatric neurosurgery". Neurosurgical Focus 42, n. 5 (maggio 2017): E7. http://dx.doi.org/10.3171/2017.2.focus16579.

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OBJECTIVEDuring the last 3 decades, robotic technology has rapidly spread across several surgical fields due to the continuous evolution of its versatility, stability, dexterity, and haptic properties. Neurosurgery pioneered the development of robotics, with the aim of improving the quality of several procedures requiring a high degree of accuracy and safety. Moreover, robot-guided approaches are of special interest in pediatric patients, who often have altered anatomy and challenging relationships between the diseased and eloquent structures. Nevertheless, the use of robots has been rarely reported in children. In this work, the authors describe their experience using the ROSA device (Robotized Stereotactic Assistant) in the neurosurgical management of a pediatric population.METHODSBetween 2011 and 2016, 116 children underwent ROSA-assisted procedures for a variety of diseases (epilepsy, brain tumors, intra- or extraventricular and tumor cysts, obstructive hydrocephalus, and movement and behavioral disorders). Each patient received accurate preoperative planning of optimal trajectories, intraoperative frameless registration, surgical treatment using specific instruments held by the robotic arm, and postoperative CT or MR imaging.RESULTSThe authors performed 128 consecutive surgeries, including implantation of 386 electrodes for stereo-electroencephalography (36 procedures), neuroendoscopy (42 procedures), stereotactic biopsy (26 procedures), pallidotomy (12 procedures), shunt placement (6 procedures), deep brain stimulation procedures (3 procedures), and stereotactic cyst aspiration (3 procedures). For each procedure, the authors analyzed and discussed accuracy, timing, and complications.CONCLUSIONSTo the best their knowledge, the authors present the largest reported series of pediatric neurosurgical cases assisted by robotic support. The ROSA system provided improved safety and feasibility of minimally invasive approaches, thus optimizing the surgical result, while minimizing postoperative morbidity.

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Wang, Wen-Ping, Long-Qi Chen, Han-Lu Zhang, Yu-Shang Yang, Song-Lin He e Yun Wang. "PS01.224: MODIFIED INTRATHORACIC ESOPHAGOGASTROSTOMY AT MINIMALLY INVASIVE ROBOT-ASSISTED IVOR-LEWIS ESOPHAGECTOMY FOR CANCER". Diseases of the Esophagus 31, Supplement_1 (1 settembre 2018): 113–14. http://dx.doi.org/10.1093/dote/doy089.ps01.224.

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Abstract Background The intrathoracic esophagogastrostomy played important role in minimally invasive Ivor-Lewis esophagectomy for cancer. The methods of intrathoracic esophagogastric anastomosis at robot-assisted Ivor-Lewis esophagectomy mostly included hand-sewn, and circular stapler (anvil placement via OrVil system or transthoracically), which were still technically challenging. In this study, we modified the techniques of intrathoracic esophagogastric anastomosis at robot-assisted Ivor-Lewis esophagectomy for cancer, in order to seek to simplify this complicated intrathoracic procedure. Then retrospective comparison between robotic and thoracoscopic cohorts was conducted. Methods We modified techniques focused on the ‘side-insertion’ anvil placement and purse string suture of intrathoracic robot-assisted esophagogastric anastomosis. The consecutive records of patients who underwent minimally invasive Ivor-Lewis esophagectomy for cancer via robot-assistant and thoracoscopic procedures in our department between January 2015 and November 2017 were retrospectively analyzed. Results Totally 47 patients were enrolled including 20 patients (male: 17, female: 3) in robot-assisted group and 27 patients (male: 21, female: 6) in thoracoscopic group. There was no conversion to open thoracotomy in both two groups. Mean operation duration of robotic group was 412.5 ± 63.5 min, significantly higher than 363.0 ± 53.3 min in thoracoscopic group (P = 0.006). Estimated blood loss in robotic group was less than that in thoracoscopic group (107.5 ± 63.5ml vs. 188.9 ± 94.3ml, respectively, P = 0.002). One patient (5.0%) in robotic group and two patients(7.4%) in thoracoscopic group had anastomotic leak. No postoperative reoperation or mortality (in-hospital or within 30 days after surgery) occurred in both groups. Conclusion Robot-assisted Ivor-Lewis esophagectomy was safe and feasible. Our modified procedure highlighting the ‘side-insertion’ method could simplify the process of intrathoracic anvil placement and purse string suture for the robot-assisted esophagogastric anastomosis. Robot-assisted Ivor-Lewis esophagectomy was nearly equivalent to thoracoscopic Ivor-Lewis esophagectomy at short-term outcomes, except higher operation time and less blood loss. Disclosure All authors have declared no conflicts of interest.

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Cormi, Clément, Guillaume Parpex, Camille Julio, Fiona Ecarnot, David Laplanche, Geoffrey Vannieuwenhuyse, Antoine Duclos e Stéphane Sanchez. "Understanding the surgeon’s behaviour during robot-assisted surgery: protocol for the qualitative Behav’Robot study". BMJ Open 12, n. 4 (aprile 2022): e056002. http://dx.doi.org/10.1136/bmjopen-2021-056002.

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IntroductionRobot-assisted surgery is spreading worldwide, accounting for more than 1.2 million procedures in 2019. Data are sparse in the literature regarding the surgeon’s mechanisms that mediate risk-taking during a procedure, especially robot-assisted. This study aims to describe and understand the behaviour of the surgeons during robot-assisted surgery and the change in their behaviour with increasing experience in using the robot.Methods and analysisThis is a qualitative study using semistructured interviews with surgeons who perform robot-assisted surgery. An interview guide comprising open questions will be used to ensure that the points to be discussed are systematically addressed during each interview (ie, (1) difference in behaviour and preparation of the surgeon between a standard procedure and a robot-assisted procedure; (2) the influence of proprioceptive modifications, gain in stability and cognitive biases, inherent in the use of a surgical robot and (3) the intrinsic effect of the learning curve on the behaviour of the surgeons. After transcription, interviews will be analysed with the help of NVivo software, using thematic analysis.Ethics and disseminationSince this project examines professional practices in the field of social and human sciences, ethics committee was not required in accordance with current French legislation (Decree no 2017-884, 9 May 2017). Consent from the surgeons is implied by the fact that the interviews are voluntary. Surgeons will nonetheless be informed that they are free to interrupt the interview at any time.Results will be presented in peer-reviewed national and international congresses and submitted to peer-reviewed journals for publication. The communication and publication of the results will be placed under the responsibility of the principal investigator and publications will be prepared in compliance with the ICMJE uniform requirements for manuscripts.Trial registration numberNCT04869995.

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Fourcade, Laurent, Sarah Amar, Khalid Alzahrani, Ann-Rose Cook, Karim Braïk, Jérôme Cros, Bernard Longis et al. "Robot-Assisted Laparoscopic Fundoplications in Pediatric Surgery: Experience Review". European Journal of Pediatric Surgery 29, n. 02 (19 dicembre 2017): 173–78. http://dx.doi.org/10.1055/s-0037-1615279.

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Introduction Laparoscopic fundoplicature for gastroesophageal reflux disease has become the gold standard because of the improvement of postoperative rehabilitation compared with the open procedure. The robot-assisted surgery has brought new advantages for the patient and the surgeon compared with laparoscopy. We studied this new approach and the learning curve. Materials and Methods Sixty robot-assisted fundoplicatures were performed in two university pediatric surgery centers. Data of the patients were recorded, including peroperative data (operation length and complications), postoperative recoveries, and clinical evolution. The learning curve was evaluated retrospectively and each variable was compared along this learning curve. Results We observed a flattening of the learning curve after the 20th case for one surgeon. The mean operative time decreased significantly to 80 ± 10 minutes after 20 cases. There were no conversions to an open procedure. A revision surgery was indicated for 4.7% of the patients by a surgical robot-assisted laparoscopic approach. Conclusion The robotic system appears to add many advantages for surgical ergonomic procedures. There is a potential benefit in operating time with a short technical apprenticeship period. The setting up system is easy with a short docking time.

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Fridami Dewi, Anak Agung, Jovita Jutamulia e Dewa Ayu Anggi Paramitha. "A Systematic Review of Robot-assisted vs Manual Vitreoretinal Surgery: Is it Feasible?" International Journal of Research and Review 10, n. 10 (9 ottobre 2023): 1–9. http://dx.doi.org/10.52403/ijrr.20231001.

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Introduction and Objectives: Vitreoretinal surgery requires high precision and fine manipulation of instruments, which can be challenging due to human physiological barriers such as tremors, jerks, and low-frequency drifts. Robotic assistance carries the potential to overcome these limitations by providing better stability and filtering involuntary movements, therefore improving safety and future opportunities for this complex procedure. This review aims to compare the feasibility and safety of robot-assisted and manual vitreoretinal surgery. Methods: A comprehensive literature search was performed on 4 online databases: PubMed, Cochrane, ProQuest, ScienceDirect, and hand searching. Human studies comparing robot-assisted and manual vitreoretinal surgery, English language, and full-text journal available were included in this review. We identified the feasibility, safety, and duration of the robot-assisted approach for vitreoretinal surgery as the main outcome measurements. Results: Three randomized controlled trials (RCTs) with a total of 45 adults were evaluated. Robotic assistance was performed on various different vitreoretinal surgery procedures, including subretinal injection of tissue plasminogen activator (TPA), peeling of epiretinal membrane (ERM), and internal limiting membrane (ILM), with one study performed both procedures. All three studies showed surgical steps carried out with robotic assistance were successfully performed without clinical complications observed. The duration was longer in robot-assisted surgery compared to manual surgery. The number of retinal microtrauma was less frequent in robot-assisted surgery compared to manual surgery. Conclusion: Even though the duration of surgery took longer in the robot-assisted group, all studies show the feasibility and safety of robotic assistance in vitreoretinal surgery. However, further studies with larger samples are needed. Keywords:robot-assisted surgery, manual surgery, vitreoretinal surgery .

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Shin, Dong Ah. "Feasibility of Percutaneous Robot-Assisted Epiduroscopic System". January 2018 1, n. 21;1 (15 settembre 2018): E565—E571. http://dx.doi.org/10.36076/ppj.2018.5.e565.

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Background: Endoscopy has replaced open surgery, especially in spinal surgery. Among them, image-guided epiduroscopy allows pain generators to be identified, including epidural adhesion, fibrotic tissues, root compression, and spinal stenosis. However, the heavy lead apron worn by pain physicians to avoid exposure to radiation can induce occupational hazards, such as orthopedic complications and radiation-induced cancer. Hence, we developed a robotic system to address these problems. Objective: The aim of the study was to evaluate the feasibility of a robot-controlled epiduroscopic system. Study Design: In vivo animal experiment. Setting: University in Republic of Korea. Methods: The robot-controlled epiduroscopic system was developed using the open architecture robot system (The Raven Surgical Robotic System, CITRIS, Berkley, CA, USA). The robotic system consists of a lab-made epiduroscope, steering section, robotic arm, and manipulator. For the in vivo study, 2 Yorkshire pigs were used to simulate an epiduroscopic procedure with the robotic system. Results: The insertion and steering of the catheter was performed safely, and epiduroscopic visualization was obtained without side effects. There were no device-related complications. Radiation exposure for the primary operator was 80% lower than the levels found during conventional epiduroscopic procedures. All live pigs showed normal behavior without any signs of pain. The mean time to reach the target region was less than 8 minutes. Limitations: The epiduroscopic procedure was performed on pigs and not on humans. The dimensions of the spinal canal of pigs cannot compare to those of humans. Conclusions: We demonstrated the feasibility of the robot-assisted epiduroscopic system. Key Words: Epiduroscopy, robotic system, spine, pig, animal model

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Cronin, C., M. Hewitt, I. Harley, K. O’Donoghue e B. A. O’Reilly. "Robot-assisted laparoscopic cervical cerclage as an interval procedure". Gynecological Surgery 9, n. 3 (14 gennaio 2012): 317–21. http://dx.doi.org/10.1007/s10397-012-0725-9.

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Lu, Qingsheng, Yu Shen, Shibo Xia, Bing Chen e Kundong Wang. "A Novel Universal Endovascular Robot for Peripheral Arterial Stent–Assisted Angioplasty: Initial Experimental Results". Vascular and Endovascular Surgery 54, n. 7 (14 luglio 2020): 598–604. http://dx.doi.org/10.1177/1538574420940832.

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Background: The bottleneck of the development of endovascular interventional robot is that it cannot fully adapt to commercialized endovascular devices, such as guidewires, catheters, and stents, and cannot complete the entire procedure of endovascular treatment, for instance, stent implantation. The purpose of this study is to evaluate whether the novel universal endovascular interventional robot can adapt to different commercialized endovascular devices and accomplish the entire procedure of endovascular treatment of peripheral vascular disease. Methods and Material: The novel universal endovascular interventional robot consists of 2 components: a master surgeon console and a robotic platform with 4 manipulators. An adult pig was served as the experimental animal. Bilateral iliac artery stent implantation was performed on the pig by the endovascular interventional robot using commercialized guidewires, catheters, and stent delivery systems. Results: The novel universal endovascular interventional robot can adapt to commercialized endovascular devices, and most interventional procedures, such as insertion, withdrawal, and rotating, can be done through remote control. By coordinating multiple manipulators, complex actions such as superselection, crossing action, or implantation of self-expanding bare stent can be realized. The entire procedure took about 50 minutes, and the total exposure time of the surgeon was less than 1 minute. Postoperative angiography showed that the position of the stent grafts was accurate. The procedure was stable without any stent or surgical-related complications. Conclusion: The novel universal endovascular interventional robot can realize peripheral arterial stent-assisted angioplasty with commercialized devices. Through the design improvement, the problem related to stent implantation is solved, and the remote operation is realized throughout the endovascular procedure.

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Gîrbacia, Florin, Silviu Butnariu, Daniel Voinea, Bogdan Tzolea, Teodora Gîrbacia e Doina Pîslă. "A Virtual Reality System for Pre-Planning of Robotic-Assisted Prostate Biopsy". Applied Mechanics and Materials 772 (luglio 2015): 585–90. http://dx.doi.org/10.4028/www.scientific.net/amm.772.585.

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Surgical robots for biopsy procedure require pre-operative planning of trajectories prior to be used for needle guiding procedures. Virtual Reality (VR) technologies allow to simulate robotic biopsy procedure and to generate accurate needle trajectories that avoid vital organs. The paper presents a serial robot which can be used for biopsy procedure and a needle trajectory planning software based on VR technologies. A virtual environment has been modelled and simulations for robotic-assisted biopsy of the prostate have been performed.

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Okamoto, Hirotaka, Suguru Maruyama e Hideki Fujii. "Initial Japanese Experience of Laparoscopic Cholecystectomy Using a New Robot-Assisted System". International Surgery 103, n. 3-4 (1 marzo 2018): 171–76. http://dx.doi.org/10.9738/intsurg-d-16-00130.1.

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The object of this paper is to clarify the feasibility and safety of robot-assisted laparoscopic cholecystectomy. Acute or chronic cholecystitis is the most common disease in patients, caused by cholecystolithiasis. Minimally invasive laparoscopic surgery is often performed for treatment of cholelithiasis. We performed robot-assisted laparoscopic cholecystectomy for the treatment of 5 patients with cholecystolithiasis. The patient underwent laparoscopic cholecystectomy using the ViKY Endo-Control System (ViKY, EndoControl, Grenoble, France). The robot-controlled laparoscopic holder was placed at the right axilla. The laparoscopic operation was performed via conventional 4-port access using the ViKY system with voice activation. All patients were treated successfully by this robot-assisted laparoscopic procedure, without any complications. Mean docking time using the ViKY was 16 minutes, mean resection time of the gallbladder was 62.2 minutes, operative time was 94.6 minutes, and the mean amount of the blood loss was minimal. Our initial experience demonstrated that robot-assisted laparoscopy was feasible and safe in patients with cholecystolithiasis, providing patient advantages. We also discuss the advantages and disadvantages of robot-assisted laparoscopic surgery.

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Hoshide, Reid, Mark Calayag, Hal Meltzer, Michael L. Levy e David Gonda. "Robot-assisted endoscopic third ventriculostomy: institutional experience in 9 patients". Journal of Neurosurgery: Pediatrics 20, n. 2 (agosto 2017): 125–33. http://dx.doi.org/10.3171/2017.3.peds16636.

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OBJECTIVEThe endoscopic third ventriculostomy (ETV) is an established and effective treatment for obstructive hydrocephalus. In its most common application, surgeons plan their entry point and the endoscope trajectory for the procedure based on anatomical landmarks, then control the endoscope freehand. Recent studies report an incidence of neural injuries as high as 16.6% of all ETVs performed in North America. The authors have introduced the ROSA system to their ETV procedure to stereotactically optimize endoscope trajectories, to reduce risk of traction on neural structures by the endoscope, and to provide a stable mechanical holder of the endoscope. Here, they present their series in which the ROSA system was used for ETVs.METHODSAt the authors’ institution, they performed ETVs with the ROSA system in 9 consecutive patients within an 8-month period. Patients had to have a favorable expected response to ETV (ETV Success Score ≥ 70) with no additional endoscopic procedures (e.g., choroid plexus cauterization, septum pellucidum fenestration). The modality of image registration (CT, MRI, surface mapping, or bone fiducials) was dependent on the case.RESULTSNine pediatric patients with an age range of 1.5 to 16 years, 4 girls and 5 boys, with ETV Success Scores ranging from 70 to 90, underwent successful ETV surgery with the ROSA system within an 8-month period. Their intracranial pathologies included tectal tumors (n = 3), communicating hydrocephalus from hemorrhage or meningeal disease (n = 2), congenital aqueductal stenosis (n = 1), compressive porencephalic cyst (n = 1), Chiari I malformation (n = 1), and pineal region mass (n = 1). Robotic assistance was limited to the ventricular access in the first 2 procedures, but was used for the entirety of the procedure for the following 7 cases. Four of these cases were combined with another procedural objective (3 stereotactic tectal mass biopsies, 1 Chiari decompression). A learning curve was observed with each subsequent surgery as registration and surgical times became shorter and more efficient. All patients had complete resolution of their preprocedural symptoms. There were no complications.CONCLUSIONSThe ROSA system provides a stable, precise, and minimally invasive approach to ETVs.

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Vasilopoulos, Charalambos Rafail, Dimitrios Dedousis, John Klavdianos, Konstantinos Deligiorgis e Athanasios Anastasiou. "Patient Preparation and Positioning on Robot-Assisted and Robotic Surgeries". International Journal of Computers in Clinical Practice 4, n. 2 (luglio 2019): 1–12. http://dx.doi.org/10.4018/ijccp.2019070101.

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The field of robotic surgery is being developed and is increasingly being applied to many and different surgical procedures. This results in the need of looking for different patient placements, which will give the surgeon the best view of the area of clinical interest. The purpose of this paper is to study and investigate the various ways of patient preparation and positioning in the field of robotic surgery. Also, this paper proposes a classification and comparing between these different positions, depending on the procedure.

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González-Martínez, Jorge, Juan Bulacio, Susan Thompson, John Gale, Saksith Smithason, Imad Najm e William Bingaman. "Technique, Results, and Complications Related to Robot-Assisted Stereoelectroencephalography". Neurosurgery 78, n. 2 (28 settembre 2015): 169–80. http://dx.doi.org/10.1227/neu.0000000000001034.

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ABSTRACT BACKGROUND: Robot-assisted stereoelectroencephalography (SEEG) may represent a simplified, precise, and safe alternative to the more traditional SEEG techniques. OBJECTIVE: To report our clinical experience with robotic SEEG implantation and to define its utility in the management of patients with medically refractory epilepsy. METHODS: The prospective observational analyses included all patients with medically refractory focal epilepsy who underwent robot-assisted stereotactic placement of depth electrodes for extraoperative brain monitoring between November 2009 and May 2013. Technical nuances of the robotic implantation technique are presented, as well as an analysis of demographics, time of planning and procedure, seizure outcome, in vivo accuracy, and procedure-related complications. RESULTS: One hundred patients underwent 101 robot-assisted SEEG procedures. Their mean age was 33.2 years. In total, 1245 depth electrodes were implanted. On average, 12.5 electrodes were implanted per patient. The time of implantation planning was 30 minutes on average (range, 15-60 minutes). The average operative time was 130 minutes (range, 45-160 minutes). In vivo accuracy (calculated in 500 trajectories) demonstrated a median entry point error of 1.2 mm (interquartile range, 0.78-1.83 mm) and a median target point error of 1.7 mm (interquartile range, 1.20-2.30 mm). Of the group of patients who underwent resective surgery (68 patients), 45 (66.2%) gained seizure freedom status. Mean follow-up was 18 months. The total complication rate was 4%. CONCLUSION: The robotic SEEG technique and method were demonstrated to be safe, accurate, and efficient in anatomically defining the epileptogenic zone and subsequently promoting sustained seizure freedom status in patients with difficult-to-localize seizures.

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Shchekaturov, S. V., I. V. Semeniakin, A. K. Zokoev, T. B. Makhmudov e R. R. Poghosyan. "Robot-assisted kidney transplantation. First experience". Russian Journal of Transplantology and Artificial Organs 22, n. 2 (12 luglio 2020): 125–31. http://dx.doi.org/10.15825/1995-1191-2020-2-125-131.

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Kidney transplantation is the preferred renal replacement therapy for patients with end-stage renal disease. Traditional surgical approaches consisting of vascular and urinary outflow reconstruction during kidney transplant have been sufficiently studied and standardized. However, surgical techniques are still evolving. The objective of this clinical report is to focus the attention of kidney transplant surgeons and specialists on the currently trending robot-assisted kidney transplantation (RAKT) as a minimally invasive procedure for surgical treatment of patients with end-stage renal disease. In our first experience, good primary graft function was achieved. This shows that RAKT is a surgical option. With considerable number of surgeries and experience, RAKT outcomes would be improved significantly.

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Dijkstra, S., E. Van de Wiel e JF Langenhuijsen. "Robot-assisted posterior retroperitoneal adrenalectomy: A step-by-step procedure". European Urology Supplements 18, n. 6 (settembre 2019): e2698. http://dx.doi.org/10.1016/s1569-9056(19)32797-6.

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Egberts, Jan-Hendrik, M. Biebl, D. R. Perez, S. T. Mees, P. P. Grimminger, B. P. Müller-Stich, H. Stein et al. "Robot-Assisted Oesophagectomy: Recommendations Towards a Standardised Ivor Lewis Procedure". Journal of Gastrointestinal Surgery 23, n. 7 (1 aprile 2019): 1485–92. http://dx.doi.org/10.1007/s11605-019-04207-y.

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Hikage, Makoto, Masanori Tokunaga, Rie Makuuchi, Yutaka Tanizawa, Etsuro Bando, Taiichi Kawamura e Masanori Terashima. "Impact of an Ultrasonically Activated Device in Robot-Assisted Distal Gastrectomy". Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 12, n. 6 (novembre 2017): 453–58. http://dx.doi.org/10.1097/imi.0000000000000437.

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Objective Robot-assisted gastrectomy is increasingly used for the treatment of gastric cancer, although it remains a time-consuming procedure. An ultrasonically activated device might be useful to shorten operation times. This study therefore assessed the effect of ultrasonically activated device use on procedural times and on other early surgical outcomes. Methods Consecutive patients (N = 42) who underwent robot-assisted distal gastrectomy for gastric cancer were included. Clinicopathological characteristics and early surgical outcomes were compared between robotic-assisted gastrectomy procedures using an ultrasonically activated device (U group, n = 21) and those without it (NU group, n = 21). Results There were no significant differences in patient characteristics between the groups; however, the median operation time was significantly less in the U group than in the NU group (291 vs 351 minutes, P = 0.006). In detail, the median duration of console time until dividing the duodenum was less in the U group (70 vs 102 minutes, P < 0.001). Estimated blood loss, incidence of postoperative morbidity, and duration of postoperative hospital stay were not different between the groups. Conclusions An ultrasonically activated device reduced the operation time of robot-assisted gastrectomy without increasing blood loss and morbidity.

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Zappa, Francesca, Alba Madoglio, Marco Ferrari, Davide Mattavelli, Alberto Schreiber, Stefano Taboni, Erika Ferrari et al. "Hybrid Robotics for Endoscopic Transnasal Skull Base Surgery: Single-Centre Case Series". Operative Neurosurgery 21, n. 6 (8 ottobre 2021): 426–35. http://dx.doi.org/10.1093/ons/opab327.

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Abstract BACKGROUND Only preclinical studies and case reports have described robotic surgery for endoscopic transnasal skull base surgery. OBJECTIVE To evaluate the role of a novel robotic endoscope holder, developed for transsphenoidal surgery. METHODS Patients were prospectively enrolled for 3 mo at the Neurosurgery Unit of Brescia. Endoscope Robot® was used to assist during the sphenoidal phase of the approach, tumor removal, and skull base reconstruction. A Likert scale questionnaire was given to all surgeons after each procedure. Patients who underwent robotic-assisted surgery were matched with nonrobotic ones for pathology and type of procedure. All surgical videos were evaluated during bimanual phases. RESULTS Twenty-one patients underwent robot-assisted, endoscopic transsphenoidal surgery for different pathologies (16 pituitary adenomas, 3 chordomas, 1 craniopharyngioma, 1 pituitary exploration for Cushing disease) for a total of 23 procedures (1 patient underwent 2 endoscopic revisions of a skull base reconstruction). Subjective advantages reported by surgeons included smoothness of movement, image steadiness, and improvement of maneuvers in narrow spaces and with angled endoscopes; as the main limitation, Endoscope Robot® appeared to be relatively heavy during the initial endoscope positioning. A comparative analysis with a historical matched cohort documented similar clinical outcomes, while endoscope lens cleaning and position readjustments were significantly less frequent in robotic procedures. CONCLUSION Although confirmation in larger studies is needed, Endoscope Robot® was a safe and effective tool, especially advantageous in lengthy interventions through deep and narrow corridors.

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Cheng, Kai, Lixia Li, Yanmin Du, Jiangtao Wang, Zhenghua Chen, Jian Liu, Xiangsheng Zhang, Lin Dong, Yuanyuan Shen e Zhenlin Yang. "A systematic review of image-guided, surgical robot-assisted percutaneous puncture: Challenges and benefits". Mathematical Biosciences and Engineering 20, n. 5 (2023): 8375–99. http://dx.doi.org/10.3934/mbe.2023367.

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<abstract><p>Percutaneous puncture is a common medical procedure that involves accessing an internal organ or tissue through the skin. Image guidance and surgical robots have been increasingly used to assist with percutaneous procedures, but the challenges and benefits of these technologies have not been thoroughly explored. The aims of this systematic review are to furnish an overview of the challenges and benefits of image-guided, surgical robot-assisted percutaneous puncture and to provide evidence on this approach. We searched several electronic databases for studies on image-guided, surgical robot-assisted percutaneous punctures published between January 2018 and December 2022. The final analysis refers to 53 studies in total. The results of this review suggest that image guidance and surgical robots can improve the accuracy and precision of percutaneous procedures, decrease radiation exposure to patients and medical personnel and lower the risk of complications. However, there are many challenges related to the use of these technologies, such as the integration of the robot and operating room, immature robotic perception, and deviation of needle insertion. In conclusion, image-guided, surgical robot-assisted percutaneous puncture offers many potential benefits, but further research is needed to fully understand the challenges and optimize the utilization of these technologies in clinical practice.</p></abstract>

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Aboudou, Taslim, MeixuanLi, WenceZhou, Zeliang Zhang, Shizhong Wang e KehuYang. "The Efficacy and Safety of Robotic Vs Laparoscopic Inguinal Hernia Repair, a Systematic Review and Meta-analysis". International Journal of Medical Science and Health Research 06, n. 03 (2022): 29–46. http://dx.doi.org/10.51505/ijmshr.2022.6304.

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Background: Surgical robots operations is an emerging technology that offers many advantages in conducting complex endoscopic procedures. However, robot-assisted inguinal hernia repair generates controversies compared to laparoscopic inguinal hernia repair. We evaluated the safety and efficiency of robot-assisted inguinal hernia repair compared to the laparoscopic. Methods: The Pub Med, EMBASE, and Cochrane Library databases was carried out to obtain studies that comparatively evaluated the efficacy, safety, and the economy between robot-assisted and laparoscopic inguinal hernia repair. Rev man software was used to analyze the data according to random effects models. Results: Six studies, of 3246 patients were included, 1025 patients underwent robot-assisted and 2221patients underwent laparoscopic surgery. The review showed that robotic-assisted inguinal hernia may reduce the pain compared with laparoscopic, while hospitals cost was significantly higher in robotic surgery than laparoscopic. There was no significant difference between robotic and laparoscopic surgery in decreasing surgical site infection (OR=4.08, 95%CI: 0.39-43.02, P=0.24), hospital length (MD=0.03, 95%CI: 0.04-0.10, P=0.34), the incidence of hematoma (OR=1.38, 95%CI: 0.57-3.37, P=0.48), seroma (OR=1.15, 95%CI: 0.61-2.15, P=0.67), urinary retention (OR=1.42, 95%CI: 0.67-2.97, P=0.36), and complication (OR=1.158, 95%CI:0.87- 2.87, P=0.14). Conclusions: This study showed robotic-assisted inguinal hernia might reduce pain compared with the laparoscopic group but incurred higher costs. There was no significant difference between robotic and laparoscopic surgery in other efficacy and safety outcomes, which im plying that robotic surgery could be an alternative procedure to laparoscopic instead of replacement in inguinal hernia repair. More robust and high-value randomized trials are required to determine the safety and efficacy of robot-assisted inguinal hernia repair.

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Ebeling, Marcel, Mario Scheurer, Andreas Sakkas, Frank Wilde e Alexander Schramm. "First-Hand Experience and Result with New Robot-Assisted Laser LeFort-I Osteotomy in Orthognathic Surgery: A Case Report". Journal of Personalized Medicine 13, n. 2 (3 febbraio 2023): 287. http://dx.doi.org/10.3390/jpm13020287.

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Background: We report the world’s first developer-independent experience with robot-assisted laser Le Fort I osteotomy (LLFO) and drill-hole marking in orthognathic surgery. To overcome the geometric limitations of conventional rotating and piezosurgical instruments for performing osteotomies, we used the stand-alone robot-assisted laser system developed by Advanced Osteotomy Tools. The aim here was to evaluate the precision of this novel procedure in comparison to the standard procedure used in our clinic using a computer-aided design/computer-aided manufacturing (CAD/CAM) cutting guide and patient-specific implant. Methods: A linear Le-Fort-I osteotomy was digitally planned and transferred to the robot. The linear portion of the Le-Fort I osteotomy was performed autonomously by the robot under direct visual control. Accuracy was analyzed by superimposing preoperative and postoperative computed tomography images, and verified intraoperatively using prefabricated patient-specific implant. Results: The robot performed the linear osteotomy without any technical or safety issues. There was a maximum difference of 1.5 mm on average between the planned and the performed osteotomy. In the robot-assisted intraoperative drillhole marking of the maxilla, which was performed for the first time worldwide, were no measurable deviations between planning and actual positioning. Conclusion: Robotic-assisted orthognathic surgery could be a useful adjunct to conventional drills, burrs, and piezosurgical instruments for performing osteotomies. However, the time required for the actual osteotomy as well as isolated minor design aspects of the Dynamic Reference Frame (DRF), among other things, still need to be improved. Still further studies for final evaluation of safety and accuracy are also needed.

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McDonnell, Jake Michael, Daniel P. Ahern, Tiarnan Ó Doinn, Denys Gibbons, Katharina Nagassima Rodrigues, Nick Birch e Joseph S. Butler. "Surgeon proficiency in robot-assisted spine surgery". Bone & Joint Journal 102-B, n. 5 (maggio 2020): 568–72. http://dx.doi.org/10.1302/0301-620x.102b5.bjj-2019-1392.r2.

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Continuous technical improvement in spinal surgical procedures, with the aim of enhancing patient outcomes, can be assisted by the deployment of advanced technologies including navigation, intraoperative CT imaging, and surgical robots. The latest generation of robotic surgical systems allows the simultaneous application of a range of digital features that provide the surgeon with an improved view of the surgical field, often through a narrow portal. There is emerging evidence that procedure-related complications and intraoperative blood loss can be reduced if the new technologies are used by appropriately trained surgeons. Acceptance of the role of surgical robots has increased in recent years among a number of surgical specialities including general surgery, neurosurgery, and orthopaedic surgeons performing major joint arthroplasty. However, ethical challenges have emerged with the rollout of these innovations, such as ensuring surgeon competence in the use of surgical robotics and avoiding financial conflicts of interest. Therefore, it is essential that trainees aspiring to become spinal surgeons as well as established spinal specialists should develop the necessary skills to use robotic technology safely and effectively and understand the ethical framework within which the technology is introduced. Traditional and more recently developed platforms exist to aid skill acquisition and surgical training which are described. The aim of this narrative review is to describe the role of surgical robotics in spinal surgery, describe measures of proficiency, and present the range of training platforms that institutions can use to ensure they employ confident spine surgeons adequately prepared for the era of robotic spinal surgery. Cite this article: Bone Joint J 2020;102-B(5):568–572.

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Princiotta, Alessandro, Davide Brusa, Damiano D’Aietti, Stefano Vidiri, Maria Angela Cerruto, Alessandro Veccia e Alessandro Antonelli. "Robot-assisted repair of rectovesical fistula". Uro-Technology Journal 6, n. 4 (29 dicembre 2022): 13–16. http://dx.doi.org/10.31491/utj.2022.12.004.

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A 76-year-old man developed a rectovesical fistula after rectal resection for adenocarcinoma complicated by peritonitis with the necessity of the creation of a colostomy. The patient was undergone a rectosigmoidoscopy with the placement of clip-type Ovesco to close the fistula, but this technique resulted ineffective. A robot- assisted closure of the rectovesical fistula was performed using Xi Da Vinci System. The surgical procedure will be divided into 3 parts: longitudinal median cystotomy, excision of the fistula tract, and the closure of the anterior rectal wall and bladder with interposition of omentum, between the suture lines of the rectum and bladder, to prevent fistula recurrence. The patient removed the catheter after 4 weeks of surgery and the patient remained free of urinary leakage from the anus. In February 2021, the surgery for intestinal re-anastomosis was performed. Robotic surgery is a good approach for the treatment of rectovesical fistula when the endoscopic treatment was unresolving

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Strother, Eric, Farid Gharagozloo, Marc Margolis e Barbara J. Tempesta. "ROBOT-ASSISTED THORACOSCOPIC RESECTION OF BRONCHOGENIC CYSTS: VIDEO PRESENTATION OF ROBOT POSITIONING AND OPERATIVE PROCEDURE". Chest 134, n. 4 (ottobre 2008): 81P. http://dx.doi.org/10.1378/chest.134.4_meetingabstracts.p81002.

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Keim, Jessica L., e Dan Theodorescu. "Robot-Assisted Radical Cystectomy in the Management of Bladder Cancer". Scientific World JOURNAL 6 (2006): 2560–65. http://dx.doi.org/10.1100/tsw.2006.396.

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The application of robotic technology to laparoscopic surgery has the potential to revolutionize the entire field of urology. The use of robotic-assisted radical cystectomy has been demonstrated in the literature only within the past 3 years, as much of the reconstruction and urinary diversion techniques associated with radical cystectomy are considered more technically challenging than other procedures. Here we review the available literature pertaining to this procedure, which consists of a limited number of case reports, case series, and pilot or feasibility studies. While theses results seem to point towards less blood loss, lower transfusion rates, and shorter hospital stays compared to open radical cystectomy, definitive conclusions and recommendations cannot yet be made because of a lack of larger and/or prospective studies or randomized trials.

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Bianchi, Roberto, Francesco Alessandro Mistretta, Gennaro Musi, Stefano Luzzago, Michele Morelli, Vito Lorusso, Michele Catellani et al. "Robot-Assisted Intracorporeal Orthotopic Ileal Neobladder: Description of the “Shell” Technique". Journal of Clinical Medicine 10, n. 16 (16 agosto 2021): 3601. http://dx.doi.org/10.3390/jcm10163601.

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Background: Robot-assisted radical cystectomy (RARC) with intracorporeal neobladder (ICNB) remains a very complicated, technically demanding and time-consuming surgical procedure. In the current study we describe our robot-assisted intracorporeal “Shell” neobladder reconstruction. Methods: From January 2017 to December 2019, we performed 30 intracorporeal ileal neobladder “Shell” reconstructions. We prospectively collected demographics and clinical and pathological data and retrospectively analysed perioperative, functional and oncological outcomes. Results: No conversion to open surgery or intraoperative blood transfusion was necessary. The median whole operative time was 493 min (IQR 433–530 min), ranging from 514 min (IQR 502–554 min) recorded during the first ten procedures to 470 min (IQR 442–503 min) of the last ten. The median estimated blood loss was 400 mL (IQR 350–700 mL). The median length of stay was 11 days (IQR 10–17). Both early and late complication rates were 46.7%. The high-grade early complication rate accounted for 20%, while the high-grade late complication rate was 30%. The daytime continence rate registered was 73.3%, while night-time continence rate was 60%. Conclusions: Our results demonstrated “Shell” neobladder reconstruction as a technically feasible procedure, with good functional outcomes in tertiary referral centre. Longer follow-up and larger populations are needed to validate these preliminary results.

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Ho, Jordan, e Herman Bami. "Robot-assisted surgical treatment in a case of superior mesenteric artery syndrome". University of Western Ontario Medical Journal 87, n. 2 (12 marzo 2019): 67–69. http://dx.doi.org/10.5206/uwomj.v87i2.1143.

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We present a case of superior mesenteric artery syndrome in a 14-year-old female. The patient was initially managed using dietary changes and postprandial assumption of the left lateral decubitus position, however, after two months with no improvement, the patient was treated using a robot-assisted Strong’s procedure. The patient fully recovered within one year. We further discuss superior mesenteric artery syndrome and its current treatment practices, and give a general overview of the current state of robot-assisted surgery.

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Van Ham, G., K. Denis, J. Vander Sloten, R. Van Audekercke, G. Van der Perre, J. De Schutter, J.-P. Simon e G. Fabry. "A semi-active milling procedure in view of preparing implantation beds in robot-assisted orthopaedic surgery". Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine 219, n. 3 (1 marzo 2005): 163–74. http://dx.doi.org/10.1243/095441105x9381.

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Bone cutting in total joint reconstructions requires a high accuracy to obtain a well-functioning and long-lasting prosthesis. Hence robot assistance can be useful to increase the precision of the surgical actions. A drawback of current robot systems is that they autonomously machine the bone, in that way ignoring the surgeon's experience and introducing a safety risk. This paper presents a semi-active milling procedure to overcome that drawback. In this procedure the surgeon controls robot motion by exerting forces on a force-controlled lever that is attached to the robot end effector. Meanwhile the robot constrains tool motion to the planned motion and generates a tool feed determined by the feed force that the surgeon executes. As a case study the presented milling procedure has been implemented on a laboratory set-up for robot-assisted preparation of the acetabulum in total hip arthroplasty. Two machining methods have been considered. In the first method the surgeon determines both milling trajectory and feed by the forces that he/she executes on the force-controlled lever. In the second method the cavity is machined contour by contour, and the surgeon only provides the feed. Machining experiments have shown that the first method results in large surface irregularities and is not useful. The second method, however, results in accurate cavity preparation and has therefore potential to be implemented in future robot systems.

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Sessa, F., A. Rivetti, R. Campi, R. Nicoletti, P. Polverino, L. Verdelli, A. Pecoraro et al. "Bladder-neck sparing robot assisted radical prostatectomy: Step-by step procedure". European Urology 81 (febbraio 2022): S1802. http://dx.doi.org/10.1016/s0302-2838(22)01315-x.

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Umari, P., N. Fossati, G. Gandaglia, A. Heinze, R. De Groote, P. Schatteman, G. De Naeyer e A. Mottrie. "Robot-assisted simple prostatectomy (RASP) step by step procedure and results". European Urology Supplements 16, n. 3 (marzo 2017): e2129-e2130. http://dx.doi.org/10.1016/s1569-9056(17)31287-3.

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Gargiulo, A. R., J. A. Greenberg e G. Sotrel. "Robot-Assisted Laparoscopic Tubocornual Anastomosis for Reversal of Essure Sterilization Procedure". Journal of Minimally Invasive Gynecology 18, n. 6 (novembre 2011): S159. http://dx.doi.org/10.1016/j.jmig.2011.08.621.

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Terrier, Laura, Vianney Gilard, Florent Marguet, Maxime Fontanilles e Stéphane Derrey. "Stereotactic brain biopsy: evaluation of robot-assisted procedure in 60 patients". Acta Neurochirurgica 161, n. 3 (24 gennaio 2019): 545–52. http://dx.doi.org/10.1007/s00701-019-03808-5.

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Gharagozloo, Farid, Marc Margolis, Arnold Schwartz, Barbara J. Tempesta e Eric Strother. "ROBOT-ASSISTED THORACOSCOPIC HELLER MYOTOMY WITHOUT AN ANTIREFLUX PROCEDURE FOR ACHALASIA". Chest 132, n. 4 (ottobre 2007): 660A. http://dx.doi.org/10.1378/chest.132.4_meetingabstracts.660.

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Mandal, Kaushik, Aseem R. Srivastava, L. Wiley Nifong e W. Randolph Chitwood. "Robot-Assisted Partial Atrioventricular Canal Defect Repair and Cryo-Maze Procedure". Annals of Thoracic Surgery 101, n. 2 (febbraio 2016): 756–58. http://dx.doi.org/10.1016/j.athoracsur.2015.02.135.

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Chellal, Arezki Abderrahim, José Lima, José Gonçalves, Florbela P. Fernandes, Fátima Pacheco, Fernando Monteiro, Thadeu Brito e Salviano Soares. "Robot-Assisted Rehabilitation Architecture Supported by a Distributed Data Acquisition System". Sensors 22, n. 23 (6 dicembre 2022): 9532. http://dx.doi.org/10.3390/s22239532.

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Rehabilitation robotics aims to facilitate the rehabilitation procedure for patients and physical therapists. This field has a relatively long history dating back to the 1990s; however, their implementation and the standardisation of their application in the medical field does not follow the same pace, mainly due to their complexity of reproduction and the need for their approval by the authorities. This paper aims to describe architecture that can be applied to industrial robots and promote their application in healthcare ecosystems. The control of the robotic arm is performed using the software called SmartHealth, offering a 2 Degree of Autonomy (DOA). Data are gathered through electromyography (EMG) and force sensors at a frequency of 45 Hz. It also proves the capabilities of such small robots in performing such medical procedures. Four exercises focused on shoulder rehabilitation (passive, restricted active-assisted, free active-assisted and Activities of Daily Living (ADL)) were carried out and confirmed the viability of the proposed architecture and the potential of small robots (i.e., the UR3) in rehabilitation procedure accomplishment. This robot can perform the majority of the default exercises in addition to ADLs but, nevertheless, their limits were also uncovered, mainly due to their limited Range of Motion (ROM) and cost.

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Martini, Alberto, e Ashutosh Kumar Tewari. "Anatomic robotic prostatectomy: current best practice". Therapeutic Advances in Urology 11 (gennaio 2019): 175628721881378. http://dx.doi.org/10.1177/1756287218813789.

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Urologic prostate surgery has changed dramatically over the past decades. Following the introduction of the robot, the surgical approach has been modified and thanks to the magnification allowed by the robot a further level of precision can be achieved. Moreover, advances in the anatomical studies have provided new evidence regarding the periprostatic anatomy. The aim of this review is to describe our approach to robot-assisted radical prostatectomy. Our holistic perspective towards patient selection, pre- and postoperative care is provided. In our center, robot-assisted radical prostatectomy is performed by means of an anterograde approach. A nonbladder-sparing dissection with a graded approach towards nerve preservation is carried out. The procedure is concluded with what we call ‘total anatomical reconstruction’.

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Li, Shibo, Xin Zhong, Yuanyuan Yang, Xiaozhi Qi, Ying Hu e Xiaojun Yang. "Force-Position Hybrid Compensation Control for Path Deviation in Robot-Assisted Bone Drilling". Sensors 23, n. 16 (21 agosto 2023): 7307. http://dx.doi.org/10.3390/s23167307.

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Bone drilling is a common procedure in orthopedic surgery and is frequently attempted using robot-assisted techniques. However, drilling on rigid, slippery, and steep cortical surfaces, which are frequently encountered in robot-assisted operations due to limited workspace, can lead to tool path deviation. Path deviation can have significant impacts on positioning accuracy, hole quality, and surgical safety. In this paper, we consider the deformation of the tool and the robot as the main factors contributing to path deviation. To address this issue, we establish a multi-stage mechanistic model of tool–bone interaction and develop a stiffness model of the robot. Additionally, a joint stiffness identification method is proposed. To compensate for path deviation in robot-assisted bone drilling, a force-position hybrid compensation control framework is proposed based on the derived models and a compensation strategy of path prediction. Our experimental results validate the effectiveness of the proposed compensation control method. Specifically, the path deviation is significantly reduced by 56.6%, the force of the tool is reduced by 38.5%, and the hole quality is substantially improved. The proposed compensation control method based on a multi-stage mechanistic model and joint stiffness identification method can significantly improve the accuracy and safety of robot-assisted bone drilling.

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Kozlov, Yuri A., Simon S. Poloyan, Eduard V. Sapukhin, Alexey S. Strashinsky, Marina V. Makarochkina, Andrey A. Marchuk, Alexander P. Rozhansky, Anton A. Byrgazov, Sergey A. Muravyov e Artem N. Narkevich. "Robot-assisted bladder diverticulum removal in a 10-year-old child". Russian Journal of Pediatric Surgery 27, n. 6 (26 dicembre 2023): 431–38. http://dx.doi.org/10.17816/ps661.

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BACKGROUND: Bladder diverticulum are hernias of the bladder mucosa that prolapse through a detrusor defect. Diverticulectomy is the treatment of choice for this disease. Surgical methods to implement this principle include open, laparoscopic and robotic approaches. In the present study, we outline our own technique for performing robotic diverticulectomy and report its short-term results. CLINICAL CASE DESCRIPTION: The study reports one case of bladder diverticulectomy performed with a robot-assisted technique in a 10-year-old boy. The diagnosis of the disease was established using voiding cystourethrography, cystoscopy and X-ray computed urography. The patient had robot-assisted bladder diverticulectomy using transperitoneal extravesical access. At the final stage of the study, short-term outcomes of the robot-assisted procedure were evaluated. The duration of the operation was 100 minutes. No intraoperative and postoperative complications were observed. The urinary catheter was removed the day after the operation. The duration of the patient's stay in the hospital was 7 days. Histological examination showed signs corresponding to a false diverticulum of the bladder with the presence of single muscle fibers in its structure. The ureteral stent was removed one month after the operation. After removal of the stent, control voiding cystography was performed, which demonstrated the absence of bladder contour deformation at the site of surgical procedure. CONCLUSION: Robot-assisted bladder diverticulectomy is a technically feasible approach to the treatment of congenital bladder diverticulum.

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Legnani, Federico G., Andrea Franzini, Luca Mattei, Andrea Saladino, Cecilia Casali, Francesco Prada, Alessandro Perin et al. "Image-Guided Biopsy of Intracranial Lesions with a Small Robotic Device (iSYS1): A Prospective, Exploratory Pilot Study". Operative Neurosurgery 17, n. 4 (23 gennaio 2019): 403–12. http://dx.doi.org/10.1093/ons/opy411.

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Abstract BACKGROUND Robotic technologies have been used in the neurosurgical operating rooms for the last 30 yr. They have been adopted for several stereotactic applications and, particularly, image-guided biopsy of intracranial lesions which are not amenable for open surgical resection. OBJECTIVE To assess feasibility, safety, accuracy, and diagnostic yield of robot-assisted frameless stereotactic brain biopsy with a recently introduced miniaturized device (iSYS1; Interventional Systems Medizintechnik GmbH, Kitzbühel, Austria), fixed to the Mayfield headholder by a jointed arm. METHODS Clinical and surgical data of all patients undergoing frameless stereotactic biopsies using the iSYS1 robotized system from October 2016 to December 2017 have been prospectively collected and analyzed. Facial surface registration has been adopted for optical neuronavigation. RESULTS Thirty-nine patients were included in the study. Neither mortality nor morbidity related to the surgical procedure performed with the robot was recorded. Diagnostic tissue samples were obtained in 38 out of 39 procedures (diagnostic yield per procedure was 97.4%). All patients received a definitive histological diagnosis. Mean target error was 1.06 mm (median 1 mm, range 0.1-4 mm). CONCLUSION The frameless robotic iSYS1-assisted biopsy technique was determined to be feasible, safe, and accurate procedure; moreover, the diagnostic yield was high. The surface matching registration method with computed tomography as the reference image set did not negatively affect the accuracy of the procedure.

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Fan, Le-Wei, Yun-Ren Li, Cheng-Mu Wu, Kai-Ti Chuang, Wei-Chang Li, Chung-Yi Liu e Ying-Hsu Chang. "Inpatient Outcomes of Patients Undergoing Robot-Assisted versus Laparoscopic Radical Cystectomy for Bladder Cancer: A National Inpatient Sample Database Study". Journal of Clinical Medicine 13, n. 3 (29 gennaio 2024): 772. http://dx.doi.org/10.3390/jcm13030772.

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Background: Bladder cancer is a common urinary tract malignancy. Minimally invasive radical cystectomy has shown oncological outcomes comparable to the conventional open surgery and with advantages over the open procedure. However, outcomes of the two main minimally invasive procedures, robot-assisted and pure laparoscopic, have yet to be compared. This study aimed to compare in-hospital outcomes between these two techniques performed for patients with bladder cancer. Methods: This population-based, retrospective study included hospitalized patients aged ≥ 50 years with a primary diagnosis of bladder cancer who underwent robot-assisted or pure laparoscopic radical cystectomy. All patient data were extracted from the US National Inpatient Sample (NIS) database 2008–2018 and were analyzed retrospectively. Primary outcomes were in-hospital mortality, prolonged length of stay (LOS), and postoperative complications. Results: The data of 3284 inpatients (representing 16,288 US inpatients) were analyzed. After adjusting for confounders, multivariable analysis revealed that patients who underwent robot-assisted radical cystectomy had a significantly lower risk of in-hospital mortality (adjusted OR [aOR], 0.50, 95% CI: 0.28–0.90) and prolonged LOS (aOR, 0.63, 95% CI: 0.49–0.80) than those undergoing pure laparoscopic cystectomy. Patients who underwent robot-assisted radical cystectomy had a lower risk of postoperative complications (aOR, 0.69, 95% CI: 0.54–0.88), including bleeding (aOR, 0.73, 95% CI: 0.54–0.99), pneumonia (aOR, 0.49, 95% CI: 0.28–0.86), infection (aOR, 0.55, 95% CI: 0.36–0.85), wound complications (aOR, 0.33, 95% CI: 0.20–0.54), and sepsis (aOR, 0.49, 95% CI: 0.34–0.69) compared to those receiving pure laparoscopic radical cystectomy. Conclusions: Patients with bladder cancer, robot-assisted radical cystectomy is associated with a reduced risk of unfavorable short-term outcomes, including in-hospital mortality, prolonged LOS, and postoperative complications compared to pure laparoscopic radical cystectomy.

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Ploussard, Guillaume, Richard Haddad, Evan Kovac, Patrick Richard, Maurice Anidjar e Franck Bladou. "Robot-assisted laparoscopic partial nephrectomy: Early single Canadian institution experience". Canadian Urological Association Journal 7, n. 9-10 (9 ottobre 2013): 348. http://dx.doi.org/10.5489/cuaj.753.

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Background: Although robot-assisted partial nephrectomy (RALPN) has been increasingly adopted, open procedures continue to be the reference nephron-sparing technique. We describe our initial surgical outcomes of RALPN in our single institution robotic program.Methods: Between January 2011 and February 2013, 65 consecutive patients underwent a RALPN by 2 surgeons. Preoperative characteristics, including the R.E.N.A.L. nephrometry score, perioperative parameters, and postoperative course, including renal function, were assessed from a retrospective database. The mean follow-up was 12 months.Results: The mean age was 60.2 years and the mean tumour size was 3.9 cm. According to the R.E.N.A.L. nephrometry score, the tumours were classified moderately and highly complex tumours in 51% and 18.5% of cases, respectively. Median warm ischemia time (WIT) was 21 minutes. Factors associated with WIT were R.E.N.A.L. nephrometry score, tumour size, complication rates and surgeon experience. No conversion or grade 4 to 5 complications were reported. The mean hospital stay was 3 days. The overall complication rate was 24.6% (re-admission rate 7.7%), and decreased to 12% after 20 cases. After these initial 20 cases, a trifecta rate (no margins, preserved renal function, no complications) of 64.3% was achieved in moderately and highly complex tumours. The mean change in estimated glomerular filtration rate was 6.7 mL/min without severe postoperative renal failure.Interpretation: RALPN is a safe and feasible procedure with low specific morbidity, even in moderately or highly complex renal masses. The WIT depends on tumour characteristics, mainly determined by the R.E.N.A.L. nephrometry score and is improved by surgeon experience. Longer follow-up is needed to assess the oncologic mid-term safety of the procedure.

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Gawęcki, Wojciech, Andrzej Balcerowiak, Paulina Podlawska, Witold Szyfter e Małgorzata Wierzbicka. "Robot-assisted cochlear implantation via a modified pericanal approach". Otolaryngologia Polska 77, n. 3 (17 aprile 2023): 1–6. http://dx.doi.org/10.5604/01.3001.0016.3414.

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Purpose: The aim of this study was to present the robot-assisted cochlear implantation via a modified pericanal approach was performed. Case presentation: The patient, a 63 y.o male, had passed the typical procedure of qualifying for a cochlear implant at our center. However the preoperative CT of the temporal bone showed very anterior position of the sigmoid sinus and very low position of the middle fossa dura in the right ear qualified for cochlear implantation. For this reason, the pericanal approach described by Husler was chosen. The surgery was performed with the use of surgical robot - the RobOtol (Collin, Bagneux, France) and the approach was slightly modified. The whole procedure was described in details in the manuscript. Postoperative CT of the temporal bone confirmed the proper intracochlear position of the electrode array. Both surgery and healing were uneventful. Conclusions: The RobOtol surgical robot allows for the correct and safe insertion of the cochlear implant electrode in patients with unusual anatomical conditions and approach to the cochlea.

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Abbas, Rawad, Fadi Al Saiegh, Kareem El Naamani, Ching-Jen Chen, Lohit Velagapudi, Georgios S. Sioutas, Joshua H. Weinberg et al. "Robot-assisted carotid artery stenting: outcomes, safety, and operational learning curve". Neurosurgical Focus 52, n. 1 (gennaio 2022): E17. http://dx.doi.org/10.3171/2021.10.focus21504.

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OBJECTIVE Over the past 2 decades, robots have been increasingly used in surgeries to help overcome human limitations and perform precise and accurate tasks. Endovascular robots were pioneered in interventional cardiology, however, the CorPath GRX was recently approved by the FDA for peripheral vascular and extracranial interventions. The authors aimed to evaluate the operational learning curve for robot-assisted carotid artery stenting over a period of 19 months at a single institution. METHODS A retrospective analysis of a prospectively maintained database was conducted, and 14 consecutive patients who underwent robot-assisted carotid artery stenting from December 2019 to June 2021 were identified. The metrics for proficiency were the total fluoroscopy and procedure times, contrast volume used, and radiation dose. To evaluate operator progress, the patients were divided into 3 groups of 5, 4, and 5 patients based on the study period. RESULTS A total of 14 patients were included. All patients received balloon angioplasty and stent placement. The median degree of stenosis was 95%. Ten patients (71%) were treated via the transradial approach and 4 patients (29%) via the transfemoral approach, with no procedural complications. The median contrast volume used was 80 mL, and the median radiation dose was 38,978.5 mGy/cm2. The overall median fluoroscopy and procedure times were 24.6 minutes and 70.5 minutes, respectively. Subgroup analysis showed a significant decrease in these times, from 32 minutes and 86 minutes, respectively, in group 1 to 21.9 minutes and 62 minutes, respectively, in group 3 (p = 0.002 and p = 0.008, respectively). CONCLUSIONS Robot-assisted carotid artery stenting was found to be safe and effective, and the learning curve for robotic procedures was overcome within a short period of time at a high-volume cerebrovascular center.

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Zhao, Yinzheng, Anne-Marie Jablonka, Niklas A. Maierhofer, Hessam Roodaki, Abouzar Eslami, Mathias Maier, Mohammad Ali Nasseri e Daniel Zapp. "Comparison of Robot-Assisted and Manual Cannula Insertion in Simulated Big-Bubble Deep Anterior Lamellar Keratoplasty". Micromachines 14, n. 6 (16 giugno 2023): 1261. http://dx.doi.org/10.3390/mi14061261.

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This study aimed to compare the efficacy of robot-assisted and manual cannula insertion in simulated big-bubble deep anterior lamellar keratoplasty (DALK). Novice surgeons with no prior experience in performing DALK were trained to perform the procedure using manual or robot-assisted techniques. The results showed that both methods could generate an airtight tunnel in the porcine cornea, and result in successful generation of a deep stromal demarcation plane representing sufficient depth reached for big-bubble generation in most cases. However, the combination of intraoperative OCT and robotic assistance received a significant increase in the depth of achieved detachment in non-perforated cases, comprising a mean of 89% as opposed to 85% of the cornea in manual trials. This research suggests that robot-assisted DALK may offer certain advantages over manual techniques, particularly when used in conjunction with intraoperative OCT.

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