Comparative study on the efficacy of transoral robotic surgery and non-robotic surgery for tongue base tumors

Objective:To compare the efficacy of transoral robotic surgery(TORS)and non-robotic surgery(NRS)in the treatment of tongue base tumors.Methods:A total of 45 patients with tongue base tumors treated in our hospital were selected,and they were divided into the TORS group and NRS group according to different surgical methods.The surgical indicators and postoperative complications of patients in the two groups were compared and analyzed.Results:Compared with the NRS group,the operative time,bleeding volume and length of hospital stay were less in the TORS group,and the postoperative recurrence rate was less in the TORS group than that in the NRS group.The incidence rate of dysphagia and restricted mouth opening in the TORS group was lower than that in the NRS group within 30 d after surgery,and the difference was statistically significant(P<0.05).Conclusion:TORS has better minimally invasive advantages in the treatment of tongue base tumors,including less intraoperative bleeding,smaller trauma,shorter length of hospital stay and faster recovery.

Incidence of port-site metastasis after undergoing robotic surgery for biliary malignancies

AIM： To investigate the incidence of clinically detected port-site metastasis （PSM） in patients who underwent robotic surgery for biliary malignancies. METHODS： Using a prospective database, the patients undergoing fully robotic surgery for biliary malignan- cies between January 2009 and January 2011 were in- cluded. Records of patients with confirmed malignancy were reviewed for clinicopathological data and informa- tion about PSM. RESULTS： Sixty-four patients with biliary tract cancers underwent robotic surgery, and sixty patients met the inclusion criteria. The median age was 67 year （range： 40-85 year）. During a median 15-mo follow-up period, two female patients were detected solitary PSM after robotic surgery. The incidence of PSM was 3.3%. Pa- tient 1 underwent robotic anatomatic left hemihepa- tectomy and extraction of biliary tumor thrombi for an Klatskin tumor. She had a subcutaneous mass located at the right lateral abdominal wall near a trocar scar. Patient 2 underwent robotic pancreaticoduodenectomy for distal biliary cancer. She had two metachronous subcutaneous mass situated at the right lateral abdomi- nal wall under a same trocar scar at 7 and 26 mo. The pathology of the excised PSM masses confirmed meta- static biliary adenocarcinoma. CONCLUSION： The incidence of PSIVls after robotic surgery for biliary malignancies is relatively low, and biliary cancer can be an indication of robotic surgery.

Clinical characteristics of remote Zeus robot-assisted laparoscopic cholecystectomy:A report of 40 cases

AIM： To summarize the performing essentials and analyze the characteristics of remote Zeus robot-assisted laparoscopic cholecystectomy. METHODS： Robot-assisted laparoscopic cholecystectomy was performed in 40 patients between May 2004 and July 2005. The operating procedures and a variety of clinical parameters were recorded and analyzed. RESULTS： Forty laparoscopic cholecystectomy procedures were successfully completed with Zeus robotic system. And there were no post-operative complications. Total operating time, system setup time and performing time were 100.3±18.5 min, 27.7±8.8 min and 65.6±18.3 min, respectively. The blood loss and postoperative hospital stay were 30.6±10.2 mL and 2.8±0.8 d, respectively. Camera clearing times and time used for operative field adjustment were 1.1±1.0 min and 2.0±0.8 rain, respectively. The operative error was 7.5%. CONCLUSION： Robot-assisted laparoscopic cholecystectomy following the principles of laparoscopic operation has specific performing essentials. It preserves the benefits of minimally invasive surgery and offers enhanced ability of controlling operation field, precise and stable operative manipulations.

Telerobotic-assisted laparoscopic abdominoperineal resection for low rectal cancer: Report of the first case in Hong Kong and China with an updated literature review

Telerobotic surgery is the most advanced development in the field of minimally invasive surgery. The da Vinci surgical system, which is currently the most widely used telerobotic device, was approved by the Food and Drug Administration of the United States of America for clinical use in all abdominal operations in July 2000. The first da Vinci surgical system in China was installed in November 2005 at our institution. We herein report the first telerobotic-assisted laparoscopic abdominoperineal resection using the 3-arm da Vinci surgical system for low rectal cancer in Hong Kong and China, which was performed in August 2006. The operative time and blood loss were 240 min and 200 mL, respectively. There was no complication, and the patient was discharged on postoperative day five. An updated review of published literature on telerobotic-assisted colorectal surgery is included in this report, with special emphasis on its advantages and limitations.

The dimensional accuracy of preparation of femoral cavity in cementless total hip arthroplasty

Objective: To observe the accuracy of femoral preparation and the position of the cementless prosthesis in femoral cavity, and to compare the results between the computer-assisted surgical group (CASPAR) and the conventional group. Methods: Ten femoral components were implanted either manually or by CASPAR in cadaver femurs. The specimens were cut to 3mm thick slices. Microradiograms of every slice were sent to a computer for analysis with special software (IDL). The gaps and the medullary cavities between component and bone, the direct bone contact area of the implant surface, the gap width and the percentage of gap and bone contact area were measured in every slice. Results: In the proximal implant coated with HA of the CASPAR group, the average percentage of bone contact reached 93.2% (ranging from 87.6% to 99.7%); the average gap percentage was 2.9% (ranging from 0.3% to 7.8%); the maximum gap width was 0.81mm and the average gap width was only 0.20mm. While in the conventional group, the average percentage of bone contact reached 60.1% (ranging from 49.2% to 70.4%); the average gap percentage was 32.8% (ranging from 25.1% to 39.9%); the maximum gap width was 2.97mm and the average gap width was 0.77mm. The average gap around the implant in the CASPAR group was only 9% of that in the manual group; the maximum and average gap widths were only about 26% of those in the manual group. On the other hand, the CASPAR group showed 33% higher bone contact than the manual group. Conclusion: With the use of robotics-assisted system, significant progress can be achieved for femoral preparation in total hip arthroplasty.

Space gripper configuration and its dimension synthesis based on genetic algorithm

The special fingers of the gripper on the space robot have been developed based on genetic algorithmfor the space application.Therefore,the symmetrical wedgelike finger composed of the 4-1ink mechanismand the relevant track were designed.To decrease the weight and optimize the kinematics and grip force,the compositive fitness function for dynamics and kinematics was created.The calculation efficiency couldbe improved by novel methods which overcame the problem of too many constraints in the solution space,such as introducing the specialist's experience and punishment function and simplifying the variables.The solutions show that the optimized finger could perform well and the methods were effectual.

An effective algorithm for needle tip displacement compensation in robot-assisted percutaneous surgery

This paper presents an automatic compensation algorithm for needle tip displacement in order to keep the needle tip always fixed at the skin entry point in the process of needle orientation in robot-assisted percutaneous surgery. The algorithm, based on a two-degree-of-freedom （2-DOF） robot wrist （not the mechanically constrained remote center of motion （RCM） mechanism） and a 3-DOF robot ann, firstly calculates the needle tip displacement caused by rotational motion of robot wrist in the arm coordinate frame using the robotic forward kinematics, and then inversely compensates for the needle tip displace- ment by real-time Cartesian motion of robot arm. The algorithm achieves the function of the RCM and eliminates many mechanical and virtual constraints caused by the RCM mechanism. Experimental result demonstrates that the needle tip displacement is within 1 inm in the process of needle orientation.

Optimization Algorithm for Operation Comfortability of Master Manipulator of Minimally Invasive Surgery Robot

To evaluate the operation comfortability in the master-slave robotic minimally invasive surgery(MIS), an optimal function was built with two operation comfortability decided indices, i.e., the center distance and volume contact ratio. Two verifying experiments on Phantom Desktop and Micro Hand S were conducted. Experimental results show that the operation effect at the optimal relative location is better than that at the random location, which means that the optimal function constructed in this paper is effective in optimizing the operation comfortability.

A Novel Tele-Operated Flexible Robot Targeted for Minimally Invasive Robotic Surgery

In this paper, a novel flexible robot system with a constrained tendon-driven serpentine manipulator(CTSM) is presented. The CTSM gives the robot a larger workspace, more dexterous manipulation, and controllable stiffness compared with the da Vinci surgical robot and traditional flexible robots. The robot is tele-operated using the Novint Falcon haptic device. Two control modes are implemented, direct mapping and incremental mode. In each mode, the robot can be manipulated using either the highest stiffness scheme or the minimal movement scheme. The advantages of the CTSM are shown by simulation and experimental results.

Magnetic Helical Micro-and Nanorobots:Toward Their Biomedical Applications

Magnetic helical micro- and nanorobots can perform 3D navigation in various liquids with a sub- micrometer precision under low-strength rotating magnetic fields （〈 10 rer）. Since magnetic fields with low strengths are harmless to cells and tissues, magnetic helical micro/ nanorobots are promising tools for biomedical applications, such as minimally invasive surgery, cell manipulation and analysis, and targeted therapy. This review provides general information on magnetic helical micro/nanorobots, including their fabrication, motion control, and further functionalization for biomedical applications.

A protocol for the reporting and methodological quality of robotic surgery case reports

Background:Robotic surgery is a complex innovation intervention.Recently,the number of robotic surgery case reports is increasing,but there is unclear on its reporting and methodological quality.Methods:The PubMed database will be searched with high-specificity search strategy from Jan 1,2012 to Aug 1,2018 to identify relevant records.Microsoft Excel 2016 will be used to generate random number and to select 100 robotic surgery case reports according our eligibility criteria.A data extraction form will be used to extract relevant information including first author,year of publication,journal,etc.The CARE guideline and JBI checklist will be used to separately assess the reporting and methodological quality of included studies.The data extraction and assessment of quality will be completed by independent two authors and any disagreement will be resolved through discussion or consulting the third author.Stratified analyses will be conducted based on extracted information.Review Manager 5.3 software will be used to present the results of stratified analyses with Inverse-Variance random-effect model.Results:The study is ongoing and will be submitted to a peerreviewed journal.Conclusion:The present study will summarize evidence on the reporting and methodological quality of robotic surgery case reports,and provide reference for future case reports but not limited to robotic surgery.Ethics and dissemination:Ethical approval is not required because this study will not include any confidential personal data and interventions on the patients.The results of this study will be published in a peerreviewed publication.

Basic Characteristics of the Hydraulic-Driven Forceps for Force Feedback

A surgical manipulator has widely been used for laparoscopic surgery. It has been chosen mainly for the use in supporting human operations and in robot systems like the da Vinci surgical system. These manipulator systems are suitable for careful work, but they have a few problems. One of the problems is that the manipulator is not equipped with haptic sensing functions. Therefore, the operator must know the advanced techniques for visually detecting the physical contact state during surgical operations. These haptic sensing functions thus need to be incorporated into a surgical manipulator. We have developed hydraulic-driven forceps with a micro bearing and a bellows tube that can convey haptic sense to the operator. This system can measure the small forces acting on the tips of the forceps using Pascal＇s principle. A model of the system is provided from the relationship between the internal pressure of the bellows tube and the refraction angles of the forceps. It was confirmed using this model that the developed system makes it possible to estimate both the strength and the direction of the external force applied to the forceps by measuring the internal pressure of the bellows tube. An operator using a three-dimensional haptic device was able to feel the force response during an experiment in which they used the forceps to hold a blood vessel. This report describes the most appropriate method for letting the operator feel the force conveyed by using our system.

Arduino Based Planar Two DoF Robot Manipulator

In this research, two DoF five bar robot manipulator is controlled by using a human-machine interface program working in a computer. The human machine interface program is developed in Visual C#. Net environment after completing inverse kinematic analysis of the robot manipulator. Human machine interface in computer screen calculates two rotational joint variables for given positions of the robot end point. Then the computer program sends a data package containing these joint variables to Arduino microcontxoller. Arduino microcontxoller set the position of two servo motors according to calculated joint angles. Any position in workspace can be obtained by using the algorithm. The robot can follow traj ectories such as a line, a circle and a rectangle. Furthermore, a lot of patterns can be generated using function with variable radius and angle of rotation.

Shop-Floor Controller Based on RT-Middleware Technology

Nowadays the flexible configuration of manufacturing cells becomes to an important requirement especially at small and medium sized companies. This method can make the production fast and effective at small series or frequent manufacturing changes. The shop-floor control method, presented in this paper, offers a solution for the facing problem of fast and easy reconfiguration. The hardware of the controller designed modular with software components for online configuration. This solution allows sensor integration on different levels for every part of the manufacturing cell. With unified programming language and the machine specific controllers （post-processing） the cells can be defined easily by different types of human-machine interaction. The shop-floor control architecture is implemented and validated on an Adept SCARA （selective compliance assembly robot arm） robot. The robot is driven by standalone, low-level, interchangeable, software and hardware components.

Remote-Controlled Ambidextrous Robot Hand Concept

In the development of robotic limbs, the side of members is of importance to define the shape of artificial limbs and the range of movements. It is mainly significant tbr biomedical applications concerning patients suffering arms or legs injuries, fn this paper, the concept of an ambidextrous design lbr robot hands is introduced. The fingers can curl in one xvay or another, to imitate either a right hand or a left hand. The advantages and inconveniences of different models have been investigated to optimise the range and the maximum force applied by fingers. Besides, a remote control interthce is integrated to the system, allowing both to send comrnands through internet and to display a video streaming of the ambidextrous hand as feedback. Therefore, a robotic prosthesis could be used for the first time in telerehabilitation. The main application areas targeted are physiotherapy alter strokes or management of phantom pains/br amputees by/earning to control the ambidextrous hand. A client application is also accessible on Facehook social network, making the robotic limb easily reachable for the patients. Additionally the ambidextrous hand can be used tbr robotics research as well as artistic performances.

腹部无辅助切口经阴道取标本的机器人根治性全胃切除术(GC-NOSESⅧ式)

目的探讨机器人(达芬奇Xi)应用于胃癌经自然腔道取标本手术(natural orifice specimen extraction surgery,NOSES)的可行性和安全性。方法选取南昌大学第一附属医院普外科一例胃癌患者并行腹部无辅助切口经阴道取标本的机器人根治性全胃切除术。结果手术顺利,无中转,手术时间190 min,术中出血量约50 ml,患者术后顺利出院。结论腹部无辅助切口经阴道取标本的机器人根治性全胃切除术是安全、可行的,相比腹腔镜,机器人应用于NOSES有着更大优势。

Re-appraisal and consideration of minimally invasive surgery in colorectal cancer

Throughout history,surgeons have been on a quest to refine the surgical treatment options for their patients and to minimize operative trauma.During the last three decades,there have been tremendous advances in the field of minimally invasive colorectal surgery,with an explosion of different technologies and approaches offered to treat well-known diseases.Laparoscopic surgery has been shown to be equal or superior to open surgery.The boundaries of laparoscopy have been pushed further,in the form of single-incision laparoscopy,natural-orifice transluminal endoscopic surgery and robotics.This paper critically reviews the pathway of development of minimally invasive surgery,and appraises the different minimally invasive colorectal surgical approaches available to date.