Oncologic outcomes with and without amniotic membranes in robotic-assisted radical prostatectomy:A propensity score matched analysis

Objective:Placement of human placenta derived grafts during robotic-assisted radical prostatectomy(RARP)hastens the return of continence and potency.The long-term impact on the oncologic outcomes remains to be investigated.Our objective was to determine the oncologic outcomes of patients with dehydrated human amnion chorion membrane(dHACM)at RARP compared to a matched cohort.Methods:In a referral centre,from August 2013 to October 2019,599 patients used dHACM in bilateral nerve-sparing RARP.We excluded patients with less than 12 months follow-up,simple prostatectomy,and unilateral nerve-sparing.Patients with dHACM(amnio group)were 529,and were propensity score matched 1:1 to 2465 patients without dHACM(non-amnio group)and a minimum follow-up of 36 months.At the time of RARP,dHACM was placed around the neurovascular bundle in the amnio group.Continuous and categorical variables in matched groups was tested by two-sample Kolmogorov-Smirnov test and Fisher's exact test respectively.Outcomes measured were biochemical recurrence(BCR),adjuvant and salvage therapy rates.Results:Propensity score matching resulted in two groups of 444 patients.Cumulative incidence functions for BCR did not show a difference between the groups(p=0.3).Patients in the non-amnio group required salvage therapy more frequently than the amnio group,particularly after partial nerve-sparing RARP(6.3%vs.2.3%,p=0.001).Limitations are the absence of prospective randomization.Conclusion:The data suggest that using dHACM does not have a negative impact on BCR in patients.Outcomes of cancer specific and overall survival will require follow-up study to increase our understanding of these grafts’impact on prostate cancer biology.

Geometric Programming for Nonlinear Satellite Buffer Networks With Time Delays under L_(1)-Gain Performance

Dear Editor,This letter concerns the parameter tuning problem for nonlinear satellite buffer networks with communication delays, aiming to optimize their stability properties under L_(1)-gain. We first model the satellite buffer networks by a nonlinear time-delay positive system and propose a novel characterization under which the nonlinear system is asymptotically stable with a prescribed L_(1)-induced performance.

Untethered Micro/Nanorobots for Remote Sensing:Toward Intelligent Platform

Untethered micro/nanorobots that can wirelessly control their motion and deformation state have gained enormous interest in remote sensing applications due to their unique motion characteristics in various media and diverse functionalities.Researchers are developing micro/nanorobots as innovative tools to improve sensing performance and miniaturize sensing systems,enabling in situ detection of substances that traditional sensing methods struggle to achieve.Over the past decade of development,significant research progress has been made in designing sensing strategies based on micro/nanorobots,employing various coordinated control and sensing approaches.This review summarizes the latest developments on micro/nanorobots for remote sensing applications by utilizing the self-generated signals of the robots,robot behavior,microrobotic manipulation,and robot-environment interactions.Providing recent studies and relevant applications in remote sensing,we also discuss the challenges and future perspectives facing micro/nanorobots-based intelligent sensing platforms to achieve sensing in complex environments,translating lab research achievements into widespread real applications.

Designing and Optimization of an Off-line Programming System for Robotic Belt Grinding Process

Off-line programming （OLP） system becomes one of the most important programming modules for the robotic belt grinding process, however there lacks research on increasing the grinding dexterous space depending on the OLP system. A new type of grinding robot and a novel robotic belt grinding workcell are forwarded, and their features are briefly introduced. An open and object-oriented off-line programming system is developed for this robotic belt grinding system. The parameters of the trimmed surface are read from the initial graphics exchange specification （IGES） file of the CAD model of the workpiece. The deBoor-Cox basis function is used to sample the grinding target with local contact frame on the workpiece. The numerical formula of inverse kinematics is set up based on Newton＇s iterative procedure, to calculate the grinding robot configurations corresponding to the grinding targets. After the grinding path is obtained, the OLP system turns to be more effective than the teach-by-showing system. In order to improve the grinding workspace, an optimization algorithm for dynamic tool frame is proposed and performed on the special robotic belt grinding system. The initial tool frame and the interval of neighboring tool frames are defined as the preparation of the algorithm. An optimized tool local frame can be selected to grind the complex surface for a maximum dexterity index of the robot. Under the optimization algorithm, a simulation of grinding a vane is included and comparison of grinding workspace is done before and after the tool frame optimization. By the algorithm, the grinding workspace can be enlarged. Moreover the dynamic tool frame can be considered to add one degree-of-freedom to the grinding kinematical chain, which provides the theoretical support for the improvement of robotic dexterity for the complex surface grinding.

Robotic assisted andrological surgery

The introduction of the operative microscope for andrological surgery in the 1970s provided enhanced magnification and accuracy, unparalleled to any previous visual loop or magnification techniques. This technology revolutionized techniques for microsurgery in andrology. Today, we may be on the verge of a second such revolution by the incorporation of robotic assisted platforms for microsurgery in andrology. Robotic assisted microsurgery is being utilized to a greater degree in andrology and a number of other microsurgical fields, such as ophthalmology, hand surgery, plastics and reconstructive surgery. The potential advantages of robotic assisted platforms include elimination of tremor, improved stability, surgeon ergonomics, scalability of motion, multi-input visual interphases with up to three simultaneous visual views, enhanced magnification, and the ability to manipulate three surgical instruments and cameras simultaneously. This review paper begins with the historical development of robotic microsurgery. It then provides an in-depth presentation of the technique and outcomes of common robotic microsurgical andrological procedures, such as vasectomy reversal, subinguinal varicocelectomy, targeted spermatic cord denervation （for chronic orchialgia） and robotic assisted microsurgical testicular sperm extraction （microTESE）.

Surfel-based surface modeling for robotic belt grinding simulation

The new free-form surface modelling technology for robotic belt grinding simulation presented in this paper is based on discrete surfel elements generated from the surface approximation point set and can facilitate the simulation implementation. A local process model exploits the advantage of surfel representation to compute the material removal rate and the final surface grinding error can be easily carried out. With the help of this system, robot programmers can improve the path planning and predict potential problems by visualizing the manufacturing process.

Robotic surgery techniques to approach benign prostatic hyperplasia disease:A comprehensive literature review and the state of art

Objective:The robotic-assisted approach to simple prostatectomy(RASP)was conceived,essentially reproducing the fundaments of open simple prostatectomy.Since the first report,RASP underwent several technical modifications.The study aims to identify and describe the current robotic surgery techniques to approach benign prostatic hyperplasia(BPH).Methods:The paper performed a non-systematic literature review accessing PubMed and Embase databases for all full-text articles published from 2008 to May 2020,assessing robot-assisted surgical techniques for BPH treatment using the terms“robot-assisted simple prostatectomy”OR“robotic simple prostatectomy”OR“RASP”AND“surgical technique”.Results:After careful review of 180 studies in PubMed and 198 in Embase,16 papers reporting different RASP techniques.After the first procedure described by Sotelo et al.[9],several authors contributed to the development of the RASP technique.John et al.[24]proposed the extraperitoneal access,and Yuh et al.[23]first reported the adenoma transcapsular dissection.Some modifications were proposed by Coelho et al.[31]on trigonization,posterior reconstruction,and urethro-vesical anastomosis.Other groups focused on urethral-preserving procedures.Moschovas et al.[28]and Clavijo et al.[32]recently described an intrafascial RASP with the removal of the entire prostatic tissue.Finally,Kaouk et al.[29]reported the feasibility and safety of the da Vinci Single Port approach.Conclusion:In the last eighteen years,the robotic-assisted approach to BPH disease has been evolved,and different techniques have been described.This review details all the technical developments on RASP that distinctive groups have proposed since the multiport robotic platforms until the new da Vinci Single Port.

Design Considerations for an Underactuated Robotic Finger Mechanism

A design approach is presented in this paper for underactuation in robotic finger mechanisms. The characters of underactuated finger mechanisms are introduced as based on linkage and spring systems. The feature of self-adaptive enveloping grasp by underactuated finger mechanisms is discussed with feasible in grasping unknown objects. The design problem of robotic fingers is analyzed by looking at many aspects for an optimal functionality. Design problems and requirements for underactuated mechanisms are formulated as related to human-like robotic fingers. In particular, characteristics of finger mechanisms are analyzed and optimality criteria are summarized with the aim to formulate a general design algorithm. A general multi-objective optimization design approach is applied as based on a suitable optimization problem by using suitable expressions of optimality criteria. An example is illustrated as an improvement of finger mechanism in Laboratory of Robotics and Mechatronics （LARM） Hand. Results of design outputs and grasp simulations are reported with the aim to show the practical feasibility of the proposed concepts and computations.

HIT anthropomorphic robotic hand and finger motion control

Nowadays many anthropomorphic robotic hands have been put forward. These hands emphasize different aspects according to their applications. HIT Anthropomorphic Robotic Hand (ARhand) is a simple, lightweight and dexterous design per the requirements of anthropomorphic robots. Underactuated self-adaptive theory is adopted to decrease the number of motors and weight. The fingers of HIT ARhand with multi phalanges have the same size as those of an adult hand. Force control is realized with the position sensor, joint torque sensor and fingertip torque sensor. From the 3D model, the whole hand, with the low power consumption DSP control board integrated in it, will weigh only 500 g. It will be assembled on a BIT-Anthropomorphic Robot.

Robotic renal and adrenal oncologic surgery:A contemporary review

Robot-assisted surgery has evolved over time.Radical nephrectomy with inferior vena cava thrombectomy is feasible and safe for level I,II and III thrombus in high volume centers.Though it is feasible for level IV thrombus,this procedure needs a multi-departmental cooperation.However,the safety of robot-assisted procedures in this subset is still unknown.Robot-assisted partial nephrectomy has been universally approved and found oncologically safe.Robotic adrenalectomy has been increasingly utilized for select cases,especially in bilateral tumors and for retroperitoneal adrenalectomy.

Design of Industrial Robotic Controller Based on DSP

This paper describes the design of industrial robot controller based on the DSP technology. Robotic real time control is realized by PC and DSP motion control card and this method improves the performance of robotic controller. Finally this paper gives some experiment results and conclusion.

Fuzzy reasoning model using fuzzy Petri Nets for the monitoring of robotic assembly

This paper presented a fuzzy Petri net model to deal with the monitoring of robotic assembly. Based on the fuzzy Petri net model, an efficient composite reasoning mode was proposed to perform fuzzy reasoning automatically. It can determine whether there exists an antecedent-consequence relationship between two contact states. Furthermore, various types of sensor signals can be converted to the same form of real values between zero and one, and the contradiction among large number, high degree of truth and importance of input conditions can be resolved very well by introducing the weight factors and priorities for sensor signals. Finally, a peg-in-the-hole example was given to illustrate the reasonability and feasibility of the proposed model.

Application of Artificial Neural Network in Robotic Hybrid Position/Force Control

A hybrid position/force controller is designed for the joint 2 and the joint 3 of thePUMA 560 robot.The hybrid controller includes a multilayered neural network,which canidentify the dynamics of the contacted environment and can optimize the parameters of PIDcontroller.The experimental results show that after having been trained,the robot has sta-ble response to the training patterns and strong adaptive ability to the situation between thepatterns.

Discrete-event modeling for internet multi-robotics

Internet multi-robotics is a typical discrete-event system. In order to describe joint activities between multiple operators and multiple robots, a 4-level discrete-event model is proposed in this paper based on the controlled condition/event Petri nets (CCEP). On the first or mission level, the task splitting of the system is defined; on the second or multi-operator level, a precedence graph is introduced for every operator to plan his or her robotic actions; on the third or coordination level, the above precedence graphs are translated and integrated into the corresponding CCEPs in terms of specific rules; and on the last or multi-robot level, operators can select their control range by setting the corresponding control marks of the obtained CCEPs. As a consequence, a clear mechanism of operator-robot collaboration is obtained to conduct the development of the system.

Robotic urologic surgery:Past,present and future

The robotic surgery revolution has undoubtedly changed how surgeons’and patients’view and perform surgical intervention.While this evolution in surgical technology has affected many surgical fields,it has had the most impact in the field of urologic surgery.Most intra-abdominal surgical procedures in urology are now performed robotically in the United States and Europe.

An object oriented multi-robotic graphic simulation environment for programming the welding tasks

An object oriented multi robotic graphic simulation environment is described in this paper. Object oriented programming is used to model the physical objects of the robotic workcell in the form of software objects or classes. The virtual objects are defined to provide the user with a user friendly interface including realistic graphic simulation and clarify the software architecture. The programming method of associating the task object with active object effectively increases the software reusability, maintainability and modifiability. Task level programming is also demonstrated through a multi robot welding task that allows the user to concentrate on the most important aspects of the tasks. The multi thread programming technique is used to simulate the interaction of multiple tasks. Finally, a virtual test is carried out in the graphic simulation environment to observe design and program errors and fix them before downloading the software to the real workcell.

Experimental study of Internet telerobotics based on virtual guides

For the virtual environment (VE) to control remote robots through Internet, this paper proposes an operational idea based on virtual guides (VGs). The VGs consist of three types, line VG, plane VG, and body VG, which can greatly enhance the safety and flexibility of the man-machine system. Through the analysis of several common cases, the idea of the VGs are first introduced and described. Second, detailed descriptions of the three VGs are given, and then a uniform representation of all VGs is given. Finally, a typical experiment is designed and implemented according to the modes of video feedback, video&VE feedback, and video&VE&VG feedback. Experimental results show that the operation based on VEs and VGs have significant advantages over that based on video feedback, and VGs can greatly improve the ability of the VE to control remote robots, thus obtaining high and efficient man-machine cooperation.

Cardiovascular Complications of Large Hiatal Hernias: Expanding the Indications for Robotic Surgical Anatomic and Physiologic Repair: A Review

Background: Historically, the pathophysiology of Hiatal Hernias (HH) has not been fully understood. As a result, the surgical therapy of HH has focused primarily on gastrointestinal symptoms and Gastroesophageal Reflux (GERD). This treatment strategy has been associated with poor relief of symptoms and poor long-term outcomes. In fact, until recently, most patients with HH have been watched and referred for surgery as a last resort. Recent experience has shown that a large (giant) Hiatal Hernia (GHH) is a common problem known to impact adjacent organs such as the hearts and lungs. Those referred for surgical repair often complain of dyspnea, which is erroneously attributed to pulmonary compression or aspiration, but has been shown to be from tamponade caused from compression of the heart by herniated abdominal contents. This article reviews the present understanding of GHH, the cardiac complications which result from GHH, and the most advanced robotic minimally invasive surgical approach to the anatomic and physiologic repair of GHH. Methods: In a prospective cohort study, we evaluated patients undergoing RRHH with at least a 2-year follow-up. All patients undergoing elective (RRHH) were identified preoperatively and enrolled prospectively in this study. Preoperative characteristics, medical comorbidities, and clinical information were all recorded prospectively and recorded into a secure surgical outcomes database. All patients received the previously validated Gastroesophageal Reflux Disease-Health-Related Quality of Life (GERD-HRQL) questionnaire preoperatively and at postoperative time points of 1 month, 1 year, and 2 years. Patients routinely had a barium swallow postoperatively before discharge but did not undergo a barium swallow, an endoscopy, or a CT scan study at the 1-month time point unless indicated by symptoms. At 6 months, 1 year, and yearly intervals thereafter, all patients received an endoscopy study to ascertain the presence of a recurrence, regardless of symptoms. Recurrence was defined as over 2 cm or 10% of the stomach above the diaphragm detected by CT, esophagogram or endoscopy. In addition, an extensive search was conducted using Pub Med in order to extract references to the cardiovascular complications of HH. Results: 423 patients underwent RRHH. With a long-term follow-up, there was a significant decrease in the Median Symptom Severity Score from 42.0 preoperatively, to 3.0 postoperatively. Recurrence was seen in 5 patients (5/423) for a recurrence rate of 1.1%. Conclusion: This experience has been the basis of two important realizations: 1) all patients with GHH have at least some degrees of clinically relevant compression of the inferior vena cava and the left atrium which causes tamponade and cardiogenic dyspnea which completely resolves after successful surgical repair;and 2) primary care providers and gastroenterologists who usually treat patients for GHH repair rarely recognize cardiac compression and tamponade as the cause of the shortness of breath and gradual increase in dyspnea on exertion and progressive fatigability in these patients. This article reviews the present understanding of GHH, the cardiac complications which result from GHH and the most advanced robotic minimally invasive surgical approach to the anatomic and physiologic repair of GHH.

SYNTHESIS OF ROBOTIC MECHANISM FOR MICROSURGICAL CORNEAL GRAFTING

In order to enhance the effect of comeal grafting, an assisting microsurgical robot has been developed. As one of principal issues for the robotic system design, type and size synthesis of the robotic mechanism is discussed. For this purpose, timeline subtask is analyzed with surgical component motion in manual comeal grafting microsurgery, as the reference of robotic mechanism synthesis. On the basis of study on the kinematic correlation between the arm structures and the wrist structures, configuration of joint is determined for the surgical task and motion in type synthesis of the mechanism. The objective for size synthesis of robotic mechanism is optimization of the mechanism dexterity as a manipulation capability. The condition number based on Jacob matrix is chosen as dexterity measure of the mechanism. The prototype is developed.