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PubMed2005

Robotic mitral valve repair: a community hospital experience.

Robotically assisted cardiac surgery has been presented as less invasive than conventional surgery, with shortened hospital stays and faster return to daily activities. We evaluated our experience with the da Vinci robot to determine whether we could in fact demonstrate those findings. All mitral and tricuspid valve repairs were performed by the same surgeon. Cardiopulmonary bypass was performed with femoral cannulation, antegrade cardioplegia, and transthoracic aortic cross-clamping. Multiple valve repair techniques were used, including quadrant resection, cord replacement, Alfieri leaflet coaptation, and ring annuloplasty. Access was by 2 ports and a 5-cm right anterolateral thoracotomy. All annuloplasty rings were secured using surgical clips. From October 2003 through September 2004, 32 patients underwent robotically assisted mitral valve repair. The mean age of our population was 676 years (range, 43-82 years). Four patients also underwent the 1st tricuspid valve repair using the da Vinci robot in the United States. There were 3 conversions for irreparable valves, 1 stroke, and 2 deaths. The average procedure time, cardiopulmonary bypass time, and aortic cross-clamp time were all reduced, when the first 20 patients were compared with the last 12. Length-of-stay also improved. One patient required early mitral valve replacement for recurrent regurgitation. Two patients required late (> 3 month) mitral valve replacement for recurrent regurgitation. We have shown that a dedicated nonacademic institute can develop a robotic cardiac surgery program and perform mitral and tricuspid valve repairs successfully. There is a several-case learning curve, and patient selection is paramount.

Aged↗

PubMed1992

Evaluation of a vocational robot with a quadriplegic employee.

A vocational robotic workstation capable of performing activities of daily living (ADL) and vocational tasks was placed for 18 months in the work site of an employee with C4 to C5 quadriplegia. A single-subject study was conducted to evaluate the performance of the robot vs that of a human attendant. The employee preferred the robot over the attendant for performance of all vocational tasks and ADLs, with the exception of feeding. Results indicated that the robot was capable of safely replacing the attendant for two five-hour periods during the workday, thus proving to be a cost-effective alternative to full-time, on-the-job attendant care. The study demonstrated the potential of robotics technology for returning independence and control to disabled employees and for offering corporate employers a solution to the problem of reasonable accommodation in the workplace.

Activities of Daily Living↗

PubMed2005

[Robotics and gastrointestinal surgery].

Robotics are now being used in all surgical fields. Because of increased intra-abdominal articulations while operating through small incisions, robotics are increasingly being used in a large number of visceral and solid organ operations including surgery on the gallbladder, esophagus, stomach, intestines, colon, and rectum as well as for the endocrine organs. As a specialty, robotics should continue to grow. As the robotic era invades the field of general surgeon, more and more complex procedures would be able to be approached through small incision. As technology catches up with our imagination, robotic instruments and 3D monitoring will become routine, and continue to improve patient care by providing surgeons with most precise, least traumatic ways of treating surgical disease.

Digestive System Surgical Procedures↗

PubMed2005

Robotic-assisted laparoscopic adrenalectomy.

Robotic surgical systems have recently been used to perform laparoscopic procedures in several diseases. We report the initial 2 cases of robotic-assisted laparoscopic adrenalectomy from Taiwan. Both cases were performed transperitoneally using the ZEUS surgical system (Intuitive Surgical Inc., Mountain View, CA, USA). This system consists of 3 interactive robotic arms and a remote control unit, allowing the surgeon to control the 2 instrument arms and 1 camera arm via a surgical console. The key component of the ZEUS surgical system is the MicroWrist (Computer Motion Inc., CA, USA) technology, which allows the surgeon to roll, pitch and grip laparoscopic tools freely and provides the surgeon with a 3-dimensional view of the operative field. Postoperative courses were uneventful and the patients were discharged on the third and fourth postoperative days, respectively. No intraoperative or postoperative complications were encountered. These cases suggest that robotic-assisted laparoscopic adrenalectomy is technically feasible, and that the role of robotic surgery in urologic laparoscopy is likely to expand in Taiwan.

Adrenalectomy↗

PubMed2006

Zeus robot-assisted laparoscopic cholecystectomy in comparison with conventional laparoscopic cholecystectomy.

BACKGROUND: The robotic surgical system overcomes many technological obstacles of conventional laparoscopic surgery, and possesses enormous clinical applied potential. The aim of this study was to compare the efficacy of Zeus robot-assisted laparoscopic cholecystectomy with conventional laparoscopic cholecystectomy. METHODS: Forty patients undergoing elective cholecystectomy were randomly divided into two groups. Patients in group A (n=20) underwent Zeus robot-assisted laparoscopic cholecystectomy, and patients in group B (n=20) received conventional laparoscopic cholecystectomy. The parameters on operative field, operative time, the number of actions, the rate of operative errors and minimal trauma were evaluated and compared between the two groups. RESULTS: The number of clearing camera (1.1+/-1.0 times) and the time of adjusting the operative field (2.2+/-0.7 minutes) in group A were significantly less than those (4.5+/-1.5 times) and (7.5+/-1.2 minutes) in group B. The number of dissection actions (337+/-86 times) and the rate of operative errors (10%) in group A were less than those (389+/-94 times), (25%) in group B. The total operation time (104.9+/-20.5 minutes) and setup time (29.5+/-9.8 minutes) in group A were significantly longer than those (78.6+/-17.1 minutes), (12.6+/-2.5 minutes) in group B. Blood loss and postoperative hospitalization were similar. No postoperative complications occurred in both groups, and open cholecystectomy was performed in each group. CONCLUSIONS: Zeus robot-assisted cholecystectomy inherits the benefits of minimally invasive surgery. The Zeus robotic surgical system is better than conventional laparoscopic technique in controlling the operative field and can be manipulated precisely and stably though it requires more operative time.

Adult↗

PubMed2006

Care of the patient undergoing radical cystectomy with a robotic approach.

Radical cystectomy or cystoprostatectomy with urinary diversion is the gold standard for the treatment of muscle-invasive bladder cancer. Cystectomy can be through an open or robotic-assisted laparoscopic approach. Advances in laparoscopy, robotic surgery, and urological oncology have made it possible for select surgeons to perform nerve-sparing robotic-assisted laparoscopic radical cystoprostatectomy. Advantages of robotic surgery may be minimal blood loss, shorter hospital stay, quicker recovery, and possibly more precise and rapid removal of the bladder depending on the experience and expertise of the surgeon. Appropriate patient selection and thorough pre-operative evaluation, however, are key in maximizing positive surgical outcomes. The experience at the University of Virginia with robotic-assisted laparoscopic radical cystectomy will be discussed.

Blood Loss, Surgical↗

PubMed2006

[Initial experience with da Vinci robotic system in vascular surgery].

Robotic operational systems improve accuracy, control of and skilful management of surgical procedures up to levels unachievable by a human factor itself. A surgeon is also allowed to conduct the types of miniinvasive procedures, which cannot be conducted using contemporary technologies. High degree of the procedure's safety can be achieved. Currently, the robotic surgical systems are used in top clinics worldwide and the concept of the robotic operating theatre is considered to become standard for some procedures in future. In October 2005, a multispecialist robotic centre was opened in the Hospital Na Homolce, which then created a new qualitative standard in the miniinvasive surgical management. The authors present the initial group of patients, who were operated from November 2005 to January 2006 with employement of the da Vinci robotic system, listing its pros and cons.

Aged↗

PubMed1994

Robotic automation of dideoxyribonucleotide sequencing reactions.

We developed a robot to carry out standard Sanger dideoxyribonucleotide sequencing reactions efficiently and with minimal human intervention. A commercial robot was adapted to our design and specifications, and we programmed it to perform up to 240 sequencing reactions in a single unattended run of 7 h. The robot configuration can be easily altered to allow 480 reactions to be performed in an unattended run of 14 h. The special features of our robot include cooled reagent reservoirs and cooled chambers for storage of DNA templates and completed reactions as well as reproducible aspiration of small volumes by using a sensing algorithm. The robot has successfully performed over 3500 DNA reactions in about 30 separate runs in our DNA core facility.

DNA-Directed DNA Polymerase↗

PubMed1998

[Thoracoscopic surgery using voice controlled robot for spontaneous pneumothorax].

We investigated the feasibility and applicability of using voice controlled robot-assisted thoracoscopic surgery for spontaneous pneumothorax. Eleven patients with spontaneous pneumothorax were involved in this study. Five patients were treated by voice controlled robot-assisted thoracoscopic procedure and 6 by historical human-assisted thoracoscopic procedure. All procedures were successfully completed without complications. The number of times the thoracoscope required cleaning per 60-minute interval for cases involving voice controlled robot-assisted surgery were 1.4 compared to 8 per 60-minute interval for comparable cases when the robot was not used. Operative times, the amount of analgesics, the duration of indwelling chest tube, the number of recurrences after operation during thoracoscopic procedures were not statistically different. We found that use of voice-controlled robot as surgical assistant during thoracoscopic surgery for spontaneous pneumothorax is feasible.

Adolescent↗

PubMed1996

Optimum Design for Emergency Stop Button on Robot Teach Pendants.

This study deals with designing robot teach pendants for industrial robots. The emergency stop button on robot teach pendants is the primary safety device for industrial robots. Recommendations for the design of the emergency stop button were proposed based on experimental evaluations. Human performance was measured by the reaction time necessary to press the button on a pendant. The variation factors were randomly combined by seven button locations and three different button sizes. The results indicated that the shortest reaction time was obtained for the 38-mm button located on the left and left-down of the seven button positions on the pendant.

emergency stop button↗

PubMed2006

Novel percutaneous catheter thrombectomy in acute massive pulmonary embolism: rotational bidirectional thrombectomy (ROBOT).

BACKGROUND: Although thrombolysis is a standard therapy in cases of pulmonary embolism (PE), fatal outcome is often observed. We designed and investigated the efficacy of a novel percutaneous catheter therapy, rotational bidirectional thrombectomy (ROBOT), for PE. METHODS AND RESULTS: Eighteen patients with acute massive PE (Miller score > or = 20) were included in this study. We separated them into two groups [group A (n = 10), thrombolysis; group B (n = 8): thrombolysis and ROBOT or ROBOT alone]. There was no difference in the hemodynamic indices between the groups at diagnosis. ROBOT was designed to fragment emboli by rotating a regular pigtail catheter. Three deaths occurred in group A because of hemodynamic impairment, but there was no death in group B. One day after treatment, systolic pulmonary artery pressure had decreased from 53 +/- 8 to 30 +/- 8 mm Hg (P < 0.05) in group B and from 54 +/- 5 to 42 +/- 19 mm Hg (NS) in group A. The hospitalization period in group B was shorter than that in group A (17 +/- 6 vs. 27 +/- 10 days, P < 0.05). CONCLUSION: ROBOT therapy results in a significant, rapid improvement in the hemodynamic situation and in a better outcome than conventional therapy in patients with acute massive pulmonary embolism.

Acute Disease↗

PubMed2002

Robots that imitate humans.

The study of social learning in robotics has been motivated by both scientific interest in the learning process and practical desires to produce machines that are useful, flexible, and easy to use. In this review, we introduce the social and task-oriented aspects of robot imitation. We focus on methodologies for addressing two fundamental problems. First, how does the robot know what to imitate? And second, how does the robot map that perception onto its own action repertoire to replicate it? In the future, programming humanoid robots to perform new tasks might be as simple as showing them.

Journal Article↗

PubMed2001

Robotics in endoscopic surgery: can mechanical manipulators provide a more simple solution for the problem of limited degrees of freedom?

Robotic manipulators for endoscopic surgery have been developed on an experimental basis from the early 1990s and are now in clinical use. The main motivation to apply robotics technology to endoscopic surgery is to re-establish six degrees of freedom (DoF) of motion at the tip of the instrument. The costbenefit ratio of these devices is still unclear. Although the products offered today are based on excellent technology and show a high functionality, most hospitals still hesitate to invest in robotic manipulators for fiscal reasons. For a significant number of procedures, especially in non-microsurgical disciplines, the functionality offered by robotic manipulators is not required, although the procedures would profit from instrumentation with 6 DoF. Mechanical manipulators with 6 DoF, but without computerised control, may be the right solution for these procedures. We have developed a workplace solution for endoscopic surgery that involves mechanical instrument-guiding systems and manipulators that offer 6 DoF, but use a significantly simplified technology at low cost. Further studies will need to show whether these mechanical manipulators answer the needs of the surgeon and offer an affordable alternative to robotic manipulators in surgical areas where microsurgical manipulations are not dominant.

Journal Article↗

PubMed2001

Robotic manipulators in cardiac surgery: the computer-assisted surgical system ZEUS.

Minimally invasive strategies continue to evolve in cardiac surgery. Robotic-assisted systems have been introduced recently, to increase the precision of endoscopic coronary surgery. This report describes the experimental and clinical use of the computer-assisted robotic system ZEUS for endoscopic coronary artery bypass anastomoses. The ZEUS system consists of three interactive robotic arms and a control unit, allowing the surgeon to move the instrument arms in a scaled-down mode. The third arm (AESOP) positions the endoscope under voice control. The present study demonstrates the feasibility of endoscopic coronary artery bypass grafting using a computer-assisted surgical robotic system on the arrested heart, as well as on the beating heart in selected patients. However, robotic-assisted cardiac surgery is still developing, and tremendous efforts are still required to establish a routine procedure.

Journal Article↗

PubMed1998

Physical and temporal scaling considerations in a robot model of cricket calling song preference.

Behavioral experiments with crickets show that female crickets respond to male calling songs with syllable rates within a certain bandwidth only. We have made a robot model in which we implement a simple neural controller that is less complex than the controllers traditionally hypothesized for cricket phonotaxis and syllable rate preference. The simple controller, which had been successfully used with a slowed and simplified signal, is here demonstrated to function, using songs with identical parameters to those found in real male cricket song, using an analog electronic model of the peripheral auditory morphology of the female cricket as the sensor. We put the robot under the same experimental conditions as the female crickets, and it responds with phonotaxis to calling songs of real male Gryllus bimaculatus. Further, the robot only responds to songs with syllable rates within a bandwidth similar to the bandwidth found for crickets. By making polar plots of the heading direction of the robot, we obtain behavioral data that can be used in statistical analyses. These analyses show that there are statistically significant differences between the behavioral responses to calling songs with syllable rates within the bandwidth and calling songs with syllable rates outside the bandwidth. This gives the verification that the simple neural control mechanism (together with morphological auditory matched filtering) can account for the syllable rate preference found in female crickets. With our robot system, we can now systematically explore the mechanisms controlling recognition and choice behavior in the female cricket by experimental replication.

Animals↗

PubMed2006

Robot-assisted reaching exercise promotes arm movement recovery in chronic hemiparetic stroke: a randomized controlled pilot study.

BACKGROUND AND PURPOSE: Providing active assistance to complete desired arm movements is a common technique in upper extremity rehabilitation after stroke. Such active assistance may improve recovery by affecting somatosensory input, motor planning, spasticity or soft tissue properties, but it is labor intensive and has not been validated in controlled trials. The purpose of this study was to investigate the effects of robotically administered active-assistive exercise and compare those with free reaching voluntary exercise in improving arm movement ability after chronic stroke. METHODS: Nineteen individuals at least one year post-stroke were randomized into one of two groups. One group performed 24 sessions of active-assistive reaching exercise with a simple robotic device, while a second group performed a task-matched amount of unassisted reaching. The main outcome measures were range and speed of supported arm movement, range, straightness and smoothness of unsupported reaching, and the Rancho Los Amigos Functional Test of Upper Extremity Function. RESULTS AND DISCUSSION: There were significant improvements with training for range of motion and velocity of supported reaching, straightness of unsupported reaching, and functional movement ability. These improvements were not significantly different between the two training groups. The group that performed unassisted reaching exercise improved the smoothness of their reaching movements more than the robot-assisted group. CONCLUSION: Improvements with both forms of exercise confirmed that repeated, task-related voluntary activation of the damaged motor system is a key stimulus to motor recovery following chronic stroke. Robotically assisting in reaching successfully improved arm movement ability, although it did not provide any detectable, additional value beyond the movement practice that occurred concurrently with it. The inability to detect any additional value of robot-assisted reaching may have been due to this pilot study's limited sample size, the specific diagnoses of the participants, or the inclusion of only individuals with chronic stroke.

Journal Article↗

PubMed2026

Structured robotic colorectal training in a non-tertiary NHS hospital: a 502-case consecutive cohort implementation study.

Robotic-assisted colorectal surgery has expanded rapidly across NHS practice in the UK. Structured unit-wide training pathways are essential for safe technology adoption, yet published outcome data from non-tertiary hospitals remain limited. This study describes the implementation and feasibility of a unit-wide robotic colorectal program at a high-volume non-tertiary hospital, reporting outcomes across 502 consecutive resections performed by eight consultant surgeons and presenting these in the context of nationally published benchmarks. A retrospective cohort study of 502 consecutive robotic colorectal resections performed at York Teaching Hospital between May 2022 and December 2025. Eight consultant surgeons (A-H) participated in a structured four-phase training pathway incorporating simulation training, proctored cases, complexity-based case progression, and formal credentialing. Primary outcomes were 30-day mortality, unplanned return to theatre (RTT), and anastomotic leak (AL). Anastomotic leak was calculated using only patients who underwent anastomosis as the denominator. Procedure-stratified and individual surgeon outcomes with 95% confidence intervals were reported. Risk-adjusted cumulative sum (RA-CUSUM) analysis was performed to evaluate learning curves. Outcomes are presented descriptively alongside nationally published reference data; no formal statistical comparison against national benchmarks was performed. 502 robotic colorectal resections were performed. Mean patient age was 70.0 ± 11.3 years; 58.4% were male. Median ASA grade was III. The indication was malignancy in 89.2% of cases. Length of stay was non-normally distributed and is therefore reported using median and interquartile range in the revised analysis. Key outcomes: - 30-day mortality: 1.0% (5/502; 95% CI 0.4-2.3%) - Unplanned return to theatre (RTT): 5.2% (26/502; 95% CI 3.6-7.5%) - Anastomotic leak (AL): 3.3% (15/450; 95% CI 2.0-5.5%; denominator = patients with anastomosis) - 30-day unplanned readmission: 5.0% (25/502; 95% CI 3.4-7.2%) - Conversion to open surgery: 3.6% (18/502; 95% CI 2.3-5.6%) - Lymph node yield ≥12: 91.3% of cancer resections - R0 resection rate: 95.1% of cancer resections All primary outcomes fell within or below the published reference ranges used for descriptive context. RA-CUSUM trajectories were heterogeneous: no surgeon crossed the predefined upper control limit, but several curves showed later upward movement. Accordingly, the analysis is interpreted as safety surveillance rather than evidence of uniform performance improvement. RA-CUSUM monitoring showed that no surgeon crossed the predefined upper control limit; however, heterogeneous trajectories precluded a claim of uniform performance improvement.

Humans↗

PubMed2000

A C-arm fluoroscopy-guided progressive cut refinement strategy using a surgical robot.

We describe a new method to cut a precise, high-quality femoral cavity in Revision Total Hip Replacement surgery (RTHR) using a surgical robot and an intra-operative C-arm fluoroscope. With respect to previous approaches, our method contains several new features. (1) We describe a novel checkerboard plate designed to correct the geometric distortion within fluoroscopic images. Unlike previous distortion correction devices, the plate does not completely obscure any part of the image, and the distortion correction algorithm works well even when there are some overlaid objects in the field of view. (2) Also included are a novel corkscrew fiducial object designed to be integrated with the robot end-effector, and a 6D pose estimation algorithm based on the two-dimensional (2D) projection of the corkscrew, used in robot-imager registration and imager co-registration. (3) In addition, we develop a cavity location algorithm, which utilizes image subtraction and 2D anatomy contour registration techniques. (4) Finally, we propose a progressive cut refinement strategy, which progressively improves the robot registration during the procedure. We have conducted several experiments, in both simulated and in vitro environments. The results indicate that our strategy is a promising method for precise orthopedic procedures like total hip replacement.

Algorithms↗