Robot-assisted surgery has evolved into a crucial treatment for prostate cancer(PCa).However,from its appearance to today,brain-computer interface,virtual reality,and metaverse have revolutionized the field of robot-a...Robot-assisted surgery has evolved into a crucial treatment for prostate cancer(PCa).However,from its appearance to today,brain-computer interface,virtual reality,and metaverse have revolutionized the field of robot-assisted surgery for PCa,presenting both opportunities and challenges.Especially in the context of contemporary big data and precision medicine,facing the heterogeneity of PCa and the complexity of clinical problems,it still needs to be continuously upgraded and improved.Keeping this in mind,this article summarized the 5 stages of the historical development of robot-assisted surgery for PCa,encompassing the stages of emergence,promotion,development,maturity,and intelligence.Initially,safety concerns were paramount,but subsequent research and engineering advancements have focused on enhancing device efficacy,surgical technology,and achieving precise multi modal treatment.The dominance of da Vinci robot-assisted surgical system has seen this evolution intimately tied to its successive versions.In the future,robot-assisted surgery for PCa will move towards intelligence,promising improved patient outcomes and personalized therapy,alongside formidable challenges.To guide future development,we propose 10 significant prospects spanning clinical,research,engineering,materials,social,and economic domains,envisioning a future era of artificial intelligence in the surgical treatment of PCa.展开更多
Objective:Robot-assisted radical prostatectomy(RARP)requires pneumoperitoneum(Pnp)and a steep head-down position that may disturb respiratory system compliance(Crs)during surgery.Our aim was to compare the effects of ...Objective:Robot-assisted radical prostatectomy(RARP)requires pneumoperitoneum(Pnp)and a steep head-down position that may disturb respiratory system compliance(Crs)during surgery.Our aim was to compare the effects of different degrees of neuromuscular block(NMB)on Crs with the same Pnp pressure during RARP.Methods:One hundred patients who underwent RARP were enrolled and randomly allocated to a deep or moderate NMB group with 50 patients in each group.Rocuronium was administered to both groups:in the moderate NMB group to maintain 1–2 responses to train-of-four(TOF)stimulation;and in the deep NMB group to maintain no response to TOF stimulation and 1–2 responses in the post-tetanic count.Pnp pressure in both groups was 10 mm Hg(1 mm Hg=133.3 Pa).Peak inspiratory pressure(Ppeak),mean pressure(Pmean),Crs,and airway resistance(Raw)were recorded after anesthesia induction and at 0,30,60,and 90 min of Pnp and post-Pnp.Surgical space conditions were evaluated after the procedure on a 4-point scale.Results:Immediately after the Pnp,Ppeak,Pmean,and Raw significantly increased,while Crs decreased and persisted during Pnp in both groups.The results did not significantly differ between the two groups at any of the time points.There was no difference in surgical space conditions between groups.Body movements occurred in 14 cases in the moderate NMB group and in one case in the deep NMB group,and all occurred during obturator lymphadenectomy.A significant difference between the two groups was observed.Conclusions:Under the same Pnp pressure in RARP,deep and moderate NMBs resulted in similar changes in Crs,and in other respiratory mechanics and surgical space conditions.However,deep NMB significantly reduced body movements during surgery.展开更多
We present a definition of general Sobolev spaces with respect to arbitrary measures, Wk,p(Ω,μ) for 1 .≤p≤∞.In [RARP] we proved that these spaces are complete under very light conditions. Now we prove that if we ...We present a definition of general Sobolev spaces with respect to arbitrary measures, Wk,p(Ω,μ) for 1 .≤p≤∞.In [RARP] we proved that these spaces are complete under very light conditions. Now we prove that if we consider certain general types of measures, then Cτ∞(R) is dense in these spaces. As an application to Sobolev orthogonal polynomials, toe study the boundedness of the multiplication operator. This gives an estimation of the zeroes of Sobolev orthogonal polynomials.展开更多
基金supported by the Fundamental Research Funds for the Central Universities(2023SCU12057)the National Natural Science Foundation of China(82373106,82372831,and 32270690).
文摘Robot-assisted surgery has evolved into a crucial treatment for prostate cancer(PCa).However,from its appearance to today,brain-computer interface,virtual reality,and metaverse have revolutionized the field of robot-assisted surgery for PCa,presenting both opportunities and challenges.Especially in the context of contemporary big data and precision medicine,facing the heterogeneity of PCa and the complexity of clinical problems,it still needs to be continuously upgraded and improved.Keeping this in mind,this article summarized the 5 stages of the historical development of robot-assisted surgery for PCa,encompassing the stages of emergence,promotion,development,maturity,and intelligence.Initially,safety concerns were paramount,but subsequent research and engineering advancements have focused on enhancing device efficacy,surgical technology,and achieving precise multi modal treatment.The dominance of da Vinci robot-assisted surgical system has seen this evolution intimately tied to its successive versions.In the future,robot-assisted surgery for PCa will move towards intelligence,promising improved patient outcomes and personalized therapy,alongside formidable challenges.To guide future development,we propose 10 significant prospects spanning clinical,research,engineering,materials,social,and economic domains,envisioning a future era of artificial intelligence in the surgical treatment of PCa.
基金Project supported by the Zhejiang Province Public Welfare Technology Application Research Project(No.LGF20H010006),China。
文摘Objective:Robot-assisted radical prostatectomy(RARP)requires pneumoperitoneum(Pnp)and a steep head-down position that may disturb respiratory system compliance(Crs)during surgery.Our aim was to compare the effects of different degrees of neuromuscular block(NMB)on Crs with the same Pnp pressure during RARP.Methods:One hundred patients who underwent RARP were enrolled and randomly allocated to a deep or moderate NMB group with 50 patients in each group.Rocuronium was administered to both groups:in the moderate NMB group to maintain 1–2 responses to train-of-four(TOF)stimulation;and in the deep NMB group to maintain no response to TOF stimulation and 1–2 responses in the post-tetanic count.Pnp pressure in both groups was 10 mm Hg(1 mm Hg=133.3 Pa).Peak inspiratory pressure(Ppeak),mean pressure(Pmean),Crs,and airway resistance(Raw)were recorded after anesthesia induction and at 0,30,60,and 90 min of Pnp and post-Pnp.Surgical space conditions were evaluated after the procedure on a 4-point scale.Results:Immediately after the Pnp,Ppeak,Pmean,and Raw significantly increased,while Crs decreased and persisted during Pnp in both groups.The results did not significantly differ between the two groups at any of the time points.There was no difference in surgical space conditions between groups.Body movements occurred in 14 cases in the moderate NMB group and in one case in the deep NMB group,and all occurred during obturator lymphadenectomy.A significant difference between the two groups was observed.Conclusions:Under the same Pnp pressure in RARP,deep and moderate NMBs resulted in similar changes in Crs,and in other respiratory mechanics and surgical space conditions.However,deep NMB significantly reduced body movements during surgery.
基金Research Partially Supported by a Grant from DGES (MEC), Spain.
文摘We present a definition of general Sobolev spaces with respect to arbitrary measures, Wk,p(Ω,μ) for 1 .≤p≤∞.In [RARP] we proved that these spaces are complete under very light conditions. Now we prove that if we consider certain general types of measures, then Cτ∞(R) is dense in these spaces. As an application to Sobolev orthogonal polynomials, toe study the boundedness of the multiplication operator. This gives an estimation of the zeroes of Sobolev orthogonal polynomials.
