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At least 883 records · Page 49Linked to original sources

PubMed2002

Use of the robot system Da Vinci for laparoscopic repair of gastro-oesophageal reflux in children.

In adult patients, laparoscopic surgery, using a robot system (Da Vinci, Intuitive Surgical, Mountain View, California), has been recently introduced into surgical practice. To investigate the feasibility of the system in paediatric surgery, laparoscopic fundoplications as well as cholecystectomies have been performed. In July 2000 we used the robot system for the first time on an 11-year-old girl with gastro-oesophageal reflux, and since that time on 7 other children. Altogether 5 Thal and 3 Nissen procedures have been carried out. The average age was 12 years, with a range of 7 to 16 years. All operations were performed without complications and without conversion to open surgery. The medium operating time was 146 min with a range of 105 to 180 minutes. Compared to conventional laparoscopy, the 3-dimensional high-quality vision, the advanced instrument movements and the ergonomic position of the surgeon seems to enhance surgical precision. In our opinion, the use of the robot system is feasible and safe in paediatric surgery. The technique is limited due to the fact that instruments adapted to the size of small children are not yet available.

Adolescent↗

PubMed2006

Dynamical network interactions in distributed control of robots.

In this paper the dynamical network model of the interactions within a group of mobile robots is investigated and proposed as a possible strategy for controlling the robots without central coordination. Motivated by the results of the analysis of our simple model, we show that the system performance in the presence of noise can be improved by including long-range connections between the robots. Finally, a suitable strategy based on this model to control exploration and transport is introduced.

Algorithms↗

PubMed2006

Controlling chaotic robots with kinematical redundancy.

Robots with kinematical redundancy under the pseudoinverse control exhibit undesirable chaotic joint motion, which leads to erratic behaviors. In this study, we used the delayed feedback method to control chaotic motions of a planar 3R rigid and a planar 3R flexible redundant robot under the pseudoinverse control when the end-effector traces a closed-path repeatedly in the work space. It was demonstrated that chaotic motions of robots with kinematical redundancy can be turned into regular motion when the delayed feedback method was applied with some appropriate parameters. This study provides a new insight helpful to solve the repeatability problem of redundant manipulators.

Biomechanical Phenomena↗

PubMed2002

Robot-assisted laparoscopic aortobifemoral bypass for aortoiliac occlusive disease: a report of two cases.

This article describes the use of robotic technology in laparoscopic aortobifemoral bypass grafting. In two patients with disabling intermittent claudication on the basis of severe aortoiliac occlusive disease, laparoscopic aortobifemoral bypass grafting was performed with a proximal end-to-side anastomosis constructed with robotic arms that had been mounted on the operating table and were controlled from a separate console. No complications occurred. Operating times were 290 and 260 minutes, and aortic anastomosis times were 48 and 37 minutes, respectively. Blood loss was less than 200 mL in both cases. A normal diet was resumed on the second postoperative day, and the patients were discharged home on postoperative days 4 and 6. To our knowledge, this is the first report on robot-assisted laparoscopic aortobifemoral bypass in the world literature.

Aorta↗

PubMed2002

Robotically-milled bone cavities: a comparison with hand-broaching in different types of cementless hip stems.

We performed an experimental study to compare the effectiveness of robotic bone milling (Robodoc and CASPAR) with hand-broaching as regards primary rotational stability of 7 different cementless stems. Using 48 synthetic femora and a specially-designed apparatus, we compared the implant stability of proximal and distal rotational stem displacement (slip) in relation to the cortex. We also measured stem deformation (twist) and the location of torque transfer from stem to cortex (i.e., fixation pattern). 5-ROM, Antega, and ABG stems were more stable in hand-broached femora. Osteolock stems showed no difference between CASPAR and hand preparation, but rotational stability was better in the Robodoc group. G2, VerSys ET and Vision 2000 stems gave increased rotational stability in the robotic groups. When placed too laterally, Vision 2000 showed a pattern of more distal fixation. The findings emphasize the current difficulties in creating a perfect match of robotically-milled cavity and stem geometry to achieve enhanced primary rotational stability. The pattern of fixation seems to depend not only on stem design, but also on canal preparation and stem positioning.

Arthroplasty, Replacement, Hip↗

PubMed1999

A tactile feedback hexapod operating robot for endoscopic procedures.

This paper describes a test prototype for precision robot-assisted surgery using a hexapod operating robot and a movable operating cockpit for tactile feedback. The objective of the work described is twofold: 1, to evaluate the use of hexapod robots for precisely manipulating endoscopes and surgical instruments in submillimeter surgery; 2, to test a new user interface concept based on tactile feedback. Based on the principle of a flight simulator, the aim is to give the surgeon motion cues in addition to the endoscope image, to assist his spatial orientation. The paper gives a detailed description of the system components and the potential applications.

Endoscopes↗

PubMedDate not supplied

A miniature bidirectional RF communication system for micro gastrointestinal robots.

This paper reports a miniature, low power, two-channel, bidirectional wireless communication system that can be used in the first generation of micro gastrointestinal (GI) robots. The system consists of a miniature RF transceiver embedded in the GI robot and a control station outside the body. ISM band radio frequency (approx. 433 MHz) was used to achieve half duplex communication between the GI robot and the control station. The Frequency Shift Keying (FSK) modulation scheme was adopted to ensure a reliable and high-speed digital RF link. Animal tests have been carried out to prove the performance of the communication system.

Animals↗

PubMedDate not supplied

Standing-up robot: an assistive rehabilitative device for training and assessment.

In this paper a robotic assistive device is presented, aimed at assisting physically impaired individuals when rising from a sitting to a standing position. The robotic device is designed as a three degrees of freedom (3-DOF) mechanism supporting the subject under the buttocks. The device is driven by an electrohydraulic servosystem capable of operating in multiple control modes. It is instrumented with a sensory system providing information about the standing-up parameters. Evaluation of the standing up assistive device was accomplished in robot-supported rising trials of a paraplegic subject. The experiments demonstrated that stable risings in different standing - up manoeuvres were achieved. The measurement results revealed the role of the arm support and the support of the artificially evoked moments in the paralysed lower extremities during rising. The results show that the device can be used efficiently for training and evaluation of standing up manoeuvres.

Adult↗

PubMed2005

Computational analysis in vitro: dynamics and plasticity of a neuro-robotic system.

When the brain interacts with the environment it constantly adapts by representing the environment in a form that is called an internal model. The neurobiological basis for internal models is provided by the connectivity and the dynamical properties of neurons. Thus, the interactions between neural tissues and external devices provide a fundamental means for investigating the connectivity and dynamical properties of neural populations. We developed this idea, suggested in the 1980s by Valentino Braitenberg, for investigating and representing the dynamical behavior of neuronal populations in the brainstem of the lamprey. The brainstem was maintained in vitro and connected in a closed loop with two types of artificial device: (a) a simulated dynamical system and (b) a small mobile robot. In both cases, the device was controlled by recorded extracellular signals and its output was translated into electrical stimuli delivered to the neural system. The goal of the first study was to estimate the dynamical dimension of neural preparation in a single-input/single-output configuration. The dynamical dimension is the number of state variables that together with the applied input determine the output of a system. The results indicate that while this neural system has significant dynamical properties, its effective complexity, as established by the dynamical dimension, is rather moderate. In the second study, we considered a more specific situation, in which the same portion of the nervous system controls a robotic device in a two-input/two-output configuration. We fitted the input-output data from the neuro-robotic preparation to neural network models having different internal dynamics and we observed the generalization error of each model. Consistent with the first study, this second experiment showed that a simple recurrent dynamical model was able to capture the behavior of the hybrid system. This experimental and computational framework provides the means for investigating neural plasticity and internal representations in the context of brain-machine interfaces.

Animals↗

PubMed2003

Rapid communication: laparoscopic Anderson-Hynes dismembered pyeloplasty using the da Vinci robot: technical considerations.

PURPOSE: To present our initial experience with laparoscopic pyeloplasty utilizing the da Vinci robot for upper tract reconstruction. CASE REPORT: A four-port transperitoneal approach was used in a 73-year-old man. The ureteropelvic (UPJ) obstruction was identified with a crossing vessel. After dismemberment of the UPJ, the renal pelvis was trimmed and reconstructed using the da Vinci robot. The total operative time was 5 hours; the time spent for reconstruction was 45 minutes. Blood loss was <150 mL. The postoperative analgesic requirement was 8 mg of morphine and 25 mg of hydrocodone. There were no intraoperative or postoperative complications. CONCLUSION: The da Vinci robot can serve as a vital surgical tool during pyeloplasty with extensive reconstruction.

Aged↗

PubMed2003

Laparoscopy-assisted robotic radical cystoprostatectomy with ileal conduit urinary diversion for muscle-invasive bladder cancer: initial two cases.

BACKGROUND AND PURPOSE: The use of the da Vinci robot is being investigated in the discipline of urologic surgery. We describe our experience with its use during radical cystoprostatectomy in two patients with organ-confined bladder cancer. PATIENTS AND METHODS: Laparoscopic radical cystoprostatectomy with ileal conduit urinary diversion was performed using the da Vinci robot. Both patients were informed about this new approach, and informed consent was obtained. RESULTS: There were no intraoperative or postoperative complications. The operative time was 10 and 12 hours. A clear liquid diet was started on the third postoperative day. Final histopathology examination in both patients revealed T(3a)N(0)M(0) transitional-cell carcinoma. The hospital stay was 6 days. Both patients returned to normal activity within 2 weeks. CONCLUSION: Robot-assisted laparoscopic radical cystoprostatectomy with ileal conduit urinary diversion for muscle-invasive bladder cancer is feasible.

Humans↗

PubMed2003

Rapid communication: pure robot-assisted laparoscopic ureteral reimplantation for ureteral stricture disease: case report.

BACKGROUND AND PURPOSE: The role of the da Vinci robot is slowly being defined in minimally invasive urologic surgery. We report its use in the management of ureteral stricture disease. CASE REPORT: A 42-year-old man with recurrent kidney stone disease was found to have a left distal-ureteral stricture. After failure of endoscopic treatment, a robot-assisted laparoscopic ureteral reimplantation was performed. The total operative time was 210 minutes. The estimated blood loss was <50 mL. There were no intraoperative or postoperative complications. Total analgesic use was 30 mg of morphine. The hospital stay was 5 days. CONCLUSION: Pure robot-assisted laparoscopic ureteral reimplantation is a safe and feasible approach to the management of ureteral stricture disease.

Adult↗

PubMed2004

Robot-assisted Bricker ileoureteral anastomosis during intracorporeal laparoscopic ileal conduit urinary diversion for prostatocutaneous fistula: case report.

BACKGROUND AND PURPOSE: The da Vinci robot is useful during minimally invasive surgery in performing intracorporeal suturing. We report one case of its application during laparoscopic ileal conduit urinary diversion for prostatocutaneous fistula. METHODS: A 58-year-old paraplegic man with a neurogenic bladder and bowel and a long history of urinary incontinence developed a prostatocutaneous fistula after numerous procedures to correct the incontinence. He underwent laparoscopic ileal conduit urinary diversion to improve his quality of life. The da Vinci robot was used to perform the ileoureteral anastomosis. RESULTS: The operative time was 10 hours. The estimated blood loss was <100 mL. There were no intraoperative complications. The patient was started on a clear liquid diet on postoperative day 3. There was no narcotic use because of the patient's neurologic status. The patient was discharged home on day 6. CONCLUSION: Laparoscopic urinary diversion remains a technically challenging procedure. The da Vinci robot is useful during laparoscopic ileal conduit construction.

Anastomosis, Surgical↗

PubMed2002

Robotic gastrointestinal surgery: early experience and system description.

BACKGROUND AND PURPOSE: Robotic technology has recently been introduced to gastrointestinal laparoscopic surgery. Its addition offers the promise of opening more procedures up to minimally invasive surgery. One system is described and illustrated in detail using antireflux surgery as an example. PATIENTS AND METHODS: Seventy patients underwent robotically assisted gastrointestinal surgical procedures. These procedures were antireflux surgery (25), bowel resection (18), cholecystectomy (8), Heller myotomy (5), splenectomy (5), exploratory laparoscopy (4), adrenalectomy (1), pyloroplasty (1), and resection of a gastric mass (1) and duodenal (1) and colonic (1) polyps. RESULTS AND CONCLUSION: Seventeen percent of patients required conversion to either an open or a standard laparoscopic procedure. This early experience with an the first Food and Drug Administration-approved general surgery robotic surgical system showed that it is safe and effective, the system has significant promise.

Adrenalectomy↗

PubMed2004

Application of haptic feedback to robotic surgery.

Robotic surgical systems have greatly contributed to the advancement of minimally invasive endoscopic surgery. However, current robotic systems do not provide tactile or haptic feedback to the operating surgeon. Under certain circumstances, particularly with the manipulation of delicate tissues and suture materials, this may prove to be a significant irritation. We hypothesize that haptic feedback, in the form of sensory substitution, facilitates the performance of surgical knot tying. This preliminary study describes evidence that visual sensory substitution permits the surgeon to apply more consistent, precise, and greater tensions to fine suture materials without breakage during robot-assisted knot tying.

Cardiac Surgical Procedures↗

PubMed2004

Vattikuti Institute prostatectomy: a technique of robotic radical prostatectomy: experience in more than 1000 cases.

The Vattikuti Institute prostatectomy (VIP), a robotic radical prostatectomy approach, was conceived, designed, and refined with the goal of finding the most surgeon-friendly technique while minimizing patient morbidity and continuing to follow the standards of open radical prostatectomy. In this approach, the entire procedure is performed extraperitoneally after the ports have been placed transperitoneally and the bladder is dissected off the anterior abdominal wall. The evolution of the VIP is an amalgam of knowledge gained from the different procedures and recreated mixing in the technical nuances of robotic assistance. The procedure has been modified further from what we began with to obtain better outcomes. In our experience, robotic assistance, with its virtues of wristed movements, three-dimensional magnified vision, and filtered movements, allowed us to adjudicate a better operation with good oncologic and functional outcomes. It is also associated with decreased morbidity and earlier convalescence with excellent cosmesis. It is an ideal choice of the treatment at our center for localized cancer of prostate. Herein, the technique is described, detailing the different steps.

Humans↗

PubMed2005

Trends in robotic surgery.

Robotic surgery began as a technology-driven innovation but is now becoming a genuine method of improving healthcare effectiveness worldwide. This comprehensive review introduces the current trends, using examples of specific systems to distinguish the various types of robotic surgical devices, from remote handling machines to those performing delicate local interventions. We end by commenting on how to extend existing systems and provide an account of the rapid developments in minimally invasive robotic surgery.

Computer-Assisted Instruction↗

PubMed2006

Initial experience with successful totally robotic laparoscopic cystoprostatectomy and ileal conduit construction in tetraplegic patients: report of two cases.

PURPOSE: To evaluate the feasibility and safety of totally robotic laparoscopic cystoprostatectomy for neurogenic bladder, with intracorporeal ileal-conduit urinary diversion in tetraplegic patients with severe neurogenic bladder complications. PATIENTS AND METHODS: Two men, 41 and 38 years old, with complete post-traumatic C7-C8 quadriplegia and poor lower urinary-tract condition underwent totally transperitoneally performed cystoprostatectomy and ileal-conduit urinary diversion with robotic assistance (Da Vinci). RESULTS: The procedures were completed without open conversion. The total surgical time was 9.25 and 6.75 hours, respectively. There were no intraoperative complications. In the postoperative period, both patients had mild complications (pulmonary and urinary infections) that were treated successfully medically. The postoperative hospital stay was 13 days in both cases. CONCLUSIONS: Our results demonstrate the safety and feasibility of robot-assisted laparoscopic cystoprostatectomy with ileal-conduit urinary diversion in two tetraplegic patients.

Adult↗