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At least 1,117 records · Page 62Linked to original sources

PubMed2005

Computational motor control in humans and robots.

Computational models can provide useful guidance in the design of behavioral and neurophysiological experiments and in the interpretation of complex, high dimensional biological data. Because many problems faced by the primate brain in the control of movement have parallels in robotic motor control, models and algorithms from robotics research provide useful inspiration, baseline performance, and sometimes direct analogs for neuroscience.

Algorithms↗

PubMed2006

Mitral valve repair robotic versus sternotomy.

OBJECTIVE: Robotically assisted mitral valve repair were compared with sternotomy mitral valve repair. Prospectively we evaluated safety and efficacy in performing simple mitral repairs. METHODS: Between February 2004 and September 2005, 25 patients with posterior leaflet insufficiency underwent mitral valve repair using the da Vinci system. They were matched retrospectively with 25 patients who underwent the same repair via a median sternotomy. The minimal invasive repairs were performed with peripheral cardiopulmonary bypass, transthoracic aortic cross-clamp, and antegrade cardioplegia. Repair was performed with two ports and a 4-cm intercostals lateral incision in the right chest for access. All patients had posterior leaflet resection and placement of a ring annuloplasty. RESULTS: All patients had successful valve repairs. There were no deaths. There was one conversion to an extended thoracotomy in the minimal invasive group due to a bleeder on the left atrial appendage. Overall mean study times showed a longer aortic cross-clamp (range, 96.1 min vs 69.6 min) and cardiopulmonary bypass (range, 122.1 min vs 85.7 min) for the minimal invasive group. Length of stay was less for the minimal group (7 days vs 9 days). At postoperative echocardiography two patients in both group developed 2+ mitral regurgitations. All other patients had a competent mitral valve repair with no insufficiency. CONCLUSIONS: Simple mitral valve repair can be successfully performed with the da Vinci robotic system. This approach is as safe as a sternotomy and long-term follow-up is needed to determine the durability of the mini invasive repair.

Aged↗

PubMed2007

A comparison of outcomes after robotic open extended thymectomy for myasthenia gravis.

OBJECTIVE: The aim of this study was to analyze the effect of the surgical approach on surgical and neurologic outcomes after extended thymectomy for myasthenia gravis. METHODS: A retrospective analysis of the institutional extended thymectomies for myasthenia gravis within the last decade was performed. Patients of group A (open access by total median sternotomy; n=10; 1996-2002) and of group B (video assisted thoracoscopic surgery approach with the da Vinci robotic system; n=9; 2003-2006) did not differ with regard to gender distribution, age, body mass index, American Association of Anaesthetists score and Osserman classification of myasthenia gravis. Primary endpoints were surgical complications and the symptomatic/neurologic outcome of the extended thymectomy. Secondary endpoints were operating times and hospital stay. RESULTS: Median follow-up was 74+/-23 months in group A and 13+/-10 months in group B. Surgical complications occurred in 4 patients in group A (requiring 2 re-interventions) and in 1 patient in group B (p<0.05). The median dose of Pyridostigminbromid was reduced 3 and 6 months postoperatively in group A to 80% and 60% of the preoperative level and in group B to 66% and 60% of the preoperative level, respectively. Within the first postoperative year all patients of group B had an improvement of their disease whereas 2 patients of group A did not benefit from thymectomy or had a worsening of symptoms. Operating times were significantly shorter in group A (110 (42-152) min vs 154 (94-312) min, p<0.05), hospital stay was significantly shorter in group B (5 (4-15) vs 10 (10-23) days, p<0.05). CONCLUSIONS: The results of this small series favour the robotic approach for extended thymectomy for myasthenia gravis in respect of both surgical and early neurologic outcome. However, prospective randomized trials are required to prove a general validity.

Female↗

PubMed2006

Positive surgical margins in robotic-assisted radical prostatectomy: impact of learning curve on oncologic outcomes.

OBJECTIVE: The presence of positive surgical margins following radical prostatectomy is a known risk factor for disease recurrence and may lead to adjuvant treatment. Our goal was to assess the incidence of positive surgical margins in our series of robotic-assisted radical prostatectomy (RARP) and its relationship to our learning curve. METHODS: Between February 2003 and August 2005, 140 patients underwent RARP by the same surgical team at our institution. The records of our first 100 consecutive RARPs were retrospectively reviewed. The patients were divided into three groups based on the time of surgery: group I included the first 33 cases; group II included the second 33 cases; and group III comprised the last 34 cases. We compared the incidence and location of positive surgical margins among the groups. Additional variables evaluated included the patient's prostate-specific antigen (PSA) level, preoperative/postoperative Gleason score, clinical/pathologic stage, and pathologic tumour volume. RESULTS: The positive margin rates were 45.4%, 21.2%, and 11.7% for groups I, II, and III, respectively. The difference in positive margin rates in the three groups was statistically significant (p=0.0053). Positive margin rates declined specifically at the apex and bladder neck when comparing the first 33 patients to the last 34 patients. Patient demographics and preoperative staging variables were comparable among all three groups, with no statistically significant differences among them. CONCLUSIONS: This study illustrates that experience gained with time led to a decrease in the incidence of positive surgical margins. We do not feel that a selection bias affected our results because clinical and pathologic staging was evenly distributed within the three study groups. A steady reduction in positive surgical margin rates demonstrates a learning curve, of approximately 30 patients, associated with RARP, and suggests that oncologic outcome is affected by the experience of the robotic surgeon.

Follow-Up Studies↗

PubMed2006

Evidence from robot-assisted laparoscopic radical prostatectomy: a systematic review.

OBJECTIVE: To review the literature available on robot-assisted laparoscopic radical prostatectomy (RALP). METHODS: A literature search was performed using EMBASE, MEDLINE, and Web Science databases through a "free text" protocol, including the following terms: robotic radical prostatectomy, da Vinci, and radical prostatectomy. Three of the authors separately reviewed the records to select the papers relevant for the topic of the review, with any discrepancies solved by open discussion. The selected articles were recorded in an electronic database and analysed by version 13.0 SPSS software. RESULTS: We identified 71 manuscripts. Eleven papers focused on surgical technique, and 35 manuscripts reported clinical, pathologic, and/or follow-up data. Seven studies included clinical data concerning surgical series with fewer than 10 patients, whereas the remaining 26 series reported larger surgical series of RALP. RALP turned out to be a feasible procedure, with limited blood loss, favourable complication rates, and short hospital stays. Positive surgical margin rates decreased with the surgeon's experience and technique improving, reaching percentages similar to those of retropubic and laparoscopic series. The available oncologic data are only preliminary. Especially interesting are the data on postoperative continence rates, whereas results on potency, although promising, are based only on a limited number of patients and have to be considered as incomplete and premature. CONCLUSION: Literature showed that RALP had a short learning curve and interesting postoperative results, especially with regard to continence recovery. The available data on recovery of erectile function and oncologic follow-up are still incomplete.

Humans↗

PubMed2006

Preservation of the puboprostatic collar and puboperineoplasty for early recovery of urinary continence after robotic prostatectomy: anatomic basis and preliminary outcomes.

OBJECTIVES: The aims of the present study are to prove the hypothesis that the preservation of the puboprostatic collar and puboperineoplasty contribute to the early recovery of urinary continence after robotic radical prostatectomy. We reconfirm the anatomy of the periurethral supporting tissue and show the preliminary result on the early continence of patients undergoing this modification. METHODS: Using 10, male, fresh cadavers, we traced the endopelvic fascia, the fascia of levator ani, puboprostatic ligaments, rhabdosphincter, and puboperinealis muscle to devise strategies in preserving this complex. The modifications were then attempted by a single surgeon (A.K.T.) in 19 patients undergoing robotic prostatectomy during September 2005. RESULTS: After incision of the endopelvic fascia within the fascial tendinous arch of the pelvis, the puboprostatic collar and the levator ani could be separated laterally. The puboperinealis muscle attached to part of the pubic symphysis behind the puboprostatic ligament and terminated at the perineal body. We were able to preserve the puboprostatic collar in all attempted cases. Furthermore, puboperineoplasty took 5min to complete. The total continence rate was 63.2% at median follow-up of 38.1 d. Immediate continence rate just after catheter removal was 42.1%. The rate at 1 and 4 wk was 52.6% and 71.4%, respectively. The margins of the examined specimens were all negative for malignancy. CONCLUSIONS: This modification should preserve or allow for early recovery of urinary continence from an anatomic perspective. Further studies are necessary to elucidate the clinical impact on a patient's early continence.

Adult↗

PubMed2006

Robotic-assisted laparoscopic prostatectomy: functional and pathologic outcomes with interfascial nerve preservation.

INTRODUCTION: Robotic-assisted laparoscopic radical prostatectomy (RLRP) is increasingly becoming an alternative to open and laparoscopic radical prostatectomy in the treatment of localized prostate cancer. RLRP has been associated with low morbidity, short convalescence and comparable oncologic and functional outcomes. We report our initial experience of 300 consecutive cases with selective use of interfascial nerve preservation (IFNP). METHODS: Between February 2003 and September 2005, 300 consecutive men underwent RLRP at our institution. Patients were followed prospectively with validated questionnaires. RESULTS: Mean operative time was 282 minutes with an estimated blood loss of 273 ml. The intra-operative complication rate was 2.3% with no mortality. Return to baseline (RTB) urinary function and subjective continence at 12 months were 71% and 90.2%, respectively. RTB sexual function and subjective potency at 12 months were 53% and 80.4%, respectively. Overall, the positive surgical margin (PSM) rate was 20.9%: 15.1% for pT2 and 52.1% for pT3 disease and 93.1% had an undetectable PSA (<0.1 ng/mL) with a mean follow-up of 17.3 months. Fifty-four percent of PSMs occured in a poster-lateral (PL) location. Retrospectively, IFNP was performed in 86.5% and 62.5% of pT2 and pT3 PSMs, respectively. Pathologic-T3 PSMs were found to occur significantly more often in a PL location when ipsilateral IFNP was performed when compared to non-IFNP (73% vs 33%, p=0.05). CONCLUSIONS: IFNP appears to result in favorable return of potency, however, postero-lateral PSMs appear to occur more frequently with this technique. Proper patient selection for robotic surgery and nerve-preservation appears to be critical in order to reduce PSM and optimize the oncologic efficacy of this technology.

Adult↗

PubMed2004

Robotic grid loading system for a transmission electron microscope.

The design, construction, and testing of a robotic grid loading system for a transmission electron microscope is presented. The system, when integrated with automated data collection software, has the potential to carry out large scale multi-grid experiments, as required, for example, by 2D protein crystallization screening trials. We present a detailed description of the system that utilizes a 6 axis articulate robotic arm to load microscope grids into a specimen holder and then load the holder into the microscope. Grids are stored in trays with a capacity of 96 that are based on the format of a standard 96-well microtiter plate. The system has been integrated with an FEI Tecnai microscope and does not require any modification to the microscope and only minor modifications to the specimen holder. Preliminary results regarding cycle time, failure rates, positioning accuracy and a 96 grid screening experiment are presented.

Automation↗

PubMed2006

Technical challenges in totally endoscopic robotic coronary artery bypass grafting.

OBJECTIVE: Robotic technology is a prerequisite for performance of totally endoscopic coronary artery bypass grafting. During the implementation phase of totally endoscopic coronary artery bypass, surgeon-related technical difficulties might be encountered. It was the aim of this study to assess the incidence of these challenges, to find risk factors, and to describe clinical results associated with technical errors. METHODS: From October 2001 through October 2004, 40 patients received robotically assisted totally endoscopic left internal thoracic artery grafts to the left anterior descending coronary artery system with the da Vinci telemanipulation device. All patients underwent remote access cardiopulmonary bypass perfusion through groin access, and all anastomoses were performed on the arrested heart. RESULTS: Undesirable technical events of various grades occurred in 20 (50%) of 40 patients: bleeding from a port hole in 3 (8%), left internal thoracic artery damage in 3 (8%), epicardial lesion in 3 (8%), remote access perfusion problems in 9 (23%), bleeding from the anastomosis in 4 (10%), and anastomotic stenosis in 2 (5%). There was no hospital mortality. The following differences were noted between patients without technical difficulties (group 1) and those in whom problems occurred (group 2): total operative time of 314 minutes (260-540 minutes) versus 418 minutes (270-690 minutes; P = .007), ventilation time of 6 hours (0-26 hours) versus 14 hours (0-278 hours; P = .004), intensive care unit stay of 20 hours (11-70 hours) versus 44 hours (16-336 hours; P=.183), hospital stay of 7 days (4-13 days) versus 8 days (5-21 days; P = .038), and cumulative freedom from angina at 36 months of 93% versus 100% (P = .317). CONCLUSION: We conclude that technical difficulties during totally endoscopic coronary artery bypass grafting translate into markedly increased operative time, moderately prolonged postoperative ventilation time, and slightly increased hospital stay. Short-term survival and freedom from angina, however, do not seem to be compromised.

Adult↗

PubMed2006

Laser-scan endoscope system for intraoperative geometry acquisition and surgical robot safety management.

In laparoscopic surgery, surgeons find particular difficulties related to the operation technique. Due to restricted view, lack of depth information from the monocular endoscope and limited degree of freedom, surgeons find their movements impeded. A support system that provides improved laparoscopic vision would help to overcome the difficulties. If real-time visualization of abdominal structures were feasible, more accurate procedures and improved quantitative evaluations in laparoscopic surgery might be possible. In this study, a laser-scan endoscope system was developed to acquire and visualize the shape and texture of the area of interest instantaneously. The intraoperative geometric information of deformable organ could be applied for robotic safety management via geometric computation of robot position and organ shape. Results of in vivo experiments on a pig liver verified effectiveness of the proposed system.

Animals↗

PubMedDate not supplied

Self-organization of distributedly represented multiple behavior schemata in a mirror system: reviews of robot experiments using RNNPB.

The current paper reviews a connectionist model, the recurrent neural network with parametric biases (RNNPB), in which multiple behavior schemata can be learned by the network in a distributed manner. The parametric biases in the network play an essential role in both generating and recognizing behavior patterns. They act as a mirror system by means of self-organizing adequate memory structures. Three different robot experiments are reviewed: robot and user interactions; learning and generating different types of dynamic patterns; and linguistic-behavior binding. The hallmark of this study is explaining how self-organizing internal structures can contribute to generalization in learning, and diversity in behavior generation, in the proposed distributed representation scheme.

Artificial Intelligence↗

PubMed2005

The dynamic wave expansion neural network model for robot motion planning in time-varying environments.

We introduce a new type of neural network--the dynamic wave expansion neural network (DWENN)--for path generation in a dynamic environment for both mobile robots and robotic manipulators. Our model is parameter-free, computationally efficient, and its complexity does not explicitly depend on the dimensionality of the configuration space. We give a review of existing neural networks for trajectory generation in a time-varying domain, which are compared to the presented model. We demonstrate several representative simulative comparisons as well as the results of long-run comparisons in a number of randomly-generated scenes, which reveal that the proposed model yields dominantly shorter paths, especially in highly-dynamic environments.

Central Nervous System↗

PubMed2005

Emotion understanding from the perspective of autonomous robots research.

In this paper, I discuss some of the contributions that modeling emotions in autonomous robots can make towards understanding human emotions-'as sited in the brain' and as used in our interactions with the environment-and emotions in general. Such contributions are linked, on the one hand, to the potential use of such robotic models as tools and 'virtual laboratories' to test and explore systematically theories and models of human emotions, and on the other hand to a modeling approach that fosters conceptual clarification and operationalization of the relevant aspects of theoretical notions and models. As illustrated by an overview of recent advances in the field, this area is still in its infancy. However, the work carried out already shows that we share many conceptual problems and interests with other disciplines in the affective sciences and that sound progress necessitates multidisciplinary efforts.

Adaptation, Psychological↗

PubMed2006

Perception through visuomotor anticipation in a mobile robot.

Several scientists suggested that certain perceptual qualities are based on sensorimotor anticipation: for example, the softness of a sponge is perceived by anticipating the sensations resulting from a grasping movement. For the perception of spatial arrangements, this article demonstrates that this concept can be realized in a mobile robot. The robot first learned to predict how its visual input changes under movement commands. With this ability, two perceptual tasks could be solved: judging the distance to an obstacle in front by 'mentally' simulating a movement toward the obstacle, and recognizing a dead end by simulating either an obstacle-avoidance algorithm or a recursive search for an exit. A simulated movement contained a series of prediction steps. In each step, a multilayer perceptron anticipated the next image, which, however, became increasingly noisy. To denoise an image, it was split into patches, and each patch was projected onto a manifold obtained by modelling the density of the distribution of training patches with a mixture of Gaussian functions.

Algorithms↗

PubMed2006

A new robotic needle insertion method to minimise attendant prostate motion.

BACKGROUND AND PURPOSE: The purpose of this study is to investigate the efficacy of a new needle insertion method (tapping instead of pushing) in reducing attendant tissue motion. This can be useful in applications where tissue motion due to needle insertion is problematic such as e.g. MRI-guided prostate brachytherapy and breast biopsies. In this study we will focus on prostate motion due to needle insertion. MATERIAL AND METHODS: Prostate motion due to needle insertion was measured in 30 patients, who were transperineally implanted with fiducial gold markers for position verification in prostate intensity modulated radiotherapy. In total 32 needles were manually pushed into the prostate and 29 were tapped with a prototype robotic system. The prostate motion in the cranio-caudal direction was measured on the video record of the ultrasound images. Differences in prostate motion between the two needle insertion methods were analysed making use of SPSS. RESULTS: The mean prostate motion was 5.6mm (range 0.3-21.6) when the needle was pushed and 0.9 mm (range 0-2.0) when the needle was tapped into the prostate (p<0.001). CONCLUSION: Prostate motion was significantly less when the needle was tapped into the prostate compared to when the needle was pushed. This result is important for the development of a tapping, MRI-guided, prostate implant robotic system.

Biopsy↗

PubMed2004

Optimizing motion scaling and magnification in robotic surgery.

BACKGROUND: Motion scaling is one possible advantage of robotic surgery. The aim of this study was to determine which scaling optimized precision and speed at different magnifications. METHODS: Three levels of motion scaling were tested at each of 3 camera magnifications. Surgically nave subjects (n = 12) were randomized as to the order of magnification level testing (3.5x, 6.5x, 9.5x) and motion scalings (10:1, 5:1, 1:1). The subjects were asked to pierce a needle through 6 printed microtargets; then accuracy and drill completion time were scored. RESULTS: At 3.5x magnification, no differences between groups were observed. At 6.5x magnification, the 5:1 scaling was superior to the 1:1 scaling in total errors, and the 10:1 scaling was significantly slower. At 9.5x magnification, 10:1 scaling resulted in fewer errors than 1:1 with no difference in time. Overall, the 10:1 and 5:1 scalings resulted in fewer errors. The 5:1 scaling resulted in less drill completion time than the 10:1 scaling. The 9.5x magnification resulted in the fewest errors. CONCLUSIONS: Motion scaling reduces the number of errors at higher magnifications, but can increase the task completion time. It is necessary to optimize both the motion scaling and magnification components of robotic systems to balance precision and speed.

Adolescent↗

PubMed2004

Robotics technology: a journey into the future.

Some major technologic improvements are needed for robotic technology to reach its ultimate potential, which includes better visualization, tactile sensing, diagnostic sensing, and miniaturization. This article gives a vision of the future of robotic technology with respect to these improvements.

Diagnostic Techniques and Procedures↗

PubMed2003

Laparoscopic robotic-assisted ileal conduit urinary diversion in a quadriplegic woman.

Urinary diversion is a therapeutic option in quadriplegic patients with poor lower urinary tract conditions, but it is an invasive procedure. Laparoscopic techniques are less invasive, but are technically demanding, and only a few surgical teams are able to complete such a complex procedure endoscopically. Robotics bring an unprecedented control of surgical instruments, shorten the learning curve, and allow open surgeons to apply more easily their technical skill to the laparoscopic approach. This complex case of laparoscopic ileal conduit in a quadriplegic woman was completed by our team with the Da Vinci system after 6 months of clinical experience in robotic surgery.

Cervical Vertebrae↗