Robotic natural orifice specimen extraction surgery I-type F method vs conventional robotic resection for lower rectal cancer

BACKGROUND Robotic resection using the natural orifice specimen extraction surgery I-type F method(R-NOSES I-F)is a novel minimally invasive surgical strategy for the treatment of lower rectal cancer.However,the current literature on this method is limited to case reports,and further investigation into its safety and feasibility is warranted.AIM To evaluate the safety and feasibility of R-NOSES I-F for the treatment of low rectal cancer.METHODS From September 2018 to February 2022,206 patients diagnosed with low rectal cancer at First Affiliated Hospital of Nanchang University were included in this retrospective analysis.Of these patients,22 underwent R-NOSES I-F surgery(RNOSES I-F group)and 76 underwent conventional robotic-assisted low rectal cancer resection(RLRC group).Clinicopathological data of all patients were collected and analyzed.Postoperative outcomes and prognoses were compared between the two groups.Statistical analysis was performed using SPSS software.RESULTS Patients in the R-NOSES I-F group had a significantly lower visual analog score for pain on postoperative day 1(1.7±0.7 vs 2.2±0.6,P=0.003)and shorter postoperative anal venting time(2.7±0.6 vs 3.5±0.7,P<0.001)than those in the RLRC group.There were no significant differences between the two groups in terms of sex,age,body mass index,tumor size,TNM stage,operative time,intrao-perative bleeding,postoperative complications,or inflammatory response(P>0.05).Postoperative anal and urinary functions,as assessed by Wexner,low anterior resection syndrome,and International Prostate Symptom Scale scores,were similar in both groups(P>0.05).Long-term follow-up revealed no significant differences in the rates of local recurrence and distant metastasis between the two groups(P>0.05).CONCLUSION R-NOSES I-F is a safe and effective minimally invasive procedure for the treatment of lower rectal cancer.It improves pain relief,promotes gastrointestinal function recovery,and helps avoid incision-related complications.

Comparisons of nozzle orifice processing methods using synchrotron X-ray micro-tomography

Based on the high flux synchrotron X-ray of the Shanghai Synchrotron Radiation Facility (SSRF), high precision 3D digital models of diesel nozzle tips have been established by X-ray micro-tomography technology, which reveal the internal surfaces and structures of orifices. To analyze the machining precision and characteristics of orifice processing methods, an ap- proach is presented based on the parameters of the internal structures of nozzle orifices, including the nozzle diameter, the orifice inner surface waviness, the eccentricity distance and the angle between orifices. Using this approach, two kinds of nozzle orifice processing methods, computerized numerical control drilling and electric discharge machining, have been studied and compared. The results show that this approach enables a simple, direct, and comprehensive contrastive analysis of nozzle orifice processing methods. When processing a single orifice, the electric discharge machining method has obvious advantages. However, when there are multiple orifices, the error levels of the two methods are similar in relation to the symmetry of distribution of the orifices.