This work is a topic highlight on the surgical treatment of the right colon pathologies,focusing on the literature state of art and comparing the open surgery to the different laparoscopic and robotic procedures.Diffe...This work is a topic highlight on the surgical treatment of the right colon pathologies,focusing on the literature state of art and comparing the open surgery to the different laparoscopic and robotic procedures.Different laparoscopic procedures have been described for the treatment of right colon tumors: Totally laparoscopic right colectomy,laparoscopic assisted right colectomy,laparoscopic facilitated right colectomy,hand-assisted right colectomy,single incision laparoscopic surgery colectomy,robotic right colectomy.Two main characteristics of these techniques are the different type of anastomosis: Intracorporeal(for totally laparoscopic right colectomy,single incision laparoscopic surgery colectomy,laparoscopic assisted right colectomy and robotic technique) or extracorporeal(for laparoscopic assisted right colectomy,laparoscopic facilitated right colectomy,hand-assisted right colectomy and open right colectomy) and the different incision(suprapubic,median or transverse on the right side of abdomen).The different laparoscopic techniques meet the same oncological criteria of radicalism as the open surgery for the right colon.The totally laparoscopic right colectomy with intracorporeal anastomosis and even more the single incision laparoscopic surgery colectomy,remain a technical challenge due to the complexity of procedures(especially for the single incision laparoscopic surgery colectomy) and the particular right colon vascular anatomy but they seem to have some theoretical advantages compared to the other laparoscopic and open procedures.Data reported in literature while confirming the advantages of laparoscopic approach,do not allow to solve controversies about which is the best laparoscopic technique(Intracorporeal vs Extracorporeal Anastomosis) to treat the right colon cancer.However,the laparoscopic techniques with intracorporeal anastomosis for the right colon seem to show some theoretical advantages(functional,technical,oncological and cosmetic advantages) even if all studies conclude that further prospective randomized trials are necessary.Robotic technique may be useful to overcome the problems related to inexperience in laparoscopy in some surgical centers.展开更多
The use of robots to augment human capabilities and assist in work has long been an aspiration.Robotics has been developing since the 1960s when the first industrial robot was introduced.As technology has advanced,rob...The use of robots to augment human capabilities and assist in work has long been an aspiration.Robotics has been developing since the 1960s when the first industrial robot was introduced.As technology has advanced,robotic-assisted surgery has shown numerous advantages,including more precision,efficiency,minimal invasiveness,and safety than is possible with conventional techniques,which are research hotspots and cutting-edge trends.This article reviewed the history of medical robot development and seminal research papers about current research progress.Taking the autonomous dental implant robotic system as an example,the advantages and prospects of medical robotic systems would be discussed which would provide a reference for future research.展开更多
Objective:Bladder neck contracture and vesicourethral anastomotic stenosis are difficult to manage endoscopically,and open repair is associated with high rates of incontinence.In recent years,there have been increasin...Objective:Bladder neck contracture and vesicourethral anastomotic stenosis are difficult to manage endoscopically,and open repair is associated with high rates of incontinence.In recent years,there have been increasing reports of robotic-assisted bladder neck reconstruction in the literature.However,existing studies are small,heterogeneous case series.The objective of this study was to perform a systematic review of robotic-assisted bladder neck reconstruction to better evaluate patency and incontinence outcomes.Methods:We performed a systematic review of PubMed from first available date to May 2023 for all studies evaluating robotic-assisted reconstructive surgery of the bladder neck in adult men.Articles in non-English,author replies,editorials,pediatric-based studies,and reviews were excluded.Outcomes of interest were patency and incontinence rates,which were pooled when appropriate.Results:After identifying 158 articles on initial search,we included only ten studies that fit all aforementioned criteria for robotic-assisted bladder neck reconstruction.All were case series published from March 2018 to March 2022 ranging from six to 32 men,with the median follow-up of 5e23 months.A total of 119 patients were included in our analysis.A variety of etiologies and surgical techniques were described.Patency rates ranged from 50%to 100%,and pooled patency was 80%(95/119).De novo incontinence rates ranged from 0%to 33%,and pooled incontinence was 17%(8/47).Our findings were limited by small sample sizes,relatively short follow-ups,and heterogeneity between studies.展开更多
The trajectory tracking control performance of nonholonomic wheeled mobile robots(NWMRs)is subject to nonholonomic constraints,system uncertainties,and external disturbances.This paper proposes a barrier function-base...The trajectory tracking control performance of nonholonomic wheeled mobile robots(NWMRs)is subject to nonholonomic constraints,system uncertainties,and external disturbances.This paper proposes a barrier function-based adaptive sliding mode control(BFASMC)method to provide high-precision,fast-response performance and robustness for NWMRs.Compared with the conventional adaptive sliding mode control,the proposed control strategy can guarantee that the sliding mode variables converge to a predefined neighborhood of origin with a predefined reaching time independent of the prior knowledge of the uncertainties and disturbances bounds.Another advantage of the proposed algorithm is that the control gains can be adaptively adjusted to follow the disturbances amplitudes thanks to the barrier function.The benefit is that the overestimation of control gain can be eliminated,resulting in chattering reduction.Moreover,a modified barrier function-like control gain is employed to prevent the input saturation problem due to the physical limit of the actuator.The stability analysis and comparative experiments demonstrate that the proposed BFASMC can ensure the prespecified convergence performance of the NWMR system output variables and strong robustness against uncertainties/disturbances.展开更多
BACKGROUND Hemolymphangioma of the jejunum is rare and lacks clinical specificity,and can manifest as gastrointestinal bleeding,abdominal pain,and intestinal obstruction.Computed tomography,magnetic resonance imaging,...BACKGROUND Hemolymphangioma of the jejunum is rare and lacks clinical specificity,and can manifest as gastrointestinal bleeding,abdominal pain,and intestinal obstruction.Computed tomography,magnetic resonance imaging,and other examinations show certain characteristics of the disease,but lack accuracy.Although capsule endoscopy and enteroscopy make up for this deficiency,the diagnosis also still re-quires pathology.CASE SUMMARY A male patient was admitted to the hospital due to abdominal distension and abdominal pain,but a specific diagnosis by computed tomography examination was not obtained.Partial resection of the small intestine was performed by robotic surgery,and postoperative pathological biopsy confirmed the diagnosis of hemo-lymphangioma.No recurrence in the follow-up examination was observed.CONCLUSION Robotic surgery is an effective way to treat hemolymphangioma through minima-lly invasive techniques under the concept of rapid rehabilitation.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
Recent advances in functionally graded additive manufacturing(FGAM)technology have enabled the seamless hybridization of multiple functionalities in a single structure.Soft robotics can become one of the largest benef...Recent advances in functionally graded additive manufacturing(FGAM)technology have enabled the seamless hybridization of multiple functionalities in a single structure.Soft robotics can become one of the largest beneficiaries of these advances,through the design of a facile four-dimensional(4D)FGAM process that can grant an intelligent stimuli-responsive mechanical functionality to the printed objects.Herein,we present a simple binder jetting approach for the 4D printing of functionally graded porous multi-materials(FGMM)by introducing rationally designed graded multiphase feeder beds.Compositionally graded cross-linking agents gradually form stable porous network structures within aqueous polymer particles,enabling programmable hygroscopic deformation without complex mechanical designs.Furthermore,a systematic bed design incorporating additional functional agents enables a multi-stimuli-responsive and untethered soft robot with stark stimulus selectivity.The biodegradability of the proposed 4D-printed soft robot further ensures the sustainability of our approach,with immediate degradation rates of 96.6%within 72 h.The proposed 4D printing concept for FGMMs can create new opportunities for intelligent and sustainable additive manufacturing in soft robotics.展开更多
The current gait planning for legged robots is mostly based on human presets,which cannot match the flexible characteristics of natural mammals.This paper proposes a gait optimization framework for hexapod robots call...The current gait planning for legged robots is mostly based on human presets,which cannot match the flexible characteristics of natural mammals.This paper proposes a gait optimization framework for hexapod robots called Smart Gait.Smart Gait contains three modules:swing leg trajectory optimization,gait period&duty optimization,and gait sequence optimization.The full dynamics of a single leg,and the centroid dynamics of the overall robot are considered in the respective modules.The Smart Gait not only helps the robot to decrease the energy consumption when in locomotion,mostly,it enables the hexapod robot to determine its gait pattern transitions based on its current state,instead of repeating the formalistic clock-set step cycles.Our Smart Gait framework allows the hexapod robot to behave nimbly as a living animal when in 3D movements for the first time.The Smart Gait framework combines offline and online optimizations without any fussy data-driven training procedures,and it can run efficiently on board in real-time after deployment.Various experiments are carried out on the hexapod robot LittleStrong.The results show that the energy consumption is reduced by 15.9%when in locomotion.Adaptive gait patterns can be generated spontaneously both in regular and challenge environments,and when facing external interferences.展开更多
Objectives Robotic-assisted surgery(RAS)is a minimally invasive technique practiced in multiple specialties.Standard training is essential for the acquisition of RAS skills.The cost of RAS is considered to be high,whi...Objectives Robotic-assisted surgery(RAS)is a minimally invasive technique practiced in multiple specialties.Standard training is essential for the acquisition of RAS skills.The cost of RAS is considered to be high,which makes it a burden for institutes and unaffordable for patients.This systematic literature review(SLR)focused on the various RAS training methods applied in different surgical specialties,as well as the cost elements of RAS,and was to summarize the opportunities and challenges associated with scaling up RAS.Methods An SLR was carried out based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses reporting guidelines.The PubMed,EBSCO,and Scopus databases were searched for reports from January 2018 through January 2024.Full-text reviews and research articles in the English language from Asia-Pacific countries were included.Articles that outlined training and costs associated with RAS were chosen.Results The most common training system is the da Vinci system.The simulation technique,which includes dry-lab,wet-lab,and virtual reality training,was found to be a common and important practice.The cost of RAS encompasses the installation and maintenance costs of the robotic system,the operation theatre rent,personnel cost,surgical instrument and material cost,and other miscellaneous charges.The synthesis of SLR revealed the challenges and opportunities regarding RAS training and cost.Conclusions The results of this SLR will help stakeholders such as decision-makers,influencers,and end users of RAS to understand the significance of training and cost in scaling up RAS from a managerial perspective.For any healthcare innovation to reach a vast population,cost-effectiveness and standard training are crucial.展开更多
There have been nearly 60 years since Thomas Starzl’s first liver transplant.During this period,advancements in medical technology have progressively enabled the adoption of new methods for transplantation.Among thes...There have been nearly 60 years since Thomas Starzl’s first liver transplant.During this period,advancements in medical technology have progressively enabled the adoption of new methods for transplantation.Among these innovations,robotic surgery has emerged in recent decades and is gradually being integrated into transplant medicine.Robotic hepatectomy and liver implantation represent significant advancements in the field of transplant surgery.The precision and minimally invasive nature of robotic surgery offer substantial benefits for both living donors and recipients.In living donors,robotic hepatectomy reduces postoperative pain,minimizes scarring,and accelerates recovery.For liver recipients,robotic liver implantation enhances surgical accuracy,leading to better graft positioning and vascular anastomosis.Robotic systems provide more precise and maneuverable control of instruments,allowing surgeons to perform complex procedures with greater accuracy and reduced risk to patients.This review encompasses publications on minimally invasive donor liver surgery,with a specific focus on robotic liver resection in transplantation,and aims to summarize current knowledge and the development status of robotic surgery in liver transplantation,focusing on liver resection in donors and graft implantation in recipients.展开更多
To improve locomotion and operation integration, this paper presents an integrated leg-arm quadruped robot(ILQR) that has a reconfigurable joint. First, the reconfigurable joint is designed and assembled at the end of...To improve locomotion and operation integration, this paper presents an integrated leg-arm quadruped robot(ILQR) that has a reconfigurable joint. First, the reconfigurable joint is designed and assembled at the end of the legarm chain. When the robot performs a task, reconfigurable configuration and mode switching can be achieved using this joint. In contrast from traditional quadruped robots, this robot can stack in a designated area to optimize the occupied volume in a nonworking state. Kinematics modeling and dynamics modeling are established to evaluate the mechanical properties for multiple modes. All working modes of the robot are classified, which can be defined as deployable mode, locomotion mode and operation mode. Based on the stability margin and mechanical modeling, switching analysis and evaluation between each mode is carried out. Finally, the prototype experimental results verify the function realization and switching stability of multimode and provide a design method to integrate and perform multimode for quadruped robots with deployable characteristics.展开更多
The most widely adopted method for diagnosing respiratory infectious diseases is to conduct polymerase chain reaction(PCR)assays on patients’respiratory specimens,which are collected through either nasal or oropharyn...The most widely adopted method for diagnosing respiratory infectious diseases is to conduct polymerase chain reaction(PCR)assays on patients’respiratory specimens,which are collected through either nasal or oropharyngeal swabs.The manual swab sampling process poses a high risk to the examiner and may cause false-negative results owing to improper sampling.In this paper,we propose a pneumatically actuated soft end-effector specifically designed to achieve all of the tasks involved in swab sampling.The soft end-effector utilizes circumferential instability to ensure grasping stability,and exhibits several key properties,including high load-to-weight ratio,error tolerance,and variable swab-tip stiffness,leading to successful automatic robotic oropharyngeal swab sampling,from loosening and tightening the transport medium tube cap,holding the swab,and conducting sampling,to snapping off the swab tail and sterilizing itself.Using an industrial collaborative robotic arm,we integrated the soft end-effector,force sensor,camera,lights,and remote-control stick,and developed a robotic oropharyngeal swab sampling system.Using this swab sampling system,we conducted oropharyngeal swab-sampling tests on 20 volunteers.Our Digital PCR assay results(RNase P RNA gene absolute copy numbers for the samples)revealed that our system successfully collected sufficient numbers of cells from the pharyngeal wall for respiratory disease diagnosis.In summary,we have developed a pharyngeal swab-sampling system based on an“enveloping”soft actuator,studied the sampling process,and imple-mented whole-process robotic oropharyngeal swab-sampling.展开更多
Background:Minimally invasive surgery is the optimal treatment for insulinoma.The present study aimed to compare short-and long-term outcomes of laparoscopic and robotic surgery for sporadic benign insulinoma.Methods:...Background:Minimally invasive surgery is the optimal treatment for insulinoma.The present study aimed to compare short-and long-term outcomes of laparoscopic and robotic surgery for sporadic benign insulinoma.Methods:A retrospective analysis of patients who underwent laparoscopic or robotic surgery for insulinoma at our center between September 2007 and December 2019 was conducted.The demographic,perioperative and postoperative follow-up results were compared between the laparoscopic and robotic groups.Results:A total of 85 patients were enrolled,including 36 with laparoscopic approach and 49 with robotic approach.Enucleation was the preferred surgical procedure.Fifty-nine patients(69.4%)underwent enucleation;among them,26 and 33 patients underwent laparoscopic and robotic surgery,respectively.Robotic enucleation had a lower conversion rate to laparotomy(0 vs.19.2%,P=0.013),shorter operative time(102.0 vs.145.5 min,P=0.008)and shorter postoperative hospital stay(6.0 vs.8.5 d,P=0.002)than laparoscopic enucleation.There were no differences between the groups in terms of intraoperative blood loss,the rates of postoperative pancreatic fistula and complications.After a median follow-up of 65 months,two patients in the laparoscopic group developed a functional recurrence and none of the patients in the robotic group had a recurrence.Conclusions:Robotic enucleation can reduce the conversion rate to laparotomy and shorten operative time,which might lead to a reduction in postoperative hospital stay.展开更多
Objectives:To highlight critical preoperative and intraoperative considerations in approaching fistula repair robotically.Methods:A search of the literature was conducted to identify relevant articles pertaining to ro...Objectives:To highlight critical preoperative and intraoperative considerations in approaching fistula repair robotically.Methods:A search of the literature was conducted to identify relevant articles pertaining to robotic management of urinary fistulae.Results:Fistulae of the genitourinary tract can be a challenging dilemma for urologists,as definitive management may require surgical intervention.Pathogenesis of both enteric and non-enteric fistulae are multifactorial,and successful repair hinges on the meticulous perioperative evaluation,planning,and execution.Traditional open techniques can subject patients to increased morbidity and prolonged hospitalizations.Since its introduction,the robotic surgical platform has continued to expand its indications.Its three-dimensional visualization and tremor free wristed instrument movements have made the robotic platform an attractive option for genitourinary fistula reconstruction.Conclusion:Robotic management of complex urinary fistulae is feasible in expert hands;more studies are needed to define its role in the treatment algorithm of this devastating conditions.展开更多
The current parallel ankle rehabilitation robot(ARR)suffers from the problem of difficult real-time alignment of the human-robot joint center of rotation,which may lead to secondary injuries to the patient.This study ...The current parallel ankle rehabilitation robot(ARR)suffers from the problem of difficult real-time alignment of the human-robot joint center of rotation,which may lead to secondary injuries to the patient.This study investigates type synthesis of a parallel self-alignment ankle rehabilitation robot(PSAARR)based on the kinematic characteristics of ankle joint rotation center drift from the perspective of introducing"suitable passive degrees of freedom(DOF)"with a suitable number and form.First,the self-alignment principle of parallel ARR was proposed by deriving conditions for transforming a human-robot closed chain(HRCC)formed by an ARR and human body into a kinematic suitable constrained system and introducing conditions of"decoupled"and"less limb".Second,the relationship between the self-alignment principle and actuation wrenches(twists)of PSAARR was analyzed with the velocity Jacobian matrix as a"bridge".Subsequently,the type synthesis conditions of PSAARR were proposed.Third,a PSAARR synthesis method was proposed based on the screw theory and type of PSAARR synthesis conducted.Finally,an HRCC kinematic model was established to verify the self-alignment capability of the PSAARR.In this study,93 types of PSAARR limb structures were synthesized and the self-alignment capability of a human-robot joint axis was verified through kinematic analysis,which provides a theoretical basis for the design of such an ARR.展开更多
Traditional proportional-integral-derivative(PID)controllers have achieved widespread success in industrial applications.However,the nonlinearity and uncertainty of practical systems cannot be ignored,even though most...Traditional proportional-integral-derivative(PID)controllers have achieved widespread success in industrial applications.However,the nonlinearity and uncertainty of practical systems cannot be ignored,even though most of the existing research on PID controllers is focused on linear systems.Therefore,developing a PID controller with learning ability is of great significance for complex nonlinear systems.This article proposes a deterministic learning-based advanced PID controller for robot manipulator systems with uncertainties.The introduction of neural networks(NNs)overcomes the upper limit of the traditional PID feedback mechanism’s capability.The proposed control scheme not only guarantees system stability and tracking error convergence but also provides a simple way to choose the three parameters of PID by setting the proportional coefficients.Under the partial persistent excitation(PE)condition,the closed-loop system unknown dynamics of robot manipulator systems are accurately approximated by NNs.Based on the acquired knowledge from the stable control process,a learning PID controller is developed to further improve overall control performance,while overcoming the problem of repeated online weight updates.Simulation studies and physical experiments demonstrate the validity and practicality of the proposed strategy discussed in this article.展开更多
文摘This work is a topic highlight on the surgical treatment of the right colon pathologies,focusing on the literature state of art and comparing the open surgery to the different laparoscopic and robotic procedures.Different laparoscopic procedures have been described for the treatment of right colon tumors: Totally laparoscopic right colectomy,laparoscopic assisted right colectomy,laparoscopic facilitated right colectomy,hand-assisted right colectomy,single incision laparoscopic surgery colectomy,robotic right colectomy.Two main characteristics of these techniques are the different type of anastomosis: Intracorporeal(for totally laparoscopic right colectomy,single incision laparoscopic surgery colectomy,laparoscopic assisted right colectomy and robotic technique) or extracorporeal(for laparoscopic assisted right colectomy,laparoscopic facilitated right colectomy,hand-assisted right colectomy and open right colectomy) and the different incision(suprapubic,median or transverse on the right side of abdomen).The different laparoscopic techniques meet the same oncological criteria of radicalism as the open surgery for the right colon.The totally laparoscopic right colectomy with intracorporeal anastomosis and even more the single incision laparoscopic surgery colectomy,remain a technical challenge due to the complexity of procedures(especially for the single incision laparoscopic surgery colectomy) and the particular right colon vascular anatomy but they seem to have some theoretical advantages compared to the other laparoscopic and open procedures.Data reported in literature while confirming the advantages of laparoscopic approach,do not allow to solve controversies about which is the best laparoscopic technique(Intracorporeal vs Extracorporeal Anastomosis) to treat the right colon cancer.However,the laparoscopic techniques with intracorporeal anastomosis for the right colon seem to show some theoretical advantages(functional,technical,oncological and cosmetic advantages) even if all studies conclude that further prospective randomized trials are necessary.Robotic technique may be useful to overcome the problems related to inexperience in laparoscopy in some surgical centers.
基金supported by the National Natural Science Foundation of China[grant number 81970987].
文摘The use of robots to augment human capabilities and assist in work has long been an aspiration.Robotics has been developing since the 1960s when the first industrial robot was introduced.As technology has advanced,robotic-assisted surgery has shown numerous advantages,including more precision,efficiency,minimal invasiveness,and safety than is possible with conventional techniques,which are research hotspots and cutting-edge trends.This article reviewed the history of medical robot development and seminal research papers about current research progress.Taking the autonomous dental implant robotic system as an example,the advantages and prospects of medical robotic systems would be discussed which would provide a reference for future research.
文摘Objective:Bladder neck contracture and vesicourethral anastomotic stenosis are difficult to manage endoscopically,and open repair is associated with high rates of incontinence.In recent years,there have been increasing reports of robotic-assisted bladder neck reconstruction in the literature.However,existing studies are small,heterogeneous case series.The objective of this study was to perform a systematic review of robotic-assisted bladder neck reconstruction to better evaluate patency and incontinence outcomes.Methods:We performed a systematic review of PubMed from first available date to May 2023 for all studies evaluating robotic-assisted reconstructive surgery of the bladder neck in adult men.Articles in non-English,author replies,editorials,pediatric-based studies,and reviews were excluded.Outcomes of interest were patency and incontinence rates,which were pooled when appropriate.Results:After identifying 158 articles on initial search,we included only ten studies that fit all aforementioned criteria for robotic-assisted bladder neck reconstruction.All were case series published from March 2018 to March 2022 ranging from six to 32 men,with the median follow-up of 5e23 months.A total of 119 patients were included in our analysis.A variety of etiologies and surgical techniques were described.Patency rates ranged from 50%to 100%,and pooled patency was 80%(95/119).De novo incontinence rates ranged from 0%to 33%,and pooled incontinence was 17%(8/47).Our findings were limited by small sample sizes,relatively short follow-ups,and heterogeneity between studies.
基金the China Scholarship Council(202106690037)the Natural Science Foundation of Anhui Province(19080885QE194)。
文摘The trajectory tracking control performance of nonholonomic wheeled mobile robots(NWMRs)is subject to nonholonomic constraints,system uncertainties,and external disturbances.This paper proposes a barrier function-based adaptive sliding mode control(BFASMC)method to provide high-precision,fast-response performance and robustness for NWMRs.Compared with the conventional adaptive sliding mode control,the proposed control strategy can guarantee that the sliding mode variables converge to a predefined neighborhood of origin with a predefined reaching time independent of the prior knowledge of the uncertainties and disturbances bounds.Another advantage of the proposed algorithm is that the control gains can be adaptively adjusted to follow the disturbances amplitudes thanks to the barrier function.The benefit is that the overestimation of control gain can be eliminated,resulting in chattering reduction.Moreover,a modified barrier function-like control gain is employed to prevent the input saturation problem due to the physical limit of the actuator.The stability analysis and comparative experiments demonstrate that the proposed BFASMC can ensure the prespecified convergence performance of the NWMR system output variables and strong robustness against uncertainties/disturbances.
基金Supported by Tianjin Key Medical Discipline(Specialty)Construction Project,No.TJYXZDXK-015A and No.TJYXZDXK-058B.
文摘BACKGROUND Hemolymphangioma of the jejunum is rare and lacks clinical specificity,and can manifest as gastrointestinal bleeding,abdominal pain,and intestinal obstruction.Computed tomography,magnetic resonance imaging,and other examinations show certain characteristics of the disease,but lack accuracy.Although capsule endoscopy and enteroscopy make up for this deficiency,the diagnosis also still re-quires pathology.CASE SUMMARY A male patient was admitted to the hospital due to abdominal distension and abdominal pain,but a specific diagnosis by computed tomography examination was not obtained.Partial resection of the small intestine was performed by robotic surgery,and postoperative pathological biopsy confirmed the diagnosis of hemo-lymphangioma.No recurrence in the follow-up examination was observed.CONCLUSION Robotic surgery is an effective way to treat hemolymphangioma through minima-lly invasive techniques under the concept of rapid rehabilitation.
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.
基金supported by National R&D Program through the NRF funded by Ministry of Science and ICT(2021M3D1A2049315)and the Technology Innovation Program(20021909,Development of H2 gas detection films(?0.1%)and process technologies)funded by the Ministry of Trade,Industry&Energy(MOTIE,Korea)supported by the Basic Science Program through the NRF of Korea,funded by the Ministry of Science and ICT,Korea.(Project Number:NRF-2022R1C1C1008845)supported by Basic Science Research Program through the NRF funded by the Ministry of Education(Project Number:NRF-2022R1A6A3A13073158)。
文摘Recent advances in functionally graded additive manufacturing(FGAM)technology have enabled the seamless hybridization of multiple functionalities in a single structure.Soft robotics can become one of the largest beneficiaries of these advances,through the design of a facile four-dimensional(4D)FGAM process that can grant an intelligent stimuli-responsive mechanical functionality to the printed objects.Herein,we present a simple binder jetting approach for the 4D printing of functionally graded porous multi-materials(FGMM)by introducing rationally designed graded multiphase feeder beds.Compositionally graded cross-linking agents gradually form stable porous network structures within aqueous polymer particles,enabling programmable hygroscopic deformation without complex mechanical designs.Furthermore,a systematic bed design incorporating additional functional agents enables a multi-stimuli-responsive and untethered soft robot with stark stimulus selectivity.The biodegradability of the proposed 4D-printed soft robot further ensures the sustainability of our approach,with immediate degradation rates of 96.6%within 72 h.The proposed 4D printing concept for FGMMs can create new opportunities for intelligent and sustainable additive manufacturing in soft robotics.
基金Supported by National Key Research and Development Program of China(Grant No.2021YFF0306202).
文摘The current gait planning for legged robots is mostly based on human presets,which cannot match the flexible characteristics of natural mammals.This paper proposes a gait optimization framework for hexapod robots called Smart Gait.Smart Gait contains three modules:swing leg trajectory optimization,gait period&duty optimization,and gait sequence optimization.The full dynamics of a single leg,and the centroid dynamics of the overall robot are considered in the respective modules.The Smart Gait not only helps the robot to decrease the energy consumption when in locomotion,mostly,it enables the hexapod robot to determine its gait pattern transitions based on its current state,instead of repeating the formalistic clock-set step cycles.Our Smart Gait framework allows the hexapod robot to behave nimbly as a living animal when in 3D movements for the first time.The Smart Gait framework combines offline and online optimizations without any fussy data-driven training procedures,and it can run efficiently on board in real-time after deployment.Various experiments are carried out on the hexapod robot LittleStrong.The results show that the energy consumption is reduced by 15.9%when in locomotion.Adaptive gait patterns can be generated spontaneously both in regular and challenge environments,and when facing external interferences.
基金The authors are the awardees of the Indian Council of Social Science Research(ICSSR)Research Program(F.No.G-11/2021-22/ICSSR/RP)This paper is largely an outcome of the research program sponsored by the ICSSR.However,the responsibility for the facts stated,opinions expressed,and conclusions drawn is entirely that of the authors.
文摘Objectives Robotic-assisted surgery(RAS)is a minimally invasive technique practiced in multiple specialties.Standard training is essential for the acquisition of RAS skills.The cost of RAS is considered to be high,which makes it a burden for institutes and unaffordable for patients.This systematic literature review(SLR)focused on the various RAS training methods applied in different surgical specialties,as well as the cost elements of RAS,and was to summarize the opportunities and challenges associated with scaling up RAS.Methods An SLR was carried out based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses reporting guidelines.The PubMed,EBSCO,and Scopus databases were searched for reports from January 2018 through January 2024.Full-text reviews and research articles in the English language from Asia-Pacific countries were included.Articles that outlined training and costs associated with RAS were chosen.Results The most common training system is the da Vinci system.The simulation technique,which includes dry-lab,wet-lab,and virtual reality training,was found to be a common and important practice.The cost of RAS encompasses the installation and maintenance costs of the robotic system,the operation theatre rent,personnel cost,surgical instrument and material cost,and other miscellaneous charges.The synthesis of SLR revealed the challenges and opportunities regarding RAS training and cost.Conclusions The results of this SLR will help stakeholders such as decision-makers,influencers,and end users of RAS to understand the significance of training and cost in scaling up RAS from a managerial perspective.For any healthcare innovation to reach a vast population,cost-effectiveness and standard training are crucial.
文摘There have been nearly 60 years since Thomas Starzl’s first liver transplant.During this period,advancements in medical technology have progressively enabled the adoption of new methods for transplantation.Among these innovations,robotic surgery has emerged in recent decades and is gradually being integrated into transplant medicine.Robotic hepatectomy and liver implantation represent significant advancements in the field of transplant surgery.The precision and minimally invasive nature of robotic surgery offer substantial benefits for both living donors and recipients.In living donors,robotic hepatectomy reduces postoperative pain,minimizes scarring,and accelerates recovery.For liver recipients,robotic liver implantation enhances surgical accuracy,leading to better graft positioning and vascular anastomosis.Robotic systems provide more precise and maneuverable control of instruments,allowing surgeons to perform complex procedures with greater accuracy and reduced risk to patients.This review encompasses publications on minimally invasive donor liver surgery,with a specific focus on robotic liver resection in transplantation,and aims to summarize current knowledge and the development status of robotic surgery in liver transplantation,focusing on liver resection in donors and graft implantation in recipients.
基金Supported by National Natural Science Foundation of China (Grant Nos. 52375003, 52205006)National Key R&D Program of China (Grant No. 2019YFB1309600)。
文摘To improve locomotion and operation integration, this paper presents an integrated leg-arm quadruped robot(ILQR) that has a reconfigurable joint. First, the reconfigurable joint is designed and assembled at the end of the legarm chain. When the robot performs a task, reconfigurable configuration and mode switching can be achieved using this joint. In contrast from traditional quadruped robots, this robot can stack in a designated area to optimize the occupied volume in a nonworking state. Kinematics modeling and dynamics modeling are established to evaluate the mechanical properties for multiple modes. All working modes of the robot are classified, which can be defined as deployable mode, locomotion mode and operation mode. Based on the stability margin and mechanical modeling, switching analysis and evaluation between each mode is carried out. Finally, the prototype experimental results verify the function realization and switching stability of multimode and provide a design method to integrate and perform multimode for quadruped robots with deployable characteristics.
基金Supported by National Natural Science Foundation of China(Grant Nos.52222502,92048302,and 51975306)Research Project of State Key Laboratory of Mechanical System and Vibration of China(Grant No.MSV201904)Emergency Research Project for COVID-19 from Institute for Precision Medicine of Tsinghua University of China.
文摘The most widely adopted method for diagnosing respiratory infectious diseases is to conduct polymerase chain reaction(PCR)assays on patients’respiratory specimens,which are collected through either nasal or oropharyngeal swabs.The manual swab sampling process poses a high risk to the examiner and may cause false-negative results owing to improper sampling.In this paper,we propose a pneumatically actuated soft end-effector specifically designed to achieve all of the tasks involved in swab sampling.The soft end-effector utilizes circumferential instability to ensure grasping stability,and exhibits several key properties,including high load-to-weight ratio,error tolerance,and variable swab-tip stiffness,leading to successful automatic robotic oropharyngeal swab sampling,from loosening and tightening the transport medium tube cap,holding the swab,and conducting sampling,to snapping off the swab tail and sterilizing itself.Using an industrial collaborative robotic arm,we integrated the soft end-effector,force sensor,camera,lights,and remote-control stick,and developed a robotic oropharyngeal swab sampling system.Using this swab sampling system,we conducted oropharyngeal swab-sampling tests on 20 volunteers.Our Digital PCR assay results(RNase P RNA gene absolute copy numbers for the samples)revealed that our system successfully collected sufficient numbers of cells from the pharyngeal wall for respiratory disease diagnosis.In summary,we have developed a pharyngeal swab-sampling system based on an“enveloping”soft actuator,studied the sampling process,and imple-mented whole-process robotic oropharyngeal swab-sampling.
文摘Background:Minimally invasive surgery is the optimal treatment for insulinoma.The present study aimed to compare short-and long-term outcomes of laparoscopic and robotic surgery for sporadic benign insulinoma.Methods:A retrospective analysis of patients who underwent laparoscopic or robotic surgery for insulinoma at our center between September 2007 and December 2019 was conducted.The demographic,perioperative and postoperative follow-up results were compared between the laparoscopic and robotic groups.Results:A total of 85 patients were enrolled,including 36 with laparoscopic approach and 49 with robotic approach.Enucleation was the preferred surgical procedure.Fifty-nine patients(69.4%)underwent enucleation;among them,26 and 33 patients underwent laparoscopic and robotic surgery,respectively.Robotic enucleation had a lower conversion rate to laparotomy(0 vs.19.2%,P=0.013),shorter operative time(102.0 vs.145.5 min,P=0.008)and shorter postoperative hospital stay(6.0 vs.8.5 d,P=0.002)than laparoscopic enucleation.There were no differences between the groups in terms of intraoperative blood loss,the rates of postoperative pancreatic fistula and complications.After a median follow-up of 65 months,two patients in the laparoscopic group developed a functional recurrence and none of the patients in the robotic group had a recurrence.Conclusions:Robotic enucleation can reduce the conversion rate to laparotomy and shorten operative time,which might lead to a reduction in postoperative hospital stay.
文摘Objectives:To highlight critical preoperative and intraoperative considerations in approaching fistula repair robotically.Methods:A search of the literature was conducted to identify relevant articles pertaining to robotic management of urinary fistulae.Results:Fistulae of the genitourinary tract can be a challenging dilemma for urologists,as definitive management may require surgical intervention.Pathogenesis of both enteric and non-enteric fistulae are multifactorial,and successful repair hinges on the meticulous perioperative evaluation,planning,and execution.Traditional open techniques can subject patients to increased morbidity and prolonged hospitalizations.Since its introduction,the robotic surgical platform has continued to expand its indications.Its three-dimensional visualization and tremor free wristed instrument movements have made the robotic platform an attractive option for genitourinary fistula reconstruction.Conclusion:Robotic management of complex urinary fistulae is feasible in expert hands;more studies are needed to define its role in the treatment algorithm of this devastating conditions.
基金Supported by Key Scientific Research Platforms and Projects of Guangdong Regular Institutions of Higher Education of China(Grant No.2022KCXTD033)Guangdong Provincial Natural Science Foundation of China(Grant No.2023A1515012103)+1 种基金Guangdong Provincial Scientific Research Capacity Improvement Project of Key Developing Disciplines of China(Grant No.2021ZDJS084)National Natural Science Foundation of China(Grant No.52105009).
文摘The current parallel ankle rehabilitation robot(ARR)suffers from the problem of difficult real-time alignment of the human-robot joint center of rotation,which may lead to secondary injuries to the patient.This study investigates type synthesis of a parallel self-alignment ankle rehabilitation robot(PSAARR)based on the kinematic characteristics of ankle joint rotation center drift from the perspective of introducing"suitable passive degrees of freedom(DOF)"with a suitable number and form.First,the self-alignment principle of parallel ARR was proposed by deriving conditions for transforming a human-robot closed chain(HRCC)formed by an ARR and human body into a kinematic suitable constrained system and introducing conditions of"decoupled"and"less limb".Second,the relationship between the self-alignment principle and actuation wrenches(twists)of PSAARR was analyzed with the velocity Jacobian matrix as a"bridge".Subsequently,the type synthesis conditions of PSAARR were proposed.Third,a PSAARR synthesis method was proposed based on the screw theory and type of PSAARR synthesis conducted.Finally,an HRCC kinematic model was established to verify the self-alignment capability of the PSAARR.In this study,93 types of PSAARR limb structures were synthesized and the self-alignment capability of a human-robot joint axis was verified through kinematic analysis,which provides a theoretical basis for the design of such an ARR.
基金supported by the National Natural Science Foundation of China(62203262,62350083)Natural Science Foundation of Shandong Province(ZR2020ZD40,ZR2022QF124)。
文摘Traditional proportional-integral-derivative(PID)controllers have achieved widespread success in industrial applications.However,the nonlinearity and uncertainty of practical systems cannot be ignored,even though most of the existing research on PID controllers is focused on linear systems.Therefore,developing a PID controller with learning ability is of great significance for complex nonlinear systems.This article proposes a deterministic learning-based advanced PID controller for robot manipulator systems with uncertainties.The introduction of neural networks(NNs)overcomes the upper limit of the traditional PID feedback mechanism’s capability.The proposed control scheme not only guarantees system stability and tracking error convergence but also provides a simple way to choose the three parameters of PID by setting the proportional coefficients.Under the partial persistent excitation(PE)condition,the closed-loop system unknown dynamics of robot manipulator systems are accurately approximated by NNs.Based on the acquired knowledge from the stable control process,a learning PID controller is developed to further improve overall control performance,while overcoming the problem of repeated online weight updates.Simulation studies and physical experiments demonstrate the validity and practicality of the proposed strategy discussed in this article.