Malignant tumors located in the infratemporal fossa are rare diseases.When all entities are combined,such tumors account for approximately 0.5%of all head and neck tumors.1 The complex anatomy of this region makes the...Malignant tumors located in the infratemporal fossa are rare diseases.When all entities are combined,such tumors account for approximately 0.5%of all head and neck tumors.1 The complex anatomy of this region makes these tumors difficult to diagnose and treat.Bordered laterally by the zygomatic arch and the mandible and medially by the maxilla and the pterygoid process of the sphenoid bone,this area is located beneath the greater wing of the sphenoid bone.It contains significant structures such as the maxillary artery,the venous pterygoid plexus,the mandibular nerve,and the otic ganglion2.展开更多
OBJECTIVE To evaluate the safety and effectiveness of robot-assisted percutaneous coronary intervention(R-PCI)compared to traditional manual percutaneous coronary intervention(M-PCI).METHODS This prospective,multicent...OBJECTIVE To evaluate the safety and effectiveness of robot-assisted percutaneous coronary intervention(R-PCI)compared to traditional manual percutaneous coronary intervention(M-PCI).METHODS This prospective,multicenter,randomized controlled,non-inferior clinical trial enrolled patients with coronary heart disease who met the inclusion criteria and had indications for elective percutaneous coronary intervention.Participants were randomly assigned to either the R-PCI group or the M-PCI group.Primary endpoints were clinical and technical success rates.Clinical success was defined as visually estimated residual post-percutaneous coronary intervention stenosis<30% with no 30-day major adverse cardiac events.Technical success in the R-PCI group was defined as successful completion of percutaneous coronary intervention using the ETcath200 robot-assisted system,without conversion to M-PCI in the event of a guidewire or balloon/stent catheter that was unable to cross the vessel or was poorly supported by the catheter.Secondary endpoints included total procedure time,percutaneous coronary intervention procedure time,fluoroscopy time,contrast volume,operator radiation exposure,air kerma,and dose-area product.RESULTS The trial enrolled 152 patients(R-PCI:73 patients,M-PCI:79 patients).Lesions were predominantly B2/C type(73.6%).Both groups achieved 100% clinical success rate.No major adverse cardiac events occurred during the 30-day follow-up.The R-PCI group had a technical success rate of 100%.The R-PCI group had longer total procedure and fluoroscopy times,but lower operator radiation exposure.The percutaneous coronary intervention procedure time,contrast volume,air kerma,and dose-area product were similar between the two groups.CONCLUSIONS For certain complex lesions,performing percutaneous coronary intervention using the ETcath200 robot-assisted system is safe and effective and does not result in conversion to M-PCI.展开更多
Dear Editor,Radical cystectomy(RC)remains the standard treatment for muscle-invasive bladder cancer[1].However,urinary diversion after RC can lead to a range of postoperative complications,including parastomal hernia,...Dear Editor,Radical cystectomy(RC)remains the standard treatment for muscle-invasive bladder cancer[1].However,urinary diversion after RC can lead to a range of postoperative complications,including parastomal hernia,incontinence,urinary retention,recurrent urinary tract infections,and metabolic disorders,significantly impacting patients'quality of life[2].Partial cystectomy(PC)is a bladdersparing alternative for patients who cannot accept RC and has been utilized in managing muscle-invasive bladder cancer since the last century.However,the application of PC has always been a subject of controversy in clinical practice due to the high recurrence rate.In a matched case-control analysis conducted by Knoedler et al.[3],38%of the patients experienced intravesical tumor recurrence,and 19%of the patients ultimately underwent RC.Another study in the Memorial Sloan-Kettering Cancer Center showed that 22 of 58 patients who received PC experienced superficial or advanced recurrence[4].展开更多
Dear Editor,Robotic-assisted laparoscopic varicocelectomy(RALV)has been recently described in the pediatric field[1].Although the learning curve of surgical procedures is flattened by a robotic approach[2],complicatio...Dear Editor,Robotic-assisted laparoscopic varicocelectomy(RALV)has been recently described in the pediatric field[1].Although the learning curve of surgical procedures is flattened by a robotic approach[2],complications may occur especially at the beginning of experience.We herein describe an unexpected severe case of parietal blood dripping in a boy who underwent RALV.The study was approved by the institutional review board of Federico Il University Hospital in Naples,Italy(approval number:Fll/2024-PL149).All procedures performed were in accordance with the ethical standards of the institution and/or national research committee.The written informed consent was obtained by his parents to agree the treatment and publish this paper.展开更多
Approximately 5%of patients with renal cancer present with synchronous bilateral renal masses(SBRM).1,2 Bilateral renal tumors associated with hereditary syndromes often exhibit more aggressive biological behaviors co...Approximately 5%of patients with renal cancer present with synchronous bilateral renal masses(SBRM).1,2 Bilateral renal tumors associated with hereditary syndromes often exhibit more aggressive biological behaviors compared to sporadic SBRM cases.3,4 Notably,the prognosis for sporadic cases,in terms of cancerspecific and distant metastasis-free survival,is comparable to that of unilateral renal masses.展开更多
1.Introduction Due to the continuous progress in surgical methodologies and the swift evolution of surgical tools,minimally invasive procedures have emerged as the dominant approach in urologic oncology surgeries.Nota...1.Introduction Due to the continuous progress in surgical methodologies and the swift evolution of surgical tools,minimally invasive procedures have emerged as the dominant approach in urologic oncology surgeries.Notably,robot-assisted surgery(RAS)has led to its extensive adoption in the surgical management of urinary system tumors due to its enhanced maneuverability,precision in suturing,and anastomotic capabilities.展开更多
Segmentation of demonstration trajectories and learning the contained motion primitives can effectively enhance the assistive robot's intelligence to flexibly reproduce learnt tasks in an unstructured environment....Segmentation of demonstration trajectories and learning the contained motion primitives can effectively enhance the assistive robot's intelligence to flexibly reproduce learnt tasks in an unstructured environment.With the aim to conveniently and accurately segment demonstration trajectories,a novel demonstration trajectory segmentation approach is proposed based on the beta process autoregressive hidden Markov model(BP-ARHMM)algorithm and generalised time warping(GTW)algorithm aiming to enhance the segmentation accuracy utilising acquired demonstration data.This approach first adopts the GTW algorithm to align the multiple demonstration trajectories for the same task.Then,it adopts the BP-AR-HMM algorithm to segment the demonstration trajectories,acquire the contained motion primitives,and establish the related task library.This segmentation approach is validated on the 6-degree-of-freedom JACO robotic arm by assisting users to accomplish a holding water glass task and an eating task.The experimental results show that the motion primitives within the trajectories can be correctly segmented with a high segmentation accuracy.展开更多
Objective:To investigate the effects of prostate cancer(PCa)surgery on the stress system and to identify potential independent factors associating with stress recovery.Methods:The design of the study was prospective a...Objective:To investigate the effects of prostate cancer(PCa)surgery on the stress system and to identify potential independent factors associating with stress recovery.Methods:The design of the study was prospective and PCa surgery included robot assisted radical prostatectomy(RARP)or retropubic radical prostatectomy(RRP).Between February 2013 to December 2014,315 consecutive patients were evaluated.The effects of PCa surgery on the stress system were measured by cortisol serum levels before and after surgery on postoperative day(POD)0,1,3,5 and 45.Cortisol variations in the population and subpopulation(RARP vs.RRP)of patients were investigated by statistical methods.Factors associating with stress recovery were assessed by simple linear regression(SLR)and multiple linear regression(MLR)analysis.Results:RARP was performed in 75.9%of cases.In the patient population,there were wide serum cortisol perioperative variations.PCa surgery triggered the stress system which immediately(POD 0)responded by cortisol overproduction which induced the negative feedback mechanism that started on POD 1,continued on POD 3,was still ongoing on POD 5 and completely settled on POD 45(stress recovery).In the subpopulation of patients,significantly lower cortisol serum levels were detected on POD 3e5 in RARP cases inwhomcortisol levels were close to preoperative levels(stress recovery)on POD 5.Independent predictive factors of serum cortisol on POD 5(stress recovery)were preoperative cortisol(p Z 0.02),cortisol levels on POD 3(p<0.0001)and RARP(p Z 0.03)in which the association was negative(stress recovery faster than RRP).Conclusion:Our study shows that PCa surgery immediately(POD 0)triggers the stress system which respond by overproduction of cortisol which induces the negative feedback mechanism that starts on POD 1,is still ongoing on POD 5,but is completely settled on POD 45.Moreover,after surgical trauma,our study gives evidence that the RARP procedure associates with stress recovery faster than RRP.Further confirmatory studies are required.展开更多
Objective: to study the practical value of rapid rehabilitation nursing for patients undergoing radical prostatectomy. Methods: the control group received routine nursing. The rehabilitation group received rapid rehab...Objective: to study the practical value of rapid rehabilitation nursing for patients undergoing radical prostatectomy. Methods: the control group received routine nursing. The rehabilitation group received rapid rehabilitation nursing. Results: all indexes of rehabilitation group were better than those of control group (P<0.05). Conclusion: rapid rehabilitation nursing has better nursing effect. It is suggested to use it for reference in nursing work.展开更多
The introduction of the operative microscope for andrological surgery in the 1970s provided enhanced magnification and accuracy, unparalleled to any previous visual loop or magnification techniques. This technology re...The introduction of the operative microscope for andrological surgery in the 1970s provided enhanced magnification and accuracy, unparalleled to any previous visual loop or magnification techniques. This technology revolutionized techniques for microsurgery in andrology. Today, we may be on the verge of a second such revolution by the incorporation of robotic assisted platforms for microsurgery in andrology. Robotic assisted microsurgery is being utilized to a greater degree in andrology and a number of other microsurgical fields, such as ophthalmology, hand surgery, plastics and reconstructive surgery. The potential advantages of robotic assisted platforms include elimination of tremor, improved stability, surgeon ergonomics, scalability of motion, multi-input visual interphases with up to three simultaneous visual views, enhanced magnification, and the ability to manipulate three surgical instruments and cameras simultaneously. This review paper begins with the historical development of robotic microsurgery. It then provides an in-depth presentation of the technique and outcomes of common robotic microsurgical andrological procedures, such as vasectomy reversal, subinguinal varicocelectomy, targeted spermatic cord denervation （for chronic orchialgia） and robotic assisted microsurgical testicular sperm extraction （microTESE）.展开更多
Objective:Despite a multitude of minimally invasive surgical options available for benign prostatic enlargement,open simple prostatectomy(OSP)remains the standard for large prostates(typically greater than 100 g).OSP,...Objective:Despite a multitude of minimally invasive surgical options available for benign prostatic enlargement,open simple prostatectomy(OSP)remains the standard for large prostates(typically greater than 100 g).OSP,however,is associated with significant morbidity.Recently,a few reports touting robotic application to simple prostatectomy have been published.Herein,we reviewed our series of robotic assisted laparoscopic simple suprapubic prostatectomy(RALSSP)and detailed modifications in our technique as our experience increased.Methods:All RALSSP cases performed between January 2013 and January 2014 were reviewed for demographics,pre-operative features,and perioperative outcomes.All parameters were tabulated and mean values were calculated.Student’s t-test was utilized with p<0.05 deemed significant.Details regarding surgical technique were reviewed and highlighted.Results:Fifteen patients underwent RALSSP during this period.Mean age of these men was 68.7 years.Mean body mass index(BMI)was 28.5 kg/m^2.American Society of Anesthesiologists(ASA)score was on average 2.6.Average International Prostate Symptom Score(IPSS)was 16.2 with the majority of men experiencing some adverse clinical sequela of such benign prostatic hyperplasia(BPH).For those patients not in retention,preoperative post-void residual(PVR)was 428 mL.All patients underwent successful RALSSP without need for conversion or need for blood transfusion.Mean estimated blood loss(EBL)was 290 mL.Five patients underwent other concurrent procedures(e.g.,cystolithotomy).Mean length of hospital stay(LOS)was 2.4 days and only five patients required continuous bladder irrigation(CBI)postoperatively.Postoperative PVR improved to a mean of 33 mL and IPSS improved to 4.5(p<0.001).No major complications were identified.Adaptation of low transverse cystotomy,utilization of a robotic tenaculum in the#3 arm with its control by a surgeon on a second console,and the utilization of mucosal advancement have all subjectively aided in performance of RALSSP and perioperative outcomes.Conclusion:RALSSP allows for feasible performance of prostate adenoma enucleation with low risk of blood transfusion,short LOS,and significant improvement in IPSS and PVR;all while maintaining a minimally invasive approach.The use of a robotic tenaculum controlled by the secondary console and the mucosal advancement facilitate excellent outcomes and may play a role in minimizing hematuria and need for CBI.展开更多
Physical assistive robotics are oriented to support and improve functional capacities of people.In physical rehabilitation,robots are indeed useful for functional recovery of affected limb.However,there are still open...Physical assistive robotics are oriented to support and improve functional capacities of people.In physical rehabilitation,robots are indeed useful for functional recovery of affected limb.However,there are still open questions related to technological aspects.This work presents a systematic review of upper limb rehabilitation robotics in order to analyze and establish technological challenges and future directions in this area.A bibliometric analysis was performed for the systematic literature review.Literature from the last six years,conducted between August 2020 and May 2021,was reviewed.The methodology for the literature search and a bibliometric analysis of the metadata are presented.After a preliminary search resulted in 820 articles,a total of 66 articles were included.A concurrency network and bibliographic analysis were provided.And an analysis of occurrences,taxonomy,and rehabilitation robotics reported in the literature is presented.This review aims to provide to the scientific community an overview of the state of the art in assistive robotics for upper limb physical rehabilitation.The literature analysis allows access to a gap of unexplored options to define the technological prospects applied to upper limb physical rehabilitation robotics.展开更多
BACKGROUND‘Splenosis’is defined as the autotransplantation of splenic tissue following trauma or surgery,usually in the form of intraperitoneal nodules.The proliferation of imaging techniques has resulted in increas...BACKGROUND‘Splenosis’is defined as the autotransplantation of splenic tissue following trauma or surgery,usually in the form of intraperitoneal nodules.The proliferation of imaging techniques has resulted in increased unexpected discoveries of splenosis nodules,and achieving a differential diagnosis can be challenging.Nuclear medicine studies have been playing an increasingly important role in this process,but the clinical significance of asymptomatic nodules remains uncertain.CASE SUMMARY We present a case of pelvic splenosis in a 73-year-old man diagnosed 56 years after a splenectomy during a computed tomography(CT)follow-up for B-cell lymphoma,presenting intense contrast enhancement of an 18 mm nodule in the right recto-vesical space.18F-fluorodeoxyglucose demonstrated weak metabolic activity.Since histological diagnosis was deemed necessary,the nodule was easily removed with robotically assisted laparoscopy,together with another 6 mm left a paracolic lesion.The latter was previously undiagnosed but retrospectively visible on the CT scan.CONCLUSION In a patient requiring differential diagnosis of splenosis nodules from lymphomarecurrence, the robotic approach provided a safe en bloc removal with shorthospitalization. The Da Vinci Xi robot was particularly helpful because its opticscan be introduced from all ports, facilitating visualization and lysis of multipleintra-abdominal adhesions.展开更多
Bone connection with robot is an important topic in the research of robot assisted fracture reduction surgery.With the method to achieve bone-robot connection in current robots,requirements on reliability and low trau...Bone connection with robot is an important topic in the research of robot assisted fracture reduction surgery.With the method to achieve bone-robot connection in current robots,requirements on reliability and low trauma can not be satisfied at the same time.In this paper,the design,manufacturing,and experiments of a novel Bone Connection Robotic Hand(BCRH)with variable stiffness capability are carried out through the bionics research on human hand and the principle of particle jamming.BCRH’s variable stiffness characteristic is a special connection between“hard connection”and“soft connection”,which is different from the existing researches.It maximizes the reliability of bone-robot connection while minimizes trauma,meets the axial load requirement in clinical practice,and effectively shortens the operating time to less than 40 s(for mode 1)or 2 min(for mode 2).Meanwhile,a theoretical analysis of bone-robot connection failure based on particle jamming is carried out to provide references for the research in this paper and other related studies.展开更多
What will our life be like in the future?With the development of science and technology,our life will get better and much more colorful.I think there must be great changes taking place in the future.Maybe cars will mo...What will our life be like in the future?With the development of science and technology,our life will get better and much more colorful.I think there must be great changes taking place in the future.Maybe cars will move on the way without drivers.Some cities will be built under the sea and humans will live with sea animals.Robots will help us cook food and do some cleaning.展开更多
To the Editor:Recently,a novel robotic surgical platform,the KangDuo surgical robot(KD-SR),has emerged in China.As depicted in Supplementary Figure 1,http://links.lww.com/CM9/C379,the KD-SR-01 system integrates an ope...To the Editor:Recently,a novel robotic surgical platform,the KangDuo surgical robot(KD-SR),has emerged in China.As depicted in Supplementary Figure 1,http://links.lww.com/CM9/C379,the KD-SR-01 system integrates an open vision system,which not only enables a natural posture for surgeons and mitigates potential neck strain,but also enhances effective communication between the primary surgeon and their assistant.Previous studies have demonstrated encouraging outcomes of this novel robotic surgical system in certain instances.展开更多
Using robotic devices might improve recovery post-stroke, but the optimal way to apply robotic assistance has yet to be determined. The current study aimed to investigate whether training under the robotic active-assi...Using robotic devices might improve recovery post-stroke, but the optimal way to apply robotic assistance has yet to be determined. The current study aimed to investigate whether training under the robotic active-assisted mode improves bimanual motor skill learning(biMSkL) more than training under the active mode in stroke patients. Twenty-six healthy individuals(HI) and 23 chronic hemiparetic stroke patients with a detectable lesion on MRI or CT scan, who demonstrated motor deficits in the upper limb, were randomly allocated to two parallel groups. The protocol included a two-day training on a new bimanual cooperative task, LIFT-THE-TRAY, under either the active or activeassisted modes(where assistance decreased in a pre-determined stepwise fashion) with the bimanual version of the REAplan? robotic device. The hypothesis was that the active-assisted mode would result in greater biMSkL than the active mode. The biMSkL was quantified by a speed-accuracy trade-off(SAT) before(T1) and immediately after(T2) training on days 1 and 2(T3 and T4). The change in SAT after 2 days of training(T4/T1) indicated that both HI and stroke patients learned and retained the bimanual cooperative task. After 2 days of training, the active-assisted mode did not improve biMSkL more than the active mode(T4/T1) in HI nor stroke patients. Whereas HI generalized the learned bimanual skill to different execution speeds in both the active and active-assisted subgroups, the stroke patients generalized the learned skill only in the active subgroup. Taken together, the active-assisted mode, applied in a pre-determined stepwise decreasing fashion, did not improve biMSkL more than the active mode in HI and stroke subjects. Stroke subjects might benefit more from robotic assistance when applied "as-needed." This study was approved by the local ethical committee(Comité d'éthique médicale, CHU UCL Namur, MontGodinne, Yvoir, Belgium;Internal number: 54/2010, Eudra CT number: NUB B039201317382) on July 14, 2016 and was registered with ClinicalTrials.gov(Identifier: NCT03974750) on June 5, 2019.展开更多
Micro incision vitrectomy system(MIVS)is considered to be one of the most difficult tasks of eye surgery,due to its requirements of high accuracy and delicate operation under blurred vision environment.Therefore,robot...Micro incision vitrectomy system(MIVS)is considered to be one of the most difficult tasks of eye surgery,due to its requirements of high accuracy and delicate operation under blurred vision environment.Therefore,robot-assisted ophthalmic surgery is a potential and efficient solution.Based on that consideration,a novel master-slave system for vitreoretinal surgery is realized.A 4-DOF remote center of motion(RCM)mechanism with a novel linear stage and end-effector is designed and the master-slave control system is implemented.The forward and inverse kinematics are analyzed for the controller implementation.Then,algorithms with motion scaling are also integrated into the control architecture for the purpose to enhance the surgeon’s operation accuracy.Finally,experiments on an eye model are conducted.The results show that the eye robotic system can fulfill surgeon’s motion following and simulate operation of vitrectomy,demonstrating the feasibility of this system.展开更多
China is rapidly becoming an aging society, leading to a significant demand for chronic disease management and personalized healthcare. The development of rehabilitation and assistive robotics in China has gatheredsign...China is rapidly becoming an aging society, leading to a significant demand for chronic disease management and personalized healthcare. The development of rehabilitation and assistive robotics in China has gatheredsignificant attention not only in research fields but also in industries. Such robots aim to either guide patientsin completing therapeutic training or assist people with impaired functions in performing their daily activities.In the past decades, we have witnessed the advancement in rehabilitation and assistive robotics, with diversemechanical designs, functionalities, and purposes. However, the construction of dedicated regulations and policiesis relatively lagged compared with the flourishing development in research fields. Moreover, these kinds of robotsare working or collaborating closely with human beings, bringing unprecedented considerations on ethical issues.This paper aims to provide an overview of major dilemmas in the development of rehabilitation and assistiverobotics in China and propose several potential solutions.展开更多
Innovation Driving Transformation:The year 2024 marked a critical juncture for robotics,particularly in the realm of medical applications.As highlighted in this issue,innovations such as robot-assisted embolization te...Innovation Driving Transformation:The year 2024 marked a critical juncture for robotics,particularly in the realm of medical applications.As highlighted in this issue,innovations such as robot-assisted embolization technologies and bio-integrated microrobots(BIMs)[1]are transitioning from experimental prototypes to clinical solutions,promising to revolutionize minimally invasive procedures.The medical robotics market is projected to grow at a compound annual growth rate(CAGR)of 16.20%[2],underscoring the urgency for robust ethical frameworks and international standards.SmartBot is committed to addressing these challenges by fostering dialogue between researchers,policymakers,and industry leaders(Figure 1).展开更多
文摘Malignant tumors located in the infratemporal fossa are rare diseases.When all entities are combined,such tumors account for approximately 0.5%of all head and neck tumors.1 The complex anatomy of this region makes these tumors difficult to diagnose and treat.Bordered laterally by the zygomatic arch and the mandible and medially by the maxilla and the pterygoid process of the sphenoid bone,this area is located beneath the greater wing of the sphenoid bone.It contains significant structures such as the maxillary artery,the venous pterygoid plexus,the mandibular nerve,and the otic ganglion2.
基金supported by the National Key Research and Development Program of China(No.2022YFC3602500)Beijing High-level Public Health Technical Talents Construction Project(Discipline Leader-03-24)Beijing Hospitals Authority’s Ascent Plan(DFL20240601).
文摘OBJECTIVE To evaluate the safety and effectiveness of robot-assisted percutaneous coronary intervention(R-PCI)compared to traditional manual percutaneous coronary intervention(M-PCI).METHODS This prospective,multicenter,randomized controlled,non-inferior clinical trial enrolled patients with coronary heart disease who met the inclusion criteria and had indications for elective percutaneous coronary intervention.Participants were randomly assigned to either the R-PCI group or the M-PCI group.Primary endpoints were clinical and technical success rates.Clinical success was defined as visually estimated residual post-percutaneous coronary intervention stenosis<30% with no 30-day major adverse cardiac events.Technical success in the R-PCI group was defined as successful completion of percutaneous coronary intervention using the ETcath200 robot-assisted system,without conversion to M-PCI in the event of a guidewire or balloon/stent catheter that was unable to cross the vessel or was poorly supported by the catheter.Secondary endpoints included total procedure time,percutaneous coronary intervention procedure time,fluoroscopy time,contrast volume,operator radiation exposure,air kerma,and dose-area product.RESULTS The trial enrolled 152 patients(R-PCI:73 patients,M-PCI:79 patients).Lesions were predominantly B2/C type(73.6%).Both groups achieved 100% clinical success rate.No major adverse cardiac events occurred during the 30-day follow-up.The R-PCI group had a technical success rate of 100%.The R-PCI group had longer total procedure and fluoroscopy times,but lower operator radiation exposure.The percutaneous coronary intervention procedure time,contrast volume,air kerma,and dose-area product were similar between the two groups.CONCLUSIONS For certain complex lesions,performing percutaneous coronary intervention using the ETcath200 robot-assisted system is safe and effective and does not result in conversion to M-PCI.
基金supported by Natural Science Foundation of Hubei Province(ZRMS2020002466 to Liu Z).
文摘Dear Editor,Radical cystectomy(RC)remains the standard treatment for muscle-invasive bladder cancer[1].However,urinary diversion after RC can lead to a range of postoperative complications,including parastomal hernia,incontinence,urinary retention,recurrent urinary tract infections,and metabolic disorders,significantly impacting patients'quality of life[2].Partial cystectomy(PC)is a bladdersparing alternative for patients who cannot accept RC and has been utilized in managing muscle-invasive bladder cancer since the last century.However,the application of PC has always been a subject of controversy in clinical practice due to the high recurrence rate.In a matched case-control analysis conducted by Knoedler et al.[3],38%of the patients experienced intravesical tumor recurrence,and 19%of the patients ultimately underwent RC.Another study in the Memorial Sloan-Kettering Cancer Center showed that 22 of 58 patients who received PC experienced superficial or advanced recurrence[4].
文摘Dear Editor,Robotic-assisted laparoscopic varicocelectomy(RALV)has been recently described in the pediatric field[1].Although the learning curve of surgical procedures is flattened by a robotic approach[2],complications may occur especially at the beginning of experience.We herein describe an unexpected severe case of parietal blood dripping in a boy who underwent RALV.The study was approved by the institutional review board of Federico Il University Hospital in Naples,Italy(approval number:Fll/2024-PL149).All procedures performed were in accordance with the ethical standards of the institution and/or national research committee.The written informed consent was obtained by his parents to agree the treatment and publish this paper.
文摘Approximately 5%of patients with renal cancer present with synchronous bilateral renal masses(SBRM).1,2 Bilateral renal tumors associated with hereditary syndromes often exhibit more aggressive biological behaviors compared to sporadic SBRM cases.3,4 Notably,the prognosis for sporadic cases,in terms of cancerspecific and distant metastasis-free survival,is comparable to that of unilateral renal masses.
基金supported by grants from the National Natural Science Foundation of China(No.82172741 to Ye D)Shanghai Municipal Health Bureau(No.2020CXJQ03 to Ye D)Xuhui District Hospital Local Cooperation Project(No.23XHYD-14 to Ye D).
文摘1.Introduction Due to the continuous progress in surgical methodologies and the swift evolution of surgical tools,minimally invasive procedures have emerged as the dominant approach in urologic oncology surgeries.Notably,robot-assisted surgery(RAS)has led to its extensive adoption in the surgical management of urinary system tumors due to its enhanced maneuverability,precision in suturing,and anastomotic capabilities.
基金Doctoral Research Start-up Fund of Shandong Jiaotong University,Grant/Award Number:BS2024009Natural Science Foundation of Shandong Province of China,Grant/Award Number:ZR2022ME087+1 种基金State Key Laboratory of Robotics and Systems(HIT),Grant/Award Number:SKLRS-2024-KF-09Open Access Publication Fund of Universität Hamburg。
文摘Segmentation of demonstration trajectories and learning the contained motion primitives can effectively enhance the assistive robot's intelligence to flexibly reproduce learnt tasks in an unstructured environment.With the aim to conveniently and accurately segment demonstration trajectories,a novel demonstration trajectory segmentation approach is proposed based on the beta process autoregressive hidden Markov model(BP-ARHMM)algorithm and generalised time warping(GTW)algorithm aiming to enhance the segmentation accuracy utilising acquired demonstration data.This approach first adopts the GTW algorithm to align the multiple demonstration trajectories for the same task.Then,it adopts the BP-AR-HMM algorithm to segment the demonstration trajectories,acquire the contained motion primitives,and establish the related task library.This segmentation approach is validated on the 6-degree-of-freedom JACO robotic arm by assisting users to accomplish a holding water glass task and an eating task.The experimental results show that the motion primitives within the trajectories can be correctly segmented with a high segmentation accuracy.
文摘Objective:To investigate the effects of prostate cancer(PCa)surgery on the stress system and to identify potential independent factors associating with stress recovery.Methods:The design of the study was prospective and PCa surgery included robot assisted radical prostatectomy(RARP)or retropubic radical prostatectomy(RRP).Between February 2013 to December 2014,315 consecutive patients were evaluated.The effects of PCa surgery on the stress system were measured by cortisol serum levels before and after surgery on postoperative day(POD)0,1,3,5 and 45.Cortisol variations in the population and subpopulation(RARP vs.RRP)of patients were investigated by statistical methods.Factors associating with stress recovery were assessed by simple linear regression(SLR)and multiple linear regression(MLR)analysis.Results:RARP was performed in 75.9%of cases.In the patient population,there were wide serum cortisol perioperative variations.PCa surgery triggered the stress system which immediately(POD 0)responded by cortisol overproduction which induced the negative feedback mechanism that started on POD 1,continued on POD 3,was still ongoing on POD 5 and completely settled on POD 45(stress recovery).In the subpopulation of patients,significantly lower cortisol serum levels were detected on POD 3e5 in RARP cases inwhomcortisol levels were close to preoperative levels(stress recovery)on POD 5.Independent predictive factors of serum cortisol on POD 5(stress recovery)were preoperative cortisol(p Z 0.02),cortisol levels on POD 3(p<0.0001)and RARP(p Z 0.03)in which the association was negative(stress recovery faster than RRP).Conclusion:Our study shows that PCa surgery immediately(POD 0)triggers the stress system which respond by overproduction of cortisol which induces the negative feedback mechanism that starts on POD 1,is still ongoing on POD 5,but is completely settled on POD 45.Moreover,after surgical trauma,our study gives evidence that the RARP procedure associates with stress recovery faster than RRP.Further confirmatory studies are required.
文摘Objective: to study the practical value of rapid rehabilitation nursing for patients undergoing radical prostatectomy. Methods: the control group received routine nursing. The rehabilitation group received rapid rehabilitation nursing. Results: all indexes of rehabilitation group were better than those of control group (P<0.05). Conclusion: rapid rehabilitation nursing has better nursing effect. It is suggested to use it for reference in nursing work.
文摘The introduction of the operative microscope for andrological surgery in the 1970s provided enhanced magnification and accuracy, unparalleled to any previous visual loop or magnification techniques. This technology revolutionized techniques for microsurgery in andrology. Today, we may be on the verge of a second such revolution by the incorporation of robotic assisted platforms for microsurgery in andrology. Robotic assisted microsurgery is being utilized to a greater degree in andrology and a number of other microsurgical fields, such as ophthalmology, hand surgery, plastics and reconstructive surgery. The potential advantages of robotic assisted platforms include elimination of tremor, improved stability, surgeon ergonomics, scalability of motion, multi-input visual interphases with up to three simultaneous visual views, enhanced magnification, and the ability to manipulate three surgical instruments and cameras simultaneously. This review paper begins with the historical development of robotic microsurgery. It then provides an in-depth presentation of the technique and outcomes of common robotic microsurgical andrological procedures, such as vasectomy reversal, subinguinal varicocelectomy, targeted spermatic cord denervation （for chronic orchialgia） and robotic assisted microsurgical testicular sperm extraction （microTESE）.
文摘Objective:Despite a multitude of minimally invasive surgical options available for benign prostatic enlargement,open simple prostatectomy(OSP)remains the standard for large prostates(typically greater than 100 g).OSP,however,is associated with significant morbidity.Recently,a few reports touting robotic application to simple prostatectomy have been published.Herein,we reviewed our series of robotic assisted laparoscopic simple suprapubic prostatectomy(RALSSP)and detailed modifications in our technique as our experience increased.Methods:All RALSSP cases performed between January 2013 and January 2014 were reviewed for demographics,pre-operative features,and perioperative outcomes.All parameters were tabulated and mean values were calculated.Student’s t-test was utilized with p<0.05 deemed significant.Details regarding surgical technique were reviewed and highlighted.Results:Fifteen patients underwent RALSSP during this period.Mean age of these men was 68.7 years.Mean body mass index(BMI)was 28.5 kg/m^2.American Society of Anesthesiologists(ASA)score was on average 2.6.Average International Prostate Symptom Score(IPSS)was 16.2 with the majority of men experiencing some adverse clinical sequela of such benign prostatic hyperplasia(BPH).For those patients not in retention,preoperative post-void residual(PVR)was 428 mL.All patients underwent successful RALSSP without need for conversion or need for blood transfusion.Mean estimated blood loss(EBL)was 290 mL.Five patients underwent other concurrent procedures(e.g.,cystolithotomy).Mean length of hospital stay(LOS)was 2.4 days and only five patients required continuous bladder irrigation(CBI)postoperatively.Postoperative PVR improved to a mean of 33 mL and IPSS improved to 4.5(p<0.001).No major complications were identified.Adaptation of low transverse cystotomy,utilization of a robotic tenaculum in the#3 arm with its control by a surgeon on a second console,and the utilization of mucosal advancement have all subjectively aided in performance of RALSSP and perioperative outcomes.Conclusion:RALSSP allows for feasible performance of prostate adenoma enucleation with low risk of blood transfusion,short LOS,and significant improvement in IPSS and PVR;all while maintaining a minimally invasive approach.The use of a robotic tenaculum controlled by the secondary console and the mucosal advancement facilitate excellent outcomes and may play a role in minimizing hematuria and need for CBI.
基金Supported by Militar Nueva Granada University of Colombia (Grant No.IMP-ING-3127)。
文摘Physical assistive robotics are oriented to support and improve functional capacities of people.In physical rehabilitation,robots are indeed useful for functional recovery of affected limb.However,there are still open questions related to technological aspects.This work presents a systematic review of upper limb rehabilitation robotics in order to analyze and establish technological challenges and future directions in this area.A bibliometric analysis was performed for the systematic literature review.Literature from the last six years,conducted between August 2020 and May 2021,was reviewed.The methodology for the literature search and a bibliometric analysis of the metadata are presented.After a preliminary search resulted in 820 articles,a total of 66 articles were included.A concurrency network and bibliographic analysis were provided.And an analysis of occurrences,taxonomy,and rehabilitation robotics reported in the literature is presented.This review aims to provide to the scientific community an overview of the state of the art in assistive robotics for upper limb physical rehabilitation.The literature analysis allows access to a gap of unexplored options to define the technological prospects applied to upper limb physical rehabilitation robotics.
文摘BACKGROUND‘Splenosis’is defined as the autotransplantation of splenic tissue following trauma or surgery,usually in the form of intraperitoneal nodules.The proliferation of imaging techniques has resulted in increased unexpected discoveries of splenosis nodules,and achieving a differential diagnosis can be challenging.Nuclear medicine studies have been playing an increasingly important role in this process,but the clinical significance of asymptomatic nodules remains uncertain.CASE SUMMARY We present a case of pelvic splenosis in a 73-year-old man diagnosed 56 years after a splenectomy during a computed tomography(CT)follow-up for B-cell lymphoma,presenting intense contrast enhancement of an 18 mm nodule in the right recto-vesical space.18F-fluorodeoxyglucose demonstrated weak metabolic activity.Since histological diagnosis was deemed necessary,the nodule was easily removed with robotically assisted laparoscopy,together with another 6 mm left a paracolic lesion.The latter was previously undiagnosed but retrospectively visible on the CT scan.CONCLUSION In a patient requiring differential diagnosis of splenosis nodules from lymphomarecurrence, the robotic approach provided a safe en bloc removal with shorthospitalization. The Da Vinci Xi robot was particularly helpful because its opticscan be introduced from all ports, facilitating visualization and lysis of multipleintra-abdominal adhesions.
基金This research was supported by the National Natural Science Foundation of China(Grant Nos.51975070,62003060 and 52075051)the National Key Research and Development Program of China(Grant No.2020YFB1313000).
文摘Bone connection with robot is an important topic in the research of robot assisted fracture reduction surgery.With the method to achieve bone-robot connection in current robots,requirements on reliability and low trauma can not be satisfied at the same time.In this paper,the design,manufacturing,and experiments of a novel Bone Connection Robotic Hand(BCRH)with variable stiffness capability are carried out through the bionics research on human hand and the principle of particle jamming.BCRH’s variable stiffness characteristic is a special connection between“hard connection”and“soft connection”,which is different from the existing researches.It maximizes the reliability of bone-robot connection while minimizes trauma,meets the axial load requirement in clinical practice,and effectively shortens the operating time to less than 40 s(for mode 1)or 2 min(for mode 2).Meanwhile,a theoretical analysis of bone-robot connection failure based on particle jamming is carried out to provide references for the research in this paper and other related studies.
文摘What will our life be like in the future?With the development of science and technology,our life will get better and much more colorful.I think there must be great changes taking place in the future.Maybe cars will move on the way without drivers.Some cities will be built under the sea and humans will live with sea animals.Robots will help us cook food and do some cleaning.
基金This work was supported by the National Natural Science Foundation of China(No.62276084)the National Natural Science Foundation of China(No.U23A20482).
文摘To the Editor:Recently,a novel robotic surgical platform,the KangDuo surgical robot(KD-SR),has emerged in China.As depicted in Supplementary Figure 1,http://links.lww.com/CM9/C379,the KD-SR-01 system integrates an open vision system,which not only enables a natural posture for surgeons and mitigates potential neck strain,but also enhances effective communication between the primary surgeon and their assistant.Previous studies have demonstrated encouraging outcomes of this novel robotic surgical system in certain instances.
基金supported by the following grants Fonds de la Recherche Scientifique–FNRS 1.R.506.161.R.506.18&1.R.506.20+8 种基金Fonds de la Recherche Scientifique Médicale(FRSM)3.4.525.08.FFonds Spécial de Recherche(FSR)from the UCLouvainFondation Van Goethem-BrichantFondation Mont-Godinnesupported by the following grants FRNS-FRIA n°F3/5/5-MCF/ROI/BC-19727 and F3/5/5-MCF/XH/FC-17514Fondation Mont-Godinne 2018supported by grants from the Fondation Mont-Godinne 2015-2016Fonds Spécial de Recherche(FSR)of the UCLouvain 2016-2018Fondation Roi Baudouin/Fonds Amélie 2018-2019。
文摘Using robotic devices might improve recovery post-stroke, but the optimal way to apply robotic assistance has yet to be determined. The current study aimed to investigate whether training under the robotic active-assisted mode improves bimanual motor skill learning(biMSkL) more than training under the active mode in stroke patients. Twenty-six healthy individuals(HI) and 23 chronic hemiparetic stroke patients with a detectable lesion on MRI or CT scan, who demonstrated motor deficits in the upper limb, were randomly allocated to two parallel groups. The protocol included a two-day training on a new bimanual cooperative task, LIFT-THE-TRAY, under either the active or activeassisted modes(where assistance decreased in a pre-determined stepwise fashion) with the bimanual version of the REAplan? robotic device. The hypothesis was that the active-assisted mode would result in greater biMSkL than the active mode. The biMSkL was quantified by a speed-accuracy trade-off(SAT) before(T1) and immediately after(T2) training on days 1 and 2(T3 and T4). The change in SAT after 2 days of training(T4/T1) indicated that both HI and stroke patients learned and retained the bimanual cooperative task. After 2 days of training, the active-assisted mode did not improve biMSkL more than the active mode(T4/T1) in HI nor stroke patients. Whereas HI generalized the learned bimanual skill to different execution speeds in both the active and active-assisted subgroups, the stroke patients generalized the learned skill only in the active subgroup. Taken together, the active-assisted mode, applied in a pre-determined stepwise decreasing fashion, did not improve biMSkL more than the active mode in HI and stroke subjects. Stroke subjects might benefit more from robotic assistance when applied "as-needed." This study was approved by the local ethical committee(Comité d'éthique médicale, CHU UCL Namur, MontGodinne, Yvoir, Belgium;Internal number: 54/2010, Eudra CT number: NUB B039201317382) on July 14, 2016 and was registered with ClinicalTrials.gov(Identifier: NCT03974750) on June 5, 2019.
基金the National Natural Science Foundation of China(Nos.61973211,51911540479 and M-0221)the Project of Science and Technology Commission of Shanghai Municipality(Nos.21550714200 and 20DZ2220400)+1 种基金the Research Project of Institute of Medical Robotics of Shanghai Jiao Tong Universitythe Interdisciplinary Program of Shanghai Jiao Tong University(Nos.ZH2018QNB31 and YG2017ZD03)。
文摘Micro incision vitrectomy system(MIVS)is considered to be one of the most difficult tasks of eye surgery,due to its requirements of high accuracy and delicate operation under blurred vision environment.Therefore,robot-assisted ophthalmic surgery is a potential and efficient solution.Based on that consideration,a novel master-slave system for vitreoretinal surgery is realized.A 4-DOF remote center of motion(RCM)mechanism with a novel linear stage and end-effector is designed and the master-slave control system is implemented.The forward and inverse kinematics are analyzed for the controller implementation.Then,algorithms with motion scaling are also integrated into the control architecture for the purpose to enhance the surgeon’s operation accuracy.Finally,experiments on an eye model are conducted.The results show that the eye robotic system can fulfill surgeon’s motion following and simulate operation of vitrectomy,demonstrating the feasibility of this system.
基金the Zhejiang Provincial Philosophy and Social Science Foundation(No.22NDQN293YB)the Fund of the Science and Technology Commission of Shanghai Municipality(No.20DZ2220400)。
文摘China is rapidly becoming an aging society, leading to a significant demand for chronic disease management and personalized healthcare. The development of rehabilitation and assistive robotics in China has gatheredsignificant attention not only in research fields but also in industries. Such robots aim to either guide patientsin completing therapeutic training or assist people with impaired functions in performing their daily activities.In the past decades, we have witnessed the advancement in rehabilitation and assistive robotics, with diversemechanical designs, functionalities, and purposes. However, the construction of dedicated regulations and policiesis relatively lagged compared with the flourishing development in research fields. Moreover, these kinds of robotsare working or collaborating closely with human beings, bringing unprecedented considerations on ethical issues.This paper aims to provide an overview of major dilemmas in the development of rehabilitation and assistiverobotics in China and propose several potential solutions.
文摘Innovation Driving Transformation:The year 2024 marked a critical juncture for robotics,particularly in the realm of medical applications.As highlighted in this issue,innovations such as robot-assisted embolization technologies and bio-integrated microrobots(BIMs)[1]are transitioning from experimental prototypes to clinical solutions,promising to revolutionize minimally invasive procedures.The medical robotics market is projected to grow at a compound annual growth rate(CAGR)of 16.20%[2],underscoring the urgency for robust ethical frameworks and international standards.SmartBot is committed to addressing these challenges by fostering dialogue between researchers,policymakers,and industry leaders(Figure 1).
