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Статті в журналах з теми "Dimensional laparoscopy"

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Koppatz, Hanna E., Jukka I. Harju, Jukka E. Sirén, Panu J. Mentula, Tom M. Scheinin, and Ville J. Sallinen. "Three-dimensional versus two-dimensional high-definition laparoscopy in transabdominal preperitoneal inguinal hernia repair: a prospective randomized controlled study." Surgical Endoscopy 34, no. 11 (November 21, 2019): 4857–65. http://dx.doi.org/10.1007/s00464-019-07266-z.

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Abstract Background Three-dimensional (3D) laparoscopy improves technical efficacy in laboratory environment, but evidence for clinical benefit is lacking. The aim of this study was to determine whether the 3D laparoscopy is beneficial in transabdominal preperitoneal laparoscopic inguinal hernia repair (TAPP). Method In this prospective, single-blinded, single-center, superior randomized trial, patients scheduled for TAPP were randomly allocated to either 3D or two-dimensional (2D) TAPP laparoscopic approaches. Patients were excluded if secondary operation was planned, the risk of conversion was high, or the surgeon had less than five previous 3D laparoscopic procedures. Patients were operated on by 13 residents and 3 attendings. The primary endpoint was operation time. The study was registered in ClinicalTrials.gov (NCT02367573). Results Total 278 patients were randomized between 5th February 2015 and 23rd October 2017. Median operation time was shorter in the 3D group (56.0 min vs. 68.0 min, p < 0.001). 10 (8%) patients in 3D group and 6 (5%) patients in 2D group had clinically significant complications (Clavien–Dindo 2 or higher) (p = 0.440). Rate of hernia recurrence was similar between groups at 1-year follow-up. In the subgroup analyses, operation time was shorter in 3D laparoscopy among attendings, residents, female surgeons, surgeons with perfect stereovision, surgeons with > 50 3D laparoscopic procedures, surgeons with any experience in TAPP, patients with body mass indices < 30, and bilateral inguinal hernia repairs. Conclusion 3D laparoscopy is beneficial and shortens operation time but does not affect safety or long-term outcomes of TAPP.
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BIRKETT, DESMOND H. "Three-Dimensional Laparoscopy." Journal of Laparoendoscopic Surgery 5, no. 5 (October 1995): 327–31. http://dx.doi.org/10.1089/lps.1995.5.327.

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Cologne, Kyle G., Joerg Zehetner, Loriel Liwanag, Christian Cash, Anthony J. Senagore, and John C. Lipham. "Three-dimensional Laparoscopy." Surgical Laparoscopy, Endoscopy & Percutaneous Techniques 25, no. 4 (August 2015): 321–23. http://dx.doi.org/10.1097/sle.0000000000000168.

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Mueller, M. D., C. Camartin, E. Dreher, and W. Hänggi. "Three-dimensional laparoscopy." Surgical Endoscopy 13, no. 5 (May 1999): 469–72. http://dx.doi.org/10.1007/s004649901014.

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Shishkina, T. Yu, and V. B. Aksenova. "Potential of ultrasound elastography and three-dimensional echocardiography in the diagnosis of tubal pregnancy." Voprosy ginekologii, akušerstva i perinatologii 20, no. 6 (2021): 162–65. http://dx.doi.org/10.20953/1726-1678-2021-6-162-165.

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A clinical case describing the potential of elastography and three-dimensional echocardiography in tubal pregnancy in a patient who was not initially diagnosed during laparoscopy is presented. The dynamic observation showed an increase in serum chorionic gonadotropin; the postoperative follow-up with elastography and three-dimensional echocardiography revealed signs of initially progressive and subsequently interrupted tubal pregnancy (the patient refused a second laparoscopy). Threedimensional echocardiography contributed to better visualization of the ovum compared to the B-mode image; the sign of tubal pregnancy (a vascular “ring of fire”) was clearly identified in the glass-body mode. A laparoscopic tubal ligation was then performed. The diagnosis was confirmed histologically. Conclusion. Ultrasound elastography and three-dimensional echocardiography contribute to better diagnosis of tubal pregnancy in complicated clinical situations. Key words: tubal pregnancy, ectopic pregnancy, elastography, three-dimensional echocardiography, vascular “ring of fire”
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Lagrange, Chad A., Curtis J. Clark, Eric W. Gerber, and Stephen E. Strup. "Evaluation of Three Laparoscopic Modalities: Robotics versus Three-Dimensional Vision Laparoscopy versus Standard Laparoscopy." Journal of Endourology 22, no. 3 (March 2008): 511–16. http://dx.doi.org/10.1089/end.2007.0241.

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García-Segui, A., and J. A. Galán-Llopis. "Three dimensional (3D) urological laparoscopy." Actas Urológicas Españolas (English Edition) 37, no. 9 (October 2013): 592–93. http://dx.doi.org/10.1016/j.acuroe.2013.05.004.

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Benelli, Andrea, Virginia Varca, Marco Rosso, Francesca Peraldo, and Andrea Gregori. "3D versus 2D laparoscopic radical prostatectomy for organ confined prostate cancer: Our experience." Journal of Clinical Urology 12, no. 3 (October 8, 2018): 186–91. http://dx.doi.org/10.1177/2051415818800536.

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Objective: Three-dimensional (3D) laparoscopy was developed to overcome the main limitations of traditional laparoscopy. The aim of our study was to compare operative, functional and oncological results of 3D and two-dimensional (2D) laparoscopic radical prostatectomy. Materials and methods: A total of 102 consecutive patients with clinically localised prostate cancer underwent laparoscopic radical prostatectomy. Patients were randomly assigned into two groups, 2D high definition (HD) camera (50 patients) for the first and 3D HD camera (52 patients) for the second group. Total operative time, anastomosis time, blood loss, complications and pentafecta rates for both groups were compared. All patients had at least one year of follow-up. Results: Total operative time was, respectively, 143 ± 17 and 118 ± 15 minutes, with a mean anastomosis time of 31± 12 and 23 ± 12 minutes. Mean blood loss was 230 ± 30 ml with 2D vision and 175 ± 40 with 3D vision. Pentafecta was reached, respectively, by 46% and 50% of patients at 3 months and 60% and 67.3% at 12 months. 3D vision offers an increased speed if compared with traditional vision ( P=0.02). Pentafecta results were significantly better in the 3D group ( P=0.03). Conclusion: We believe that 3D laparoscopy offers important advantages for surgeons and patients; its use should be encouraged. Level of evidence: 1c
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Kowalczyk, Dariusz, Szymon Piątkowski, Maja Porażko, Aleksandra Woskowska, Klaudia Szewczyk, Katarzyna Brudniak, Mariusz Wójtowicz, and Karolina Kowalczyk. "Safety of Three-Dimensional versus Two-Dimensional Laparoscopic Hysterectomy during the COVID-19 Pandemic." International Journal of Environmental Research and Public Health 19, no. 21 (October 29, 2022): 14163. http://dx.doi.org/10.3390/ijerph192114163.

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Background: The COVID-19 pandemic has resulted in a significant decrease in the number of surgical procedures performed. Therefore, it is important to use surgical methods that carry the lowest possible risk of virus transmission between the patient and the operating theater staff. Aim: Safety evaluation of three-dimensional (3D) versus two-dimensional (2D) laparoscopic hysterectomy during the COVID-19 pandemic. Methods: 44 patients were assigned to a prospective case-control study. They were divided either to 3D (n = 22) or 2D laparoscopic hysterectomy (n = 22). Fourteen laparoscopic supracervical hysterectomies (LASH) and eight total laparoscopic hysterectomies (TLH) were performed in every group. The demographic data, operating time, change in patients’ hemoglobin level and other surgical outcomes were evaluated. Results: 3D laparoscopy was associated with a significantly shorter operating time than 2D. (3D vs. 2D LASH 70 ± 23 min vs. 90 ± 20 min, p = 0.0086; 3D vs. 2D TLH 72 ± 9 min vs. 85 ± 9 min, p = 0.0089). The 3D and 2D groups were not significantly different in terms of change in serum hemoglobin level and other surgical outcomes. Conclusions: Due to a shorter operating time, 3D laparoscopic hysterectomy seems to be a safer method both for both the surgeon and the patient. Regarding terms of possible virus transmission, it may be particularly considered the first-choice method during the COVID-19 pandemic.
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Benelli, Andrea, Virginia Varca, Alchiede Simonato, Carlo Terrone, and Andrea Gregori. "Pentafecta Rates of Three-Dimensional Laparoscopic Radical Prostatectomy: Our Experience after 150 Cases." Urologia Journal 84, no. 2 (April 2017): 93–97. http://dx.doi.org/10.5301/uj.5000239.

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Introduction Three-dimensional (3D) laparoscopy with a flexible camera was developed to overcome the main limitation of traditional laparoscopic surgery, which is two-dimensional (2D) vision. The aim of our article is to present the largest casistic of 3D laparoscopic radical prostatectomy (LRP) available in literature and evaluate our results in terms of pentafecta and compare it with the literature. Methods We retrospectively evaluated consecutive patients who underwent LRP with 3D technology between March 2014 and December 2015. Total operative time (TOT), anasthomosis time (AT), blood loss and complications were registered. All patients presented at least 3 months of follow-up. Surgical outcome was evaluated in terms of Pentafecta. Results One hundred fifty consecutive patients underwent 3D LRP. Mean follow-up was 16.9 months. Mean age was 67.7 ± 8.3 years (range 50-76). Mean preoperative PSA value was 8.3 ± 5.8 ng/ml and mean bioptic Gleason Score (GS) was 6.6. We had a mean TOT of 158 ± 23 minutes and a mean AT of 25 ± 12.6. Mean blood loss was 240 ± 40 ml. Eighteen (12%) postoperative complications occurred. Pathologic results: pT2 in 91 patients (58%) and pT3 in 59 (39.3%). Pentafecta was reached by 31.3% of patients at 3 months and 51.6% at 12 months. Conclusions Our oncological and functional results are comparable to those present in literature for laparoscopic and robotic surgery. We believe that our findings can encourage the use of 3D laparoscopy especially considering the increasing attention to healthcare costs.
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Дисертації з теми "Dimensional laparoscopy"

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McGowan, Linda. "Psychological dimensions of chronic pelvic pain." Thesis, Staffordshire University, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.267384.

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Книги з теми "Dimensional laparoscopy"

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Sullivan, Mark, Nilay Patel, and Inderbir Gill. Principles of laparoscopic and robotic urological surgery. Edited by John Reynard. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0033.

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The development of laparoscopic and consequently robotic urological surgery have improved the visual field for the urological surgeon and led to reductions in postoperative pain, reduced convalescence, and improved cosmesis for the patient. Laparoscopy and robotics require video systems and telescopes to produce high-resolution images. Trocars have been developed to access the surgical field together with devices to deliver the insufflating gases. Instruments have been developed to allow for tissue dissection and incision together with haemostatic devices and sealants for control of small diameter vessel bleeding. Clips and staplers are used to control larger diameter vessels. Methods of access and skills training are discussed. Robotic surgery provides three-dimensional vision, greater range of movement, and the lack of tremor. Whether these are real benefits in terms of patient outcome is not yet clear, but the learning curve for robotic surgery does appear to be shorter than for pure laparoscopy.
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Частини книг з теми "Dimensional laparoscopy"

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Lucas, Steven M., and Chandru P. Sundaram. "The MIMIC Virtual Reality Trainer: Stepping into Three-Dimensional, Binocular, Robotic Simulation." In Simulation Training in Laparoscopy and Robotic Surgery, 49–57. London: Springer London, 2012. http://dx.doi.org/10.1007/978-1-4471-2930-1_6.

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Chiu, Christopher, and Zenon Chaczko. "Multi-dimensional Representations of Laparoscopic Simulations for SANETs." In Computer Aided Systems Theory – EUROCAST 2011, 225–32. Berlin, Heidelberg: Springer Berlin Heidelberg, 2012. http://dx.doi.org/10.1007/978-3-642-27579-1_29.

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Gherman, Bogdan, Paul Tucan, Calin Vaida, Nicolae Crisan, Gabriela Rus, Iosif Birlescu, and Doina Pisla. "On the Kinematics and Dimensional Optimization of a Robotic System for Single Incision Laparoscopic Surgery." In Advances in Service and Industrial Robotics, 383–91. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-04870-8_45.

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"Three-Dimensional Camera and Video System." In Advanced Techniques in Gasless Laparoscopic Surgery, 179–85. WORLD SCIENTIFIC, 1995. http://dx.doi.org/10.1142/9789812831071_0037.

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Duta, Ciprian, Stelu Pantea, Dan Brebu, Amadeus Dobrescu, Caius Lazar, Kitty Botoca, Cristi Tarta, and Fulger Lazar. "The Robotic Approach in Rectal Cancer." In Current Topics in Colorectal Surgery [Working Title]. IntechOpen, 2021. http://dx.doi.org/10.5772/intechopen.100026.

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Since a robotic surgical system was developed in the early 1990s and the first robotic-assisted radical prostatectomy was reported in 2001, robotic surgery has spread in many surgical specialties, changing surgical management. Currently, compared to other colorectal procedures, robotic surgery appears to offer great benefits for total mesorectal excision for rectal cancer. Abdominal cavity other procedures such as right hemicolectomy and high anterior resection are relatively uncomplicated and can be performed easily by laparoscopic surgery. First reports have focused on the clinical benefits of robotic rectal cancer surgery compared with laparoscopic surgery. The indications for robotic and laparoscopic rectal cancer surgery are not different. The recently published results of the ROLARR trial, comparing robot-assisted TME to laparoscopic TME, show no advantages of robot assistance in terms of intraoperative complications, postoperative complications, plane of surgery, 30-day mortality, bladder dysfunction, and sexual dysfunction. A drawback of the study is the variability in experience of the participating surgeons in robotic surgery. After correction of this confounder, an advantage for robotic assistance was suggested in terms of risk of conversion to open surgery. For robotic rectal cancer surgery to become the preferred minimally invasive option, it must demonstrate that it does not have the technical difficulties and steep learning curve of laparoscopic surgery. Robotic surgery has several technical advantages over open and laparoscopic surgery. The system provides a stable operating platform, three-dimensional imaging, articulating instruments and a stable surgeon controlled camera which is mainly beneficial in areas where space and maneuverability is limited such as the pelvis.
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"Three-Dimensional Computed Imaging And Its Clinical Applications." In Advanced Techniques in Gasless Laparoscopic Surgery, 167–75. WORLD SCIENTIFIC, 1995. http://dx.doi.org/10.1142/9789812831071_0036.

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Qayyum, Abdul, M. K. A. Ahamed Khan, and Moona Mazher. "Pseudo LABELIng Based 3DResUNet with DEep Supervision for the Kidney PArsing Segmentation Challenge." In Advances in Transdisciplinary Engineering. IOS Press, 2022. http://dx.doi.org/10.3233/atde221123.

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Three-dimensional (3D) integrated renal structures (IRS) segmentation is an important task based on computed tomography angiography (CTA) images for laparoscopic partial nephrectomy (LPN). Fine renal artery segmentation based on a CTA image is an important step for kidney disease diagnosis and pre-operative planning. However, it could be challenging due to large inter-anatomy variation, thin structures, small volume ratio, and small labeled dataset of the fine renal artery. The Kidney PArsing Challenge (KiPA) 2022 organizers launched a challenge for automatic segmentation of kidneys, renal tumors, arteries, and veins. In this paper, we have proposed a two-stage solution for the automatic segmentation of four kidney-related structures on CTA images. In the first stage, the 3DResUNet with deep supervision has been used to generate pseudo labels. The pseudo labels generated using validation images from the first stage along with training samples are used in nnUNet to obtain the final segmentation. The proposed solution produced an optimal performance for Multi-Structure Segmentation for Renal Cancer Treatment. The code will be publicly available at: https://github.com/RespectKnowledge/Pseudo-labeling_Segmentation_KiPA22_challenege.
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Mirica, Radu, and Sorin Paun. "The Surgical Approach in Adrenal Gland Pathology." In Adrenal Glands - The Current Stage and New Perspectives of Diseases and Treatment [Working Title]. IntechOpen, 2022. http://dx.doi.org/10.5772/intechopen.106522.

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The pathology of the adrenal gland and the clinical management of the adrenal clinical entities are particularly complex. The surgical approach to adrenal disorders, both in the classic way and especially in the minimally invasive way, is reserved for highly addressable centers and experienced surgeons. The surgical treatment is dedicated to both functional and nonfunctional adrenal tumors, closely following specific criteria. Regarding adrenal pathology, the surgical treatment is indicated for adrenal tumors that secret mineralocorticoid hormones (Conn syndrome), adrenal tumors secreting glucocorticoids (Cushing syndrome), pheochromocytomas, paragangliomas, neuroblastomas, adrenal carcinomas, and metastases. At the same time, non-secreting tumors should be removed as soon as imaging details are recorded an increasing dimensions of these tumors during a short time interval (up to one year). Although laparoscopic adrenal removal became a gold standard procedure in the late 90s, the classic open surgical adrenalectomy is reserved for bulky adrenal tumors and adrenal cancers, but it is overshadowed by possible multiple complications such as lung damage, wound infections, thrombosis, bleeding, etc. The minimally invasive approach, either laparoscopically or robotically, is dedicated to small tumors, with the advantage of rapid patient recovery, rapid socio-professional reintegration, and reduction of complications. Laparoscopic adrenalectomy is indicated in a wide range of pathologies, ranging from Conn adenoma, Cushing syndrome, and pheochromocytoma, to hormonal inactive tumors or other pathologies. The surgical sparing of the adrenal cortex is advised in cases of hereditary disorders affecting the adrenal gland (such as the MEN2 syndrome) in order to avoid primary adrenal insufficiency after the surgical excision. The postoperative evolution must be closely monitored by the anesthetic-surgical team, and the subsequent follow-up must not be neglected. We will discuss the primary surgical indications and contraindications of adrenal gland pathology in this chapter, as well as the perioperative management of specific tumors, surgical approach types, pluses and minuses of various adrenal surgery procedures, surgical technique and tactics, potential complications, and postoperative management.
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Тези доповідей конференцій з теми "Dimensional laparoscopy"

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Fernandez, Raul, Richard A. Bergs, Robert C. Eberhart, Linda A. Baker, and Jeffrey A. Cadeddu. "Development of a Transabdominal Anchoring System for Trocar-Less Laparoscopic Surgery." In ASME 2003 International Mechanical Engineering Congress and Exposition. ASMEDC, 2003. http://dx.doi.org/10.1115/imece2003-42404.

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Compared with open surgery, laparoscopy results in significantly less pain, faster convalescence, and less morbidity. However, eye-hand dissociation, a two-dimensional field-of-view and fixed instrumentation with limited degrees of freedom contribute to a steep learning curve and demanding dexterity requirements for many laparoscopic procedures. One of the main limitations of laparoscopy is the fixed working envelope surrounding each trocar, often necessitating placement of multiple ports to accomodate changes in position of the instruments or laparoscope to improve visibility and efficiency. The placement of additional working ports contributes to post-operative pain and carries a small risk of bleeding or adjacent organ damage. In order to provide for greater flexibility of endoscopic viewing and instrument usage and to further reduce morbidity, a novel adjunct laparoscopic system has been developed consisting of a platform capable of supporting various laparoscopic tools which is secured magnetically to the abdominal wall and subsequently positioned within the abdominal cavity through surgeon-controlled, external magnetic couples on the patient’s abdomen. Using this technique, instruments such as miniature endoscopic cameras used to augment the surgical field of view and surgical retractors have been successfully evaluated in a dry laboratory as well as in porcine models, with several others currently under investigation. This document elaborates on the theoretical and empirical process which has led to anchoring designs optimized for size, strength and surgical compatibility, as well as the benefits, limitations and prospects for the use of incisionless, magnetically-coupled tooling in laparoscopic surgery.
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Chen, Wanru, Gang Wang, Heqing Tian, Zhedi Chen, Daming Lin, and Yuchen Liu. "Radiation Emission Test and Rectification Analysis of the Three-Dimensional Electronic Laparoscopy System." In 2022 Global Conference on Robotics, Artificial Intelligence and Information Technology (GCRAIT). IEEE, 2022. http://dx.doi.org/10.1109/gcrait55928.2022.00164.

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Jones, Jr., Edwin R., A. P. McLaurin, and J. L. Mason, Jr. "Three-dimensional imaging laparoscope." In Electronic Imaging '91, San Jose,CA, edited by John O. Merritt and Scott S. Fisher. SPIE, 1991. http://dx.doi.org/10.1117/12.46320.

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Jones, Jr., Edwin R., and A. P. McLaurin. "Single-camera three-dimensional laparoscopic system." In IS&T/SPIE 1994 International Symposium on Electronic Imaging: Science and Technology, edited by Scott S. Fisher, John O. Merritt, and Mark T. Bolas. SPIE, 1994. http://dx.doi.org/10.1117/12.173872.

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Yang, Donglin, and Xinting Zhang. "The stereo imaging technology of the three-dimensional video laparoscopic system." In International Conference of Optical Instrument and Technology, edited by Yunlong Sheng, Yongtian Wang, and Lijiang Zeng. SPIE, 2008. http://dx.doi.org/10.1117/12.807055.

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Tholey, Gregory, and Jaydev P. Desai. "A Modular, Automated Laparoscopic Grasper with Three-Dimensional Force Measurement Capability." In 2007 IEEE International Conference on Robotics and Automation. IEEE, 2007. http://dx.doi.org/10.1109/robot.2007.363795.

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Herder, Just L. "Force Directed Design of Laparoscopic Forceps." In ASME 1998 Design Engineering Technical Conferences. American Society of Mechanical Engineers, 1998. http://dx.doi.org/10.1115/detc98/mech-5978.

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Abstract Mechanical design usually applies a kinematic perspective. Desired motion is taken as point of departure for the type and dimension synthesis of a linkage. Next, actuators are added to enforce this motion at the desired velocity. In addition to this movement directed design approach, also desirable force configurations can provide a useful design perspective. Awareness of forces seems to stimulate the design of simple and efficient mechanisms. This paper aims to illustrate a simple form of a force directed design approach with an example from medical technology. A purely mechanical laparoscopic grasping instrument with extraordinary mechanical efficiency is presented, which enables surgeons to clearly perceive several physiological properties, such as stiffness of tissue and the pulse of arteries.
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Wei, K., and Y. Zhao. "A three-dimensional deformable liquid lens array for directional and wide angle laparoscopic imaging." In 2013 IEEE 26th International Conference on Micro Electro Mechanical Systems (MEMS). IEEE, 2013. http://dx.doi.org/10.1109/memsys.2013.6474195.

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Fukuda, Kohei, Takumi Kawasetsu, Hisashi Ishihara, Takato Horii, Ryoichi Nakamura, Hiroshi Kawahira, and Minoru Asada. "Measurement of Three-Dimensional Force Applied to Elastic Suture Training Pads for Laparoscopic Suturing." In 2019 41st Annual International Conference of the IEEE Engineering in Medicine & Biology Society (EMBC). IEEE, 2019. http://dx.doi.org/10.1109/embc.2019.8857660.

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Andellini, Martina, Giorgia Tedesco, Francesco Cosimo Faggiano, Pietro Derrico, and Matteo Ritrovato. "DECISION-ORIENTED HTA FOR COMPARING THREE-DIMENSIONAL (3D)/TWO-DIMENSIONAL (2D) LAPAROSCOPIC DISPLAY SYSTEMS IN A VARIETY OF PEDIATRIC SURGICAL PROCEDURES." In International Symposium on the Analytic Hierarchy Process. Creative Decisions Foundation, 2016. http://dx.doi.org/10.13033/isahp.y2016.055.

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Звіти організацій з теми "Dimensional laparoscopy"

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Dahm, Philipp, Michelle Brasure, Elizabeth Ester, Eric J. Linskens, Roderick MacDonald, Victoria A. Nelson, Charles Ryan, et al. Therapies for Clinically Localized Prostate Cancer. Agency for Healthcare Research and Quality (AHRQ), September 2020. http://dx.doi.org/10.23970/ahrqepccer230.

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Objective. To update findings from previous Agency for Healthcare Research and Quality (AHRQ)- and American Urological Association (AUA) funded reviews evaluating therapies for clinically localized prostate cancer (CLPC). Sources. Bibliographic databases (2013–January 2020); ClinicalTrials.gov; systematic reviews Methods. Controlled studies of CLPC treatments with duration ≥5 years for mortality and metastases and ≥1 year for quality of life and harms. One investigator rated risk of bias (RoB), extracted data, and assessed certainty of evidence; a second checked accuracy. We analyzed English-language studies with low or medium RoB. We incorporated findings from randomized controlled trials (RCTs) identified in the prior reviews if new RCTs provided information on the same intervention comparison. Results. We identified 67 eligible references; 17 were unique RCTs. Among clinically rather than prostate specific antigen (PSA) detected CLPC, Watchful Waiting (WW) may increase mortality and metastases versus Radical Prostatectomy (RP) at 20+ years. Urinary and erectile dysfunction were lower with WW versus RP. WW’s effect on mortality may vary by tumor risk and age but not by race, health status, comorbidities, or PSA. Active Monitoring (AM) probably results in little to no difference in mortality in PSA detected CLPC versus RP or external beam radiation (EBR) plus Androgen Deprivation (AD) regardless of tumor risk. Metastases were slightly higher with AM. Harms were greater with RP than AM and mixed between EBR plus AD versus AM. 3D-conformal EBR and AD plus low-dose-rate brachytherapy (BT) provided a small reduction in all-cause mortality versus three dimensional conformal EBR and AD but little to no difference on metastases. EBR plus AD versus EBR alone may result in a small reduction in mortality and metastases in higher risk disease but may increase sexual harms. EBR plus neoadjuvant AD versus EBR plus concurrent AD may result in little to no difference in mortality and genitourinary toxicity. Conventionally fractionated EBR versus ultrahypofractionated EBR may result in little to no difference in mortality and metastases and urinary and bowel toxicity. Active Surveillance may result in fewer harms than photodynamic therapy and laparoscopic RP may result in more harms than robotic-assisted RP. Little information exists on other treatments. No studies assessed provider or hospital factors of RP comparative effectiveness. Conclusions. RP reduces mortality versus WW in clinically detected CLPC but causes more harms. Effectiveness may be limited to younger men or to those with intermediate risk disease and requires many years to occur. AM results in little to no mortality difference versus RP or EBR plus AD. EBR plus AD reduces mortality versus EBR alone in higher risk CLPC but may worsen sexual function. Adding low-dose-rate BT to 3D-conformal EBR and AD may reduce mortality in higher risk CLPC. RCTs in PSA-detected and MRI staged CLPC are needed.
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