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Results for “Robotics”

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At least 1,495 records · Page 83Linked to original sources

PubMed2003

Cardiac MR in robotic heart surgery for preoperative identification of the target vessel and precise port placement--a theoretical model.

BACKGROUND: The identification of the ideal anastomosis site and the proper port placement are critical for the success of closed-chest robotic surgery. We investigated a new systematic procedure for precise port placement for TECABs. METHODS: We used trigonometry and a human thoracic model to determine the optimal working angles between anastomotic plane, instruments, and endoscope. We then applied the results to seven human subjects as follows: 1. A navigation grid was located extrathoracically before cardiac MR examination. 2. The ideal anastomosis site was defined with the MR. Intrathoracic distances and angles were computed with cardiac MR software and projected onto the thorax. 3. The ideal port placement points were marked on the thorax. RESULTS: The optimal working angle between endoscope and instruments was 35 degrees. 0 degrees and 90 degrees angles were associated with a significant reduction in visualization, technical ease, quality and anastomosis time. The course of the LAD was identified in all seven volunteers with MR. Mean deviation of the endoscope port from the medioclavicular line was 4.3+/-2.1 cm and of the instrument ports from the anterior axillary line 8.4+/-2.4 cm. CONCLUSIONS: Cardiac MR in combination with the navigation grid proved suitable for the visualization of coronary vessels for individually calculating port placement points on the thorax.

Adult↗

PubMed2002

Robot-assisted stapedotomy: micropick fenestration of the stapes footplate.

OBJECTIVE: Micropick fenestration of the stapes footplate, a difficult step in stapedotomy, was selected for trials evaluating the potential for robotic assistance (RA) to improve clinical measures of surgical performance. STUDY DESIGN: In a surgical model of stapedotomy, we measured accuracy of fenestration to a desired point location and force applied to the stapes footplate. Performance variables were measured for 3 experienced and 3 less-experienced surgeons. RESULTS: RA significantly reduced the maximum force applied to the stapes footplate. For fenestration targeting, RA significantly improved accuracy for less-experienced surgeons and significantly worsened targeting for more-experienced surgeons. CONCLUSIONS: RA significantly improves performance for micropick fenestration in a surgical model of stapedotomy. For certain tasks, RA differentially affects performance for users of different experience levels. CLINICAL SIGNIFICANCE: These are the first results showing quantitative improvements in performance during simulated ear surgery using RA and differential effects of RA on performance for users of different experience levels.

Clinical Competence↗

PubMed1992

Identification of highest-affinity ligands by affinity selection from equimolar peptide mixtures generated by robotic synthesis.

A fully automated peptide synthesizer has been constructed that is capable of the simultaneous synthesis of up to 36 individual peptides and the synthesis of equimolar peptide mixtures. The instrument consists of an array of reaction vessels, a series of solenoid valves to control liquid flow, and a Zymark robot to deliver solvents and reagents; all components are computer controlled and coordinated. Equimolar peptide mixtures are obtained by algorithms that automate the mixing and distribution of peptide-resin particles. This technology was used to synthesize a library of 361 peptides, generated by randomizing two critical binding residues of a 10-mer epitope known to bind an anti-human immuno-deficiency virus gp120 monoclonal antibody. Each critical residue was substituted with 19 amino acids consisting of all the natural amino acids except cysteine. The library was synthesized as 19 pools, each containing 19 peptides. Each pool was screened in a solution-phase competition ELISA assay. The 12 most inhibitory peptides in the library were isolated by a rapid affinity-selection method and were identified by mass spectrometry and amino acid analysis. The binding properties of these 12 selected peptides were verified by synthesis and assay of the individual peptides. The two critical residues investigated were found to contribute independently to antibody binding.

Amino Acid Sequence↗

PubMed2002

MUPRO: a multipurpose robot.

The aim of this article was to describe an apparatus, called multipurpose neck robot (MURPO), designed to record both the forces exerted at head level and the head rotations in the horizontal plane in the behaving monkey. It consists of a mechanical device, comprising a cardan joint, a potentiometer, an electromagnetic brake, and four flexion load cells, plus an oleodynamic system allowing head rotation in the horizontal plane between +/- 20o. These components are assembled on a column bolted to the primate's chair. An electrical device provides DC power for the potentiometer and the brake. The apparatus enables us to measure both the force fields and the head movements during training sessions and electrophysiological investigations.

Animals↗

PubMedDate not supplied

Robotic analysis of aflatoxin M1 in milk.

An automated aflatoxin M1 assay system capable of performing multiple unattended extractions and chromatographic analyses has been developed. A six-axis anthropomorphic laboratory robot and a flexible computer system are combined to operate a sample turntable, a multisolvent dispensing facility, a solid-phase extraction station, a vacuum manifold, an automatic HPLC sample preconcentration unit, an HPLC, a fluorescence detector and a computing integrator. The system is capable of handling bulk milk samples and can determine aflatoxins at the sub-micrograms/kg level with an accuracy and precision comparable to those of the manual methods of analysis. Time of analysis is reduced. The system can be run in an unattended mode of operation.

Aflatoxin M1↗

PubMed1990

Robotic arm use by very young motorically disabled children.

This paper reports on a study carried out to determine if very young children would interact with a small computer-controlled robotic arm. Six disabled and three normal children were used in the study. All children were less than 38 months in age. The arm was trained to carry out movements on activation of a single switch by the child. Fifty percent of the disabled children and 100% of the normal children did interact with the arm and use it as a tool to obtain objects out of reach. Possible relationships between the use of the arm and developmental levels in various areas are discussed.

Child, Preschool↗

PubMed2000

Classroom evaluation of the Arlyn Arm robotic workstation.

High school and junior high school students with neuromuscular weakness and other disorders of the arms evaluated a recently commercialized robotic workstation, the Arlyn Arm, to carry out art projects and science experiments. These tasks were designed for independent execution with the workstation using standard or custom-designed tools. Each task was divided into subtasks, and the execution time of each subtask was determined as a measure of efficiency. Special attention was given to the causes of required experimenter intervention. While subjects easily accomplished some subtasks, others required considerable intervention. Most of these interventions could be avoided by further customizing accessories. It is concluded that the Arlyn Arm workstation could be of considerable benefit in a classroom setting to persons with severe neuromuscular disorders.

Adolescent↗

PubMed2006

Control of soft tissue deformation during robotic needle insertion.

Accurate needle insertion into soft, inhomogeneous tissue is of practical interest because of its importance in percutaneous therapies. In procedures that involve multiple needle insertions such as transrectal ultrasound-guided prostate brachytherapy, it is important to reduce tissue deformation before puncture and during needle insertion. In order to reduce this deformation, we have studied the effect of different trajectories for a 2-DOF (degrees of freedom) robot performing needle insertion in soft tissue. To obtain an optimum trajectory, we have compared tissue indentation and frictional forces for different trajectories. According to the results of our experiments, infinitesimal force per tissue displacement is a useful parameter for online trajectory update. In addition, the results show that axial rotation can reduce tissue indentation before puncture and frictional forces after puncture. Our proposed position/force controller is shown to provide considerable improvement in performance with regard to minimizing tissue deformation before puncture.

Animals↗

PubMed2006

Comparison of the ACL and ACL graft forces before and after ACL reconstruction: an in-vitro robotic investigation.

BACKGROUND: Long-term follow-up studies have indicated that there is an increased incidence of arthrosis following anterior cruciate ligament (ACL) reconstruction, suggesting that the reconstruction may not reproduce intact ACL biomechanics. We studied not only the magnitude but also the orientation of the ACL and ACL graft forces. METHODS: 10 knee specimens were tested on a robotic testing system with the ACL intact, deficient, and reconstructed (using a bone-patella tendon-bone graft). The magnitude and orientation of the ACL and ACL graft forces were determined under an anterior tibial load of 130 N at full extension, and 15, 30, 60, and 90 degrees of flexion. Orientation was described using elevation angle (the angle formed with the tibial plateau in the sagittal plane) and deviation angle (the angle formed with respect to the anteroposterior direction in the transverse plane). RESULTS: ACL reconstruction restored anterior tibial translation to within 2.6 mm of that of the intact knee under the 130-N anterior load. Average internal tibial rotation was reduced after ACL reconstruction at all flexion angles. The force vector of the ACL graft was significantly different from the ACL force vector. The average values of the elevation and deviation angles of the ACL graft forces were higher than that of the intact ACL at all flexion angles. INTERPRETATION: Contemporary single bundle ACL reconstruction restores anterior tibial translation under anterior tibial load with different forces (both magnitude and orientation) in the graft compared to the intact ACL. Such graft function might alter knee kinematics in other degrees of freedom and could overly constrain the tibial rotation. An anatomic ACL reconstruction should reproduce the magnitude and orientation of the intact ACL force vector, so that the 6-degrees-of-freedom knee kinematics and joint reaction forces can be restored.

Aged↗

PubMed2004

An ultrasound-driven needle-insertion robot for percutaneous cholecystostomy.

A real-time ultrasound-guided needle-insertion medical robot for percutaneous cholecystostomy has been developed. Image-guided interventions have become widely accepted because they are consistent with minimal invasiveness. However, organ or abnormality displacement due to involuntary patient motion may undesirably affect the intervention. The proposed instrument uses intraoperative images and modifies the needle path in real time by using a novel ultrasonic image segmentation technique. In phantom and volunteer experiments, the needle path updating time was 130 and 301 ms per cycle, respectively. In animal experiments, the needle could be placed accurately in the target.

Animals↗

PubMed2001

Computer-assisted robotic heller myotomy: initial case report.

PURPOSE: Our objective was to determine the efficacy of computer-assisted robotic laparoscopic Heller myotomy. METHODS: A 76-year-old woman with a significant history of achalasia was evaluated for laparoscopic Heller myotomy. The daVinci surgical system was used throughout the procedure. RESULTS: Computer assistance allowed scaling of hand motions from a range of 2:1 to 5:1. Successful dissection of the esophageal musculature was accomplished, and a Toupet-type fundoplication was performed. The patient was discharged from the hospital the day after surgery with five port incisions, each <1 cm. CONCLUSIONS: Telemanipulator computer-assisted surgical devices may have applications in procedures that require advanced and finely tuned motions, such as Heller myotomy. The benefits of extra magnification and three-dimensional imaging can help prevent esophageal perforation and identify residual circular muscle fibers.

Aged↗

PubMed2005

Robotic transperitoneal detrusor myotomy: description of a novel technique.

The da Vinci Surgical Robotic System has recently been added to the armamentarium of minimally invasive surgeon and has been shown to be useful to urologists in performing complex operations. We report the first case of detrusor myotomy performed using the da Vinci, describe the novel technique, and review the indications and published outcomes of detrusor myotomy to identify potential applications of this novel technique in patients with neurogenic bladder.

Aged↗

PubMedDate not supplied

Intravesical robotically assisted bilateral ureteral reimplantation.

An efficient laparoendoscopic technique for bilateral intravesical ureteral reimplantation would offer the certainty of cure provided by open surgery with the reduced morbidity of laparoscopy. We have assessed the clinical utility of robotically assisted intravesical bilateral ureteral reimplantation in children. Ports are placed in the dome of the bladder, and the procedure is performed in a fashion identical to that used for open transtrigonal reimplantation. A catheter is left in place for 1 or 2 days. With modifications in port placement using the VersaStep radially dilating sheath system, we have not had any port-site leakage. One patient has unilateral persisting low-grade reflux. This technique may be a useful option for antireflux surgery and should be further refined.

Child, Preschool↗

PubMedDate not supplied

Rapid communication: early potency outcomes with cautery-free neurovascular bundle preservation with robotic laparoscopic radical prostatectomy.

PURPOSE: To report short-term potency outcomes with a cautery-free technique (CFT) to preserve the neurovascular bundles (NVB) during robotic laparoscopic radical prostatectomy (LRP). PATIENTS AND METHODS: All men were <66 years of age and had a Sexual Health Inventory in Men (SHIM) score of 22 to 25. They underwent unilateral or bilateral dissections. Group 1 (N = 23), the study group, had preservation of the NVB with CFT. Group 2 (N = 36) had traditional dissection using bipolar cautery. Data were collected prospectively via validated questionnaires. Potency was defined as an erection adequate for vaginal penetration. RESULTS: At 3 months, 10 patients (43%) in the CFT group reported potency versus just 3 (8.3%) in the bipolar-cautery group (P = 0.003). Additionally, only 2 (18%) of those having CFT reported zero penile fullness compared with 15 (68%) in the bipolar-cautery group (P = 0.01). CONCLUSIONS: The technique of controlling the vascular pedicle of the prostate and dissecting the NVB without cautery produced significant improvement in potency outcomes at just 3 months.

Adult↗

PubMed2006

Case report: robot-assisted laparoscopic pyeloureterostomy in a transplanted kidney with ureteral stricture.

Ureteral obstruction secondary to ischemia is the most common urologic complication of kidney transplantation. Although endoscopic management has shown satisfactory short-term success rates, surgical repair is considered the definitive therapy. To our knowledge, this procedure has been performed only through open surgery. We present a minimally invasive approach for reconstruction of a ureteral stricture in a renal transplant patient using the Da Vinci robotic system.

Adult↗

PubMed2006

Prospective evaluation of concomitant lymphadenectomy in robot-assisted radical prostatectomy: preliminary analysis of outcomes.

BACKGROUND AND PURPOSE: Lymph-node staging is important in many patients with prostate cancer, as it influences adjuvant treatment and prognosis. However, lymphadenectomy adds to the operating time, cost, and potential for complications. Herein, we compared the effects of concomitant lymphadenectomy in patients undergoing robot-assisted radical prostatectomy (RARP). PATIENTS AND METHODS: Data were collected prospectively on 145 consecutive RARPs. Patients were evaluated in two groups. Group I was patients who underwent RARP and concomitant lymphadenectomy (LAD)(N = 40), and group II consisted of patients who underwent RARP only (N = 105). Operative time (OT), length of hospital stay (LOS), estimated blood loss (EBL), cost, and complications were compared in the two groups. RESULTS: The mean number of lymph nodes removed per patient in group I was 14.08 (range 9-24). Lymph-node metastases were detected in 2 (5%) of the patients. There were no statistically significant differences in LOS, EBL, OT, operative charges, or hospital charges in the two groups. However, the mean OT increased 9.3% when LAD was performed. At a mean follow-up of 14.8 months (range 3-32 months), 16 complications had been observed in the entire series of patients (11.03%). According to the Clavien system, there were eight grade I complications, seven grade II complications, and one grade III complication. Four complications occurred in group I (10%) and 12 in group II (11.4%). There were no lymphoceles or deep venous thromboses (DVTs) in group I. Cost analysis showed no statistically significant difference between the groups. CONCLUSION: There was no significant impact of concomitant lymphadenectomy on LOS, EBL, charges, or complications when RARP was performed. Although the difference was not statistically significant, the OT will be slightly longer, as an additional procedure is being performed.

Aged↗

PubMed2004

Robotic-assisted laparoscopic pediatric Heller's cardiomyotomy: initial case report.

Achalasia is well documented in the pediatric age group. The treatment is primarily surgical, via the laparoscopic approach. This report describes two cases in which patients underwent successful robotic-assisted laparoscopic Heller's myotomy. The advantages of this novel approach are discussed, with a special emphasis on its applications to the pediatric population.

Adolescent↗

PubMed2006

Robot-assisted cortical-sparing adrenalectomy in a patient with Von Hippel-Lindau disease and bilateral pheochromocytomas separated by 9 years.

Von Hippel-Lindau disease is a heritable syndrome that confers an increased risk of developing various benign and malignant tumors to those with a germline mutation of the tumor suppressor gene. We present a case of a male patient who initially presented at age 9 with headaches, fevers, and fatigue. He was found to have a left pheochromocytoma which was successfully managed with open total adrenalectomy. He presented again at age 18 with a second pheochromocytoma in the right adrenal gland. DNA analysis revealed a de novo Val84Leu mutation in the Von Hippel-Lindau gene, not seen in either parent. The challenge presented was that of balancing the obvious benefits of cortical- sparing adrenalectomy with the risk of tumor recurrence in spared tissue. Ultimately, management consisted of a robot-assisted laparoscopic partial right adrenalectomy with successful preservation of adrenocortical function.

Adolescent↗