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Surgical Robot (surgical + robot)

Distribution by Scientific Domains

Medical Sciences	80%

Selected Abstracts

Transoral Robotic Surgery: Supraglottic Laryngectomy in a Canine Model,

THE LARYNGOSCOPE, Issue 7 2005
Gregory S. Weinstein MD
Abstract Objectives/Hypothesis: To develop a technique for computer enhanced robotic transoral supraglottic partial laryngectomy in the canine model. Study Design: Surgical procedure on the larynx in a canine model with a commercially available surgical robot. Methods: With use of the da Vinci Surgical Robot (Intuitive Surgical, Inc., Sunnyvale, CA), the supraglottic partial laryngectomy was performed on a mongrel dog that had been orotracheally intubated using general anesthesia. The videoscope and the 8 mm end-effectors of the robotic system were introduced through three ports, transorally. The surgical procedure was performed remotely from the robotic system console. The procedure was documented with still and video photography. Results: Supraglottic partial laryngectomy was successfully performed using the da Vinci Surgical Robot, with 8 mm instrumentation. The robotic system allowed for celerity and accuracy secondary to findings specific to the surgical approach, including excellent hemostasis, superb visualization of the operative field with expeditious identification of laryngeal submucosal soft tissue and skeletal landmarks, and multiplanar transection of tissues. In addition, the use of the robotic system also was found to have technical advantages inherent in robotic surgery, including the use of "wristed" instrumentation, tremor abolition, motion scaling, and three-dimensional vision. Conclusions: The da Vinci Surgical Robot allowed for successful robotic transoral supraglottic partial laryngectomy in the canine model. [source]

A rat model for evaluating physiological responses to femoral shaft fracture reduction using a surgical robot

JOURNAL OF ORTHOPAEDIC RESEARCH, Issue 12 2008
Markus Oszwald
Abstract The first step in treatment of displaced femoral shaft fractures is adequate reduction of the fracture fragments. Manually performed, reduction can be challenging, and is frequently associated with soft tissue damage, especially when repeated reduction attempts are made. The magnitude of local and systemic inflammatory responses caused by prolonged and repeated reduction maneuvers has not been fully established. We devised an operative technique utilizing a robotic reduction device for use in a rat. A femoral fracture was simulated by means of an osteotomy. The robot enabled reproduction of both manual and guided precision reductions, performed in a single path movement. An external fixator was designed specifically to manipulate the rat femur and also for fixation of the osteotomy region. First, reduction accuracy was assessed in eight femurs, then the quality of fixator placement and reduction accuracy was analyzed in 22 femurs. In the first case, 100% of the femurs were accurately reduced. In the second case, 91% had successful stable fixation and an accurate reduction was achieved in 86% of the specimens. We demonstrated the feasibility of a model of robot-assisted fracture reduction that could be used to analyze the effects of reduction on the surrounding soft tissue via biochemical and histopathological means. A future aspect will be to evaluate whether the robot confers an advantage in fracture reduction versus the conventional technique, which would have significant implications for the use of robotic devices in orthopaedic surgery. © 2008 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res [source]

3D ultrasound in robotic surgery: performance evaluation with stereo displays,

THE INTERNATIONAL JOURNAL OF MEDICAL ROBOTICS AND COMPUTER ASSISTED SURGERY, Issue 3 2006
Paul M. Novotny
Abstract Background The recent advent of real-time 3D ultrasound (3DUS) imaging enables a variety of new surgical procedures. These procedures are hampered by the difficulty of manipulating tissue guided by the distorted, low-resolution 3DUS images. To lessen the effects of these limitations, we investigated stereo displays and surgical robots for 3DUS-guided procedures. Methods By integrating real-time stereo rendering of 3DUS with the binocular display of a surgical robot, we compared stereo-displayed 3DUS with normally displayed 3DUS. To test the efficacy of stereo-displayed 3DUS, eight surgeons and eight non-surgeons performed in vitro tasks with the surgical robot. Results Error rates dropped by 50% with a stereo display. In addition, subjects completed tasks faster with the stereo-displayed 3DUS as compared to normal-displayed 3DUS. A 28% decrease in task time was seen across all subjects. Conclusions The results highlight the importance of using a stereo display. By reducing errors and increasing speed, it is an important enhancement to 3DUS-guided robotics procedures. Copyright © 2006 John Wiley & Sons, Ltd. [source]

Assessment of Intraoperative Safety in Transoral Robotic Surgery,

THE LARYNGOSCOPE, Issue 2 2006
Neil G. Hockstein MD
Abstract Introduction: Robotic technology has been safely integrated into thoracic and abdominopelvic surgery, and the early experience has been very promising with very rare complications related to robotic device failure. Recently, several reports have documented the technical feasibility of transoral robotic surgery (TORS) with the daVinci Surgical System. Proposed pharyngeal and laryngeal applications include radical tonsillectomy, base-of-tongue resection, supraglottic laryngectomy, and phonomicrosurgery. The safety of transoral placement of the robotic endoscope and instruments has not been established. Potential risks specific to the transoral use of the surgical robot include facial skin laceration, tooth injury, mucosal laceration, mandible fracture, cervical spine fracture, and ocular injury. We hypothesize that these particular risks of transoral surgery are similar with robotic assistance compared with conventional transoral surgery. Methods: To test this hypothesis, we attempted to intentionally injure a human cadaver with the daVinci Surgical System by impaling the facial skin and pharyngeal and laryngeal mucosa with the robotic instruments and endoscope. We also attempted to extract or fracture teeth and fracture the cadaver's mandible and cervical spine by applying maximal pressure and torque with the robotic arms. Experiments were documented with still and video photography. Results: Impaling the cadaver's skin and mucosa resulted in only superficial lacerations. Tooth, mandible, and cervical spine fracture could not be achieved. Conclusions: Initial experiments performing TORS on a human cadaver with the daVinci Surgical System demonstrate a safety profile similar to conventional transoral surgery. Additionally, we discuss several strategies to increase patient safety in TORS. [source]