Purpose: The purpose of the study was to review a single surgeon, seven-year experience, using the Da Vinci Telerobotic system performing 124 foregut operations. Methods: Data review from 2002-2009 including 71 Nissen...Purpose: The purpose of the study was to review a single surgeon, seven-year experience, using the Da Vinci Telerobotic system performing 124 foregut operations. Methods: Data review from 2002-2009 including 71 Nissen fundoplications, 26 esophagomyotomies, and 27 hiatal hernia repairs was performed. Parameters collected included gender, age, body mass index (BMI), estimated blood loss (EBL), port set up time (PST), robot operating time (ROT), total case time (TCT), length of stay (LOS), complications, conversions, and resident involvement. Statistical analysis was con-ducted. Results: 124 foregut operations: 45 males, 79 females, mean age of 54.8 ± 16.7 (18 - 85) years, mean TCT 174.4 ± 45.0 (102 - 321) min. Nissen fundoplication: mean BMI of 30.8 ± 3.9 (22.4 - 46.8) kg/m2, EBL 30.2 ± 21.8 (5 - 100) ml, PST 32.3 ± 9 (14 - 63) min, ROT 111.4 ± 37.3 (51 - 229) min, TCT 175.0 ± 46.4 (102 - 321) min, median LOS 1 (0 - 9) day, complication rate 7.0% (5/71), conversion rate 5.6%, resident involvement 69.0% (49/71). Esophagomyotomy: mean BMI of 26.5 ± 6.1 (15.4 - 36.6) kg/m2, EBL 39.1 ± 41.7 (10 - 200) ml, PST 28.0 ± 8.6 (16 - 47) min, ROT 122.9 ± 45 (31 - 217) min, and TCT 178.0 ± 40.5 (105 - 262) min, median LOS 1 (0 - 6) day, complication rate 15.4% (4/26), conversion rate 0%, resident involvement 69.2% (18/26). Hiatal hernia repair: mean BMI of 28.4 ± 4.2 (21.9 - 36.8) kg/m2, EBL 38.4 ± 32.7 (10 - 150) ml, PST 28.8 ± 8.0 (17 - 52) min, ROT 109.0 ± 44.5 (49 - 250) min, and TCT 169.2 ± 46.5 (102 - 299) min, median LOS 1 (1 - 14) day, complication rate 11.1% (3/27), conversion rate 3.7%, resident involvement 66.7% (18/27). Conclusion: Robotic-assisted foregut surgery is safe and effective. This series compares favorably with other robotic studies in length of hospital stay, total case time, and complication and conver-sion rates. Foregut surgery is an excellent robotic training ground for residents.展开更多
Disentangling the influence of multiple signal components on receivers and elucidating general processes influencing complex signal evolution are difficult tasks. In this study we test mate preferences of female squir...Disentangling the influence of multiple signal components on receivers and elucidating general processes influencing complex signal evolution are difficult tasks. In this study we test mate preferences of female squirrel treefrogs Hyla squirella and female tungara frogs Physalaemus pustulosus for similar combinations of acoustic and visual components of their multimodal courtship signals. In a two-choice playback experiment with squirrel treefrogs, the visual stimulus of a male model significantly increased the attractivness of a relatively unattractive slow call rate. A previous study demonstrated that faster call rates are more attractive to female squirrel treefrogs, and all else being equal, models of male frogs with large body stripes are more attractive. In a similar experiment with female tungara frogs, the visual stimulus of a robotic frog failed to increase the attractiveness of a relatively unattractive call. Females also showed no preference for the distinct stripe on the robot that males commonly bear on their throat. Thus, features of conspicuous signal components such as body stripes are not universally important and signal function is likely to differ even among species with similar ecologies and communication systems. Finally, we discuss the putative information content of anuran signals and suggest that the categorization of redundant versus multiple messages may not be sufficient as a general explanation for the evolution of multimodal signaling. Instead of relying on untested assumptions concerning the information content of signals, we discuss the value of initially collecting comparative empirical data sets related to receiver responses.展开更多
文摘Purpose: The purpose of the study was to review a single surgeon, seven-year experience, using the Da Vinci Telerobotic system performing 124 foregut operations. Methods: Data review from 2002-2009 including 71 Nissen fundoplications, 26 esophagomyotomies, and 27 hiatal hernia repairs was performed. Parameters collected included gender, age, body mass index (BMI), estimated blood loss (EBL), port set up time (PST), robot operating time (ROT), total case time (TCT), length of stay (LOS), complications, conversions, and resident involvement. Statistical analysis was con-ducted. Results: 124 foregut operations: 45 males, 79 females, mean age of 54.8 ± 16.7 (18 - 85) years, mean TCT 174.4 ± 45.0 (102 - 321) min. Nissen fundoplication: mean BMI of 30.8 ± 3.9 (22.4 - 46.8) kg/m2, EBL 30.2 ± 21.8 (5 - 100) ml, PST 32.3 ± 9 (14 - 63) min, ROT 111.4 ± 37.3 (51 - 229) min, TCT 175.0 ± 46.4 (102 - 321) min, median LOS 1 (0 - 9) day, complication rate 7.0% (5/71), conversion rate 5.6%, resident involvement 69.0% (49/71). Esophagomyotomy: mean BMI of 26.5 ± 6.1 (15.4 - 36.6) kg/m2, EBL 39.1 ± 41.7 (10 - 200) ml, PST 28.0 ± 8.6 (16 - 47) min, ROT 122.9 ± 45 (31 - 217) min, and TCT 178.0 ± 40.5 (105 - 262) min, median LOS 1 (0 - 6) day, complication rate 15.4% (4/26), conversion rate 0%, resident involvement 69.2% (18/26). Hiatal hernia repair: mean BMI of 28.4 ± 4.2 (21.9 - 36.8) kg/m2, EBL 38.4 ± 32.7 (10 - 150) ml, PST 28.8 ± 8.0 (17 - 52) min, ROT 109.0 ± 44.5 (49 - 250) min, and TCT 169.2 ± 46.5 (102 - 299) min, median LOS 1 (1 - 14) day, complication rate 11.1% (3/27), conversion rate 3.7%, resident involvement 66.7% (18/27). Conclusion: Robotic-assisted foregut surgery is safe and effective. This series compares favorably with other robotic studies in length of hospital stay, total case time, and complication and conver-sion rates. Foregut surgery is an excellent robotic training ground for residents.
文摘Disentangling the influence of multiple signal components on receivers and elucidating general processes influencing complex signal evolution are difficult tasks. In this study we test mate preferences of female squirrel treefrogs Hyla squirella and female tungara frogs Physalaemus pustulosus for similar combinations of acoustic and visual components of their multimodal courtship signals. In a two-choice playback experiment with squirrel treefrogs, the visual stimulus of a male model significantly increased the attractivness of a relatively unattractive slow call rate. A previous study demonstrated that faster call rates are more attractive to female squirrel treefrogs, and all else being equal, models of male frogs with large body stripes are more attractive. In a similar experiment with female tungara frogs, the visual stimulus of a robotic frog failed to increase the attractiveness of a relatively unattractive call. Females also showed no preference for the distinct stripe on the robot that males commonly bear on their throat. Thus, features of conspicuous signal components such as body stripes are not universally important and signal function is likely to differ even among species with similar ecologies and communication systems. Finally, we discuss the putative information content of anuran signals and suggest that the categorization of redundant versus multiple messages may not be sufficient as a general explanation for the evolution of multimodal signaling. Instead of relying on untested assumptions concerning the information content of signals, we discuss the value of initially collecting comparative empirical data sets related to receiver responses.
