In laparoscopic surgery, the surgeons are equipped with the suitable tools for the surgery, while the laparoscope is used to capture the operation environment and displays it on a monitor. This paper presents the math...In laparoscopic surgery, the surgeons are equipped with the suitable tools for the surgery, while the laparoscope is used to capture the operation environment and displays it on a monitor. This paper presents the mathematical kinematic position modeling of the laparoscopic tools used for autonomous positioning of a laparoscope in such operations. These models are obtained using Denavit-Hartenberg (D-H) Notations and Homogenous Transformation Matrix (HTM). The laparoscopic tools are considered as six degrees of freedom (DOF) mechanisms while the laparoscope has four DOF. The 3D loop closure equation is used to obtain the laparoscope kinematic position models in terms of those of the laparoscopic tools. These models are used to simulate and align the laparoscope camera with the surgeon’s laparoscopic Tools Center Points (TCP). The obtained results show the smooth positioning of the laparoscope camera for better visu-alization of laparoscopic surgery environments.展开更多
目的 观察不同气腹压力对气管隆凸位置的影响。方法 选择无明显器质性疾病腹腔镜胆囊手术5 5例,分别在平卧位及头高左斜卧位时无气腹、10 mm Hg、15 mm Hg气腹6种情况下,用OL YMPUS- L F- GP测量气管导管远端至隆凸的距离,观察隆凸形...目的 观察不同气腹压力对气管隆凸位置的影响。方法 选择无明显器质性疾病腹腔镜胆囊手术5 5例,分别在平卧位及头高左斜卧位时无气腹、10 mm Hg、15 mm Hg气腹6种情况下,用OL YMPUS- L F- GP测量气管导管远端至隆凸的距离,观察隆凸形态、位置的改变及气管导管支气管内插管发生率。结果 无气腹平卧位气管导管末端至隆凸距离为(4.5 9±1.6 6 ) cm,头高左斜卧位为(4.5 1±1.5 6 ) cm ;10 mm Hg平卧位气腹导管离隆凸为(3.5 1±1.6 2 ) cm,头高左斜卧位距离为(3.4 4±1.5 8) cm ;15 mm Hg气腹平卧位距离为(3.4 5±1.6 4 ) cm,头高左斜卧位距离为(3.4 2±1.5 9) cm。无气腹时两种体位隆凸至气管导管的距离无统计学意义上差别,P>0 .0 5 ;10 mm Hg及15 mm Hg气腹与无气腹时相比有统计学意义上差异(P<0 .0 1) ;头高左斜卧位10 mm Hg与15 mm Hg气腹间数值无统计学上差别。有3例气腹后气管导管进入支气管内。结论 气腹对气管至隆凸间的距离有影响,应适当减少气管导管插入气管的深度,以防支气管内插管。展开更多
In colon cancer surgery,ensuring the complete removal of the primary tumor and draining lymph nodes is crucial.Lymphatic drainage in the colon follows the vascular supply,typically progressing from pericolic to paraao...In colon cancer surgery,ensuring the complete removal of the primary tumor and draining lymph nodes is crucial.Lymphatic drainage in the colon follows the vascular supply,typically progressing from pericolic to paraaortic lymph nodes.While NCCN guidelines recommend the removal of 10-12 lymph nodes for ade-quate oncological resection,achieving complete oncological resection involves more than just meeting these numerical targets.Various techniques have been developed and studied over time to attain optimal oncological outcomes.A key technique central to this goal is identifying the ileocolic vessels at their origin from the superior mesenteric vessels.Complete excision of the visceral and parietal mesocolon ensures the intact removal of the specimen,while D3 lymphade-nectomy targets all draining regional lymph nodes.Although these principles emphasize different aspects,they ultimately converge to achieve the same goal of complete oncological resection.This article aims to simplify the surgical steps that align with the principle of central vascular ligation and mesocolon mobilization while ensuring adequate D3 dissection.展开更多
文摘In laparoscopic surgery, the surgeons are equipped with the suitable tools for the surgery, while the laparoscope is used to capture the operation environment and displays it on a monitor. This paper presents the mathematical kinematic position modeling of the laparoscopic tools used for autonomous positioning of a laparoscope in such operations. These models are obtained using Denavit-Hartenberg (D-H) Notations and Homogenous Transformation Matrix (HTM). The laparoscopic tools are considered as six degrees of freedom (DOF) mechanisms while the laparoscope has four DOF. The 3D loop closure equation is used to obtain the laparoscope kinematic position models in terms of those of the laparoscopic tools. These models are used to simulate and align the laparoscope camera with the surgeon’s laparoscopic Tools Center Points (TCP). The obtained results show the smooth positioning of the laparoscope camera for better visu-alization of laparoscopic surgery environments.
文摘In colon cancer surgery,ensuring the complete removal of the primary tumor and draining lymph nodes is crucial.Lymphatic drainage in the colon follows the vascular supply,typically progressing from pericolic to paraaortic lymph nodes.While NCCN guidelines recommend the removal of 10-12 lymph nodes for ade-quate oncological resection,achieving complete oncological resection involves more than just meeting these numerical targets.Various techniques have been developed and studied over time to attain optimal oncological outcomes.A key technique central to this goal is identifying the ileocolic vessels at their origin from the superior mesenteric vessels.Complete excision of the visceral and parietal mesocolon ensures the intact removal of the specimen,while D3 lymphade-nectomy targets all draining regional lymph nodes.Although these principles emphasize different aspects,they ultimately converge to achieve the same goal of complete oncological resection.This article aims to simplify the surgical steps that align with the principle of central vascular ligation and mesocolon mobilization while ensuring adequate D3 dissection.
