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Results for “Robotics”

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At least 901 records · Page 50Linked to original sources

PubMed2006

Robot-assisted laparoscopic nephroureterectomy.

BACKGROUND: Laparoscopic nephroureterectomy for upper-tract urothelial tumors is a minimally invasive approach that parallels the open technique in oncologic efficacy. Multiple approaches to manage the distal ureter have been described. We developed a new technique using the daVinci robot system to perform a transvesical excision of the distal ureter and bladder cuff. PATIENTS AND METHODS: Ten consecutive patients with upper-tract urothelial cancer underwent a laparoscopic nephroureterectomy. The daVinci robot was docked through the umbilical, ipsilateral lateral rectus, and an additional contralateral lateral rectus port. The bladder was clam-shelled in a coronal orientation at the dome and the distal ureterectomy performed. RESULTS: Our technique was successful in all ten patients. The mean operative time for the entire case was 4.4 hours. The average hospital stay was 3 days. CONCLUSIONS: Robot-assisted laparoscopic nephroureterectomy is a safe, minimally invasive approach to upper- tract urothelial cancer that reduces the technical challenge of excision of the distal ureter.

Humans↗

PubMed2006

Robotic gait analysis of bipedal treadmill stepping by spinal contused rats: characterization of intrinsic recovery and comparison with BBB.

There is a critical need to develop objective, quantitative techniques to assess motor function after spinal cord injury. Here, we assess the ability of a recently developed robotic device (the "rat stepper") to characterize locomotor impairment following contusion injury in rats. In particular, we analyzed how the kinematic features of hindlimb movement during bipedal, weight-supported treadmill stepping change following contusion, and whether these changes correlate with the recovery of open field locomotion. Female, Sprague-Dawley rats (n=29, 8 weeks of age) received mid thoracic contusion injuries of differing severities (11 mild, nine moderate, nine severe, and four sham). In a first experiment, 16 of the animals were evaluated weekly for 12 weeks using the robotic stepping device. In a second experiment, 17 of the animals were evaluated every other day for 4 weeks. The contused animals recovered open field locomotion based on the Basso, Beattie, and Bresnahan Scale (BBB) analysis, with most of the recovery occurring by 4 weeks post-injury. Analysis of 14 robotic measures of stepping revealed that several measures improved significantly during the same 4 weeks: swing velocity, step height, step length, hindlimb coordination, and the ability to support body weight. These measures were also significantly correlated with the BBB score. The number of steps taken during testing was not directly related to intrinsic recovery or correlated to the BBB score. These results suggest that it is the quality of weight-supported steps, rather than the quantity, that best reflects locomotor recovery after contusion injury, and that the quality of these steps is determined by the integrity of extensor, flexor, and bilateral coordination pathways. Thus, by measuring only a few weight-supported steps with motion capture, a sensitive, valid measure of locomotor recovery following contusion injury can be obtained across a broad range of impairment levels.

Animals↗

PubMed2006

The control system for the Honda humanoid robot.

To avoid tipping over either during walking or on standing up, humans will first push down hard on the ground with a part of the sole of the foot. Then, when the tipping force can no longer be resisted, a change in body position or an extra step (stepping out) may be required to stabilise the posture. Our biped robot's control system attempts to reproduce and execute the same postural control operations carried out by humans. In this article, we present the history of robot development at Honda, fundamental dynamics for robots and the principles of posture control.

Artificial Intelligence↗

PubMed1987

Application and flexibility of robotics in automating extraction methods for food samples.

Laboratory robotic technology has made it possible to automate the manually intensive operations associated with the extraction of vitamins from food. The modular approach to robotics allows the conversion from one extraction procedure to another by a simple addition or replacement of a module plus reprogramming. This is illustrated for the extraction of vitamins C and B1 from food samples. Because many of the organic micronutrients are unstable, storage and extraction conditions must be established to stabilize labile compounds if the full capabilities of robotics are to be realized.

Animals↗

PubMed1988

Liquid chromatographic analysis of doxazosin in human serum with manual and robotic sample preparation.

A specific method for the determination of the antihypertensive drug doxazosin in human serum is described. The method utilizes the related drug prazosin as an internal standard and is based on a simple extraction scheme followed by analysis by reversed-phase ion suppression high-performance liquid chromatography (HPLC) on an alumina-based column with fluorescence detection. The method is completely automated with a flexible robotic system for the analysis of drugs in biological fluids. The robotic automation of the method allows a 20% increase in the sample throughput and the savings of about 7 man-hours a day. Both the manual and robotic procedures yield precise quantitative results over the therapeutically relevant concentration range of 0.5 to 20 ng/mL of serum.

Chemical Phenomena↗

PubMed2004

Is an entertainment robot useful in the care of elderly people with severe dementia?

OBJECTIVE: An entertainment robot was used as occupational therapy instead of animal-assisted therapy to avoid any danger or injury to the patient and maintain cleanliness. This study compared the effectiveness of a robot animal, AIBO, with a toy. METHOD: AIBO is made of metal and responds to spoken commands. We demonstrated AIBO to severely demented elderly people living in a geriatric home and observed their reactions. RESULTS: The most frequent reactions to AIBO consisted of looking at, communicating with, and caring for AIBO. The patients recognized that AIBO was a robot. However, once we dressed AIBO, the patients perceived AIBO as either a dog or a baby. Nevertheless, the presentation of AIBO resulted in positive outcomes for the severe dementia patients, including increased communication between the patients and AIBO. CONCLUSION: AIBO was clearly an effective rehabilitation tool in the treatment of severely demented patients.

Aged↗

PubMed2000

Robotic system for biopsy and therapy of breast lesions in a high-field whole-body magnetic resonance tomography unit.

RATIONALE AND OBJECTIVES: With magnetic resonance mammography, significant progress has been achieved in the diagnosis of small breast cancers. However, biopsy and therapy of suspicious lesions must take place at a later time. Diagnosis and simultaneous biopsy and therapy in one single examination would considerably reduce costs, strain on the patient, and side effects. METHODS: ROBITOM (Robotic system for biopsy and interventional therapy of mammary lesions) is used to approach a lesion found in the breast in an image-controlled manner under a high magnetic field (eg, 1.5 T). The robotic system works in the direct vicinity of the isocenter of a magnet and consists of a trocar, coaxial sleeve, biopsy needle, laser applicator, and a control and driving unit. It contains a rack, a driving unit along the three coaxes of space, and a gripping unit for instruments or biopsy sample removal. The system has six degrees of freedom. RESULTS: In vitro experiments in pig liver including eight targets (vitamin E capsules, 4 mm in diameter) were performed. All eight capsules were hit precisely by the robotic biopsy system. The procedure was performed directly in the isocenter of a 1.5-T whole-body scanner. CONCLUSIONS: The system allows the coordinates of a lesion in the breast to be approached in a high magnetic field without shifting the patient. A combination of imaging with biopsy and subsequent therapy (eg, laser therapy or cryotherapy) seems to be feasible in the future.

Animals↗

PubMed1991

Computer- and robot-assisted resection of thalamic astrocytomas in children.

Six children ranging in age from 2 to 10 years who harbored deep benign astrocytomas were operated upon using a computer- and robot-assisted system. A radical excision was achieved in all cases with no significant morbidity nor any mortality. The system consists of an interactive, three-dimensional display of computed tomographic image contours and digitized cerebral angiograms taken using the Brown-Roberts-Wells stereotactic frame. The surgical retractor is held and manipulated using a PUMA 200 robot. The position and orientation of the surgical retractor is displayed on the three-dimensional display. Preoperative planning and simulation are important features of this system. Movement of the brain after removal of the tumor and cerebrospinal fluid is substantial, so the tumor removal is based on visually defined margins. Enhanced computer graphics and robotic devices are important adjuncts to neurosurgical procedures and will find increasing use in the future.

Astrocytoma↗

PubMed2002

Robotic-assisted laparoscopic donor nephrectomy for kidney transplantation.

BACKGROUND: Minimally invasive laparoscopic nephrectomy is a well-established alternative to open surgery in living donors for kidney transplantation. Donor mortality and morbidity rates as well as recipient outcome are comparable to the open approach. Furthermore, the procedure is associated with reduced donor discomfort, faster recovery, and improved cosmetic results. Recently, an advanced robotic system for laparoscopic surgery was approved for use in the United States. This system allows a greater freedom of movement and recreates the hand-eye coordination and three-dimensional vision that is lost in standard laparoscopic procedures. METHODS: We report the first 12 successful cases of robotic-assisted laparoscopic living donor nephrectomy performed using the da Vinci Surgical System (Intuitive Surgical, Mountain View, CA). RESULTS: Our initial experience has shown that the system allows the performance of donor nephrectomy in a safe and accurate fashion. CONCLUSIONS: As technology continues to evolve, robotic-assisted surgery has the potential to become a widely used attractive alternative to standard laparoscopic donor nephrectomy.

Adult↗

PubMed2001

Is robot-aided sensorimotor training in stroke rehabilitation a realistic option?

Stroke is the leading cause of disability, despite continued advances in prevention and treatment techniques based on novel delivery of new fibrinolytic drugs. Improved medical treatment of the complications caused by acute stroke has contributed to decreased mortality, but 90% of the survivors have significant neurological deficits. Reducing the degree of permanent disability remains the goal of poststroke neuro-rehabilitation programs, and new approaches to impairment reduction through managing sensorimotor experience may contribute further to altering disability. Recent reports from a number of laboratories using enhanced sensorimotor training protocols, particularly those with robotic devices, have indicated modest success in reducing impairment and increasing motor power in the exercised limb of patients with stroke when compared with control individuals. Whether arming the therapist with new tools, especially robotic devices, to treat impairment is a realistic approach to modern interdisciplinary rehabilitation raises questions regarding the added value of impairment reduction, and under what conditions should scientific and clinical development of robotic studies continue.

Disability Evaluation↗

PubMed2002

Robot-assisted laparoscopic Heller's cardiomyotomy.

There are many options available for the management of achalasia. Recently, the list of options has expanded to include robotic-assisted Heller's cardiomyotomy. In this article, we describe the procedure for a robotic-assisted cardiomyotomy and discuss the advantages of using a robotic, master-slave system.

Adult↗

PubMed2002

Early experience with robotically assisted internal thoracic artery harvest.

We sought to determine the efficacy of using robotic assistance to facilitate endoscopic harvesting of internal thoracic arteries (ITAs). A total of 104 patients had ITAs harvested endoscopically with use of both the AESOP 3000 system (Computer Motion, Goleta, CA, U.S.A.) and Zeus robotic telesurgical system (Computer Motion). All ITAs were harvested with a harmonic scalpel (Ethicon Endosurgery, Cincinnati, OH, U.S.A.). With the left lung collapsed, ITAs were harvested with CO2 insufflation through three 5-mm ports in the left chest. All patients tolerated insufflation without hemodynamic compromise. Average ITA harvest time was 61.3 +/- 20.9 minutes. Intraoperative graft flows averaged 36.3 +/- 22.4 mL/min. There were three distal ITA injuries; all other vessels were patent after harvesting and demonstrated no angiographic evidence of injury. This article demonstrates a technique by which ITA can be safely harvested totally endoscopically with use of computer-enhanced robotic systems and a harmonic scalpel, allowing complete pedicle dissection through 5-mm ports with minimal ITA manipulation.

Aged↗

PubMed2002

The evolution of and early experience with robot-assisted mitral valve surgery.

Cardiac surgeons have embraced minimally invasive surgery with warranted enthusiasm. The acceleration of technological advances in optics, instrumentation, and cardiopulmonary bypass has allowed safe, effective, efficient minimally invasive cardiac procedures. In this article we review the evolution of and early experience with robot-assisted mitral valve surgery. Articles by leaders in the field of minimally invasive cardiac surgery, both American and European, are reviewed to describe the development of cardiac robotic surgery. The current state of robotic mitral surgery is described.

Humans↗

PubMed2004

Initial evaluation of robotic technology for microsurgical vasovasostomy.

PURPOSE: Conventional microscope assisted vasovasostomy (MAVV) is a technically difficult procedure that is most successful in the hands of well-trained microsurgeons. Robotics may help surgeons overcome the microsurgical challenges of tremor, limited dexterity, miniaturized instrumentation and use of fine suture. We determine the feasibility of a robotic assisted vasovasostomy (RAVV) and compare performance measures with those of conventional MAVV. MATERIALS AND METHODS: One surgeon performed 10 vasovasostomies with a modified 1-layer technique and 9-zero suture on fresh human vas specimens using the robot in 5 RAVV cases and standard microsurgical instrumentation in 5 MAVV cases. Pre-specified performance measures and adverse haptic events (broken sutures, bent needles or loose stitches) were recorded. Patency was evaluated by instilling saline through the anastomoses. RESULTS: Mean operating time and number of adverse haptic events were higher for RAVV than for MAVV (84 vs 38 minutes, p = 0.01; 2.4 vs 0.0 events, p = 0.03). The number of needle passes required for the 6 full-thickness stitches was similar in both groups (16.8 vs 15.2 passes, p = 0.55). Although no tremor occurred during RAVV, minimal to moderate amounts occurred during MAVV. Minimal fatigue was noted for both groups. Patency was confirmed in all 10 operations. CONCLUSIONS: Use of RAVV in this human ex vivo vas model was feasible. While RAVV took longer to perform and was associated with adverse haptic events, elimination of tremor and comparable patency rates suggest that it may be a viable surgical alternative for microsurgical vasovasostomy.

Equipment Design↗

PubMed2005

Potency following robotic radical prostatectomy: a questionnaire based analysis of outcomes after conventional nerve sparing and prostatic fascia sparing techniques.

PURPOSE: Anatomical nerve sparing radical prostatectomy provides excellent cancer control, although the recovery of sexual function is variable. We recently described a technique to preserve the prostatic fascia (veil of Aphrodite) that appears to enhance the quality of nerve preservation during robotic prostatectomy. In January 2003 we initiated a prospective study comparing patients undergoing prostatic fascia preservation with those undergoing conventional nerve sparing robotic radical prostatectomy. We report results at 12 months of followup MATERIALS AND METHODS: From January to August 2003, 58 potent men with a Sexual Health Inventory for Men score (SHIM) of greater than 21 without phosphodiesterase 5 inhibitors underwent Vattikuti Institute prostatectomy, including 35 with preservation of the prostatic fascia (study) and 23 with conventional nerve sparing (control). Potency was assessed with self-administered SHIM questionnaires 12 months after surgery. The primary end point was achievement of erections strong enough for penetration with or without oral medications. The secondary end point was the ability to achieve normal erections (SHIM greater than 21) with and without medications. RESULTS: At 12 months of followup 17 of 23 control (74%) and 34 of 35 study (97%) patients achieved erections strong enough for intercourse (p = 0.002). Four control (17%) and 18 study (51%) patients achieved normal erections (SHIM greater than 21) without medication (p <0.0001). Six control (26%) and 30 study (86%) patients achieved normal erections with or without phosphodiesterase 5 inhibitors (p <0.0001). CONCLUSIONS: Potency rates after radical prostatectomy vary with the measure used to define potency. Irrespective of the definition used patients undergoing prostatic fascia preserving radical prostatectomy have significantly better potency outcomes than patients undergoing conventional nerve sparing robotic prostatectomy at 12 months of followup.

Aged↗

PubMed2006

Tumor ablation treatment planning coupled to robotic implementation: a feasibility study.

The technical development described herein was undertaken to create a tumor ablation treatment system that consists of a software component and a robotic hardware component. First, the software treatment planning system enables applicator placement planning before tumor ablation. For example, it allows creation of overlapping ablations with the goal of treating larger tumors. Second, the robotic hardware system allows accurate applicator placement. The combined treatment system integrates treatment planning with treatment execution by taking the coordinates dictated by the planning system and feeding them to the robotic system for implementation. The feasibility of this system was tested in two patients with large hepatic metastases that required overlapping ablations.

Aged↗

PubMed2006

A prospective comparison of robotic and laparoscopic pyeloplasty.

OBJECTIVE: To determine whether robotic-assisted pyeloplasty (RLP) has any significant clinical or cost advantages over laparoscopic pyeloplasty (LP) for surgeons already facile with intracorporeal suturing. SUMMARY BACKGROUND DATA: LP has become an established management approach for primary ureteropelvic junction obstruction. More recently, the da Vinci robot has been applied to this procedure (RLP) in an attempt to shorten the learning curve. Whether RLP provides any significant advantage over LP for the experienced laparoscopist remains unclear. METHODS: Ten consecutive cases each of transperitoneal RLP and LP performed by a single surgeon were compared prospectively with respect to surgical times and perioperative outcomes. Cost assessment was performed by sensitivity analysis using a mathematical cost model incorporating operative time, anesthesia fees, consumables, and capital equipment depreciation. RESULTS: The RLP and LP groups had statistically indistinguishable demographics, pathology, and similar perioperative outcomes. Mean operative and total room time for RLP was significantly longer than LP by 19.5 and 39.0 minutes, respectively. RLP was much more costly than LP (2.7 times), due to longer operative time, increased consumables costs, and depreciation of the costly da Vinci system. However, even if depreciation was eliminated, RLP was still 1.7 times as costly as LP. One-way sensitivity analysis showed that LP operative time must increase to almost 6.5 hours for it to become cost equivalent to RLP. CONCLUSIONS: For the experienced laparoscopist, application of the da Vinci robot resulted in no significant clinical advantage and added substantial cost to transperitoneal laparoscopic dismembered pyeloplasty.

Clinical Competence↗

PubMed2005

Robotic resection of an ectopic goiter in the mediastinum.

We report the first robotic resection of an ectopic mediastinal thyroid adenoma in a 72-year-old woman. This intervention was part of staged management for excessive bilateral cervical goiter with intrathoracic dispersion. The robotic resection was found to be feasible and safe. The robotic operating system offers better visual control and operative accuracy than does conventional thoracoscopy.

Adenoma↗