ObjectiveTo explore the feasibility of robotic sleeve lobectomy and bronchoplasty and to summarize the experience of quality control and technical process management.MethodsFrom January to December 2018, our hospital completed robotic sleeve lobectomy and bronchoplasty for 5 patients, including the upper right lung lobe in 2 patients, the middle right lung lobe in 1 patient and the lower left lung lobe in 2 patients. There were 3 males and 2 females with an age of 56.6 (39-75) years. The surgical approach was the same as the surgical incision of the robotic lobectomy. During the operation, the lobes were separated, all enlarged mediastinal lymph nodes were cleaned, pulmonary hilum was dissected, pulmonary arteriovenous vessels and bronchi were exposed, and pulmonary vessels were treated. After exposing the main bronchi, the bronchi were cut off at the distal end of the lesion, and the lobes where the lesion was located (including lesions) were excised by sleeve type and the bronchi were continuously sutured with 3-0 Prolene from the back wall for anastomosis. After the anastomosis, no air leakage was found in the expanded lung, and the anastomosis was no longer wrapped.ResultsThe operation time was 147.4 (100-192) min, including bronchial anastomosis time 17.6 (14-25) min. Intraoperative blood loss was 60.0 (20-100) mL, and 20 (9-37) lymph nodes were dissected. Three patients had squamous cell carcinoma, 1 adenocarcinoma, and 1 neuroendocrine tumor. All patients showed negative results in the freezing pathology of bronchial stump during operation. All patients recovered well after surgery, without perioperative complications, and the anastomosis was smooth. Postoperative hospital stay was 10.8 (7-14) days. The patients were followed up for 6 to 12 months without anastomotic stenosis or other complications.ConclusionSince the robot system is a special instrument with 3D vision and 7 degrees of freedom for movable joints, the robotic bronchial suture is more flexible and accurate. The robotic sleeve lobectomy and bronchoplasty are safe and feasible.
Objective To evaluate the safety and feasibility of remote robot-assisted thoracoscopic surgery utilizing 5G technology. Methods Clinical data from five patients who underwent 5G remote robot-assisted thoracoscopic surgery at the Thoracic Surgery Center of Gansu Provincial People's Hospital from May to October 2024 were retrospectively analyzed. Results Finally, five patients were included. There were 2 males and 3 females at median age of 50 (42-63) years. All five surgeries (including 1 patient of lobectomy, 3 patients of partial lung resection and 1 patient of mediastinal lesion resection) were successfully completed without conversion to thoracotomy, complications, or mortality. The median intraoperative signal delay across the patients was 39 (37-42) ms. The median psychological load score for the surgeons was 9 (3-13). The median operation time was 100 (80-122) minutes with a median intraoperative blood loss of 100 (30-200) mL. Catheter drainage lasted a median of 4 (3-5) days, and the median drainage volumes on the first, second, and third postoperative day were 200 (100-300) mL, 150 (60-220) mL, and 80 (30-180) mL, respectively. The median postoperative hospital stay was 4 (3-7) days, and the median pain scores on the third postoperative day were 3 (1-4), 3 (0-3), and 1 (0-3), respectively. Conclusion 5G remote robot-assisted thoracoscopic surgery is safe and effective, with good surgical experience, smooth operation and small intraoperative delay.
Objective To summarize the current research progress of endoscopic/robotic surgery for breast cancer, so as to provide theoretical basis for surgeons and patients to choose surgical methods. Method The relevant literatures on breast cancer endoscopic/robotic surgery at home and abroad in recent years were summarized and reviewed. Results Endoscopic/robotic surgery for breast cancer had the advantages of low intraoperative bleeding, fewer postoperative complications, fast postoperative recovery, good cosmetic results and high patient satisfaction. Conclusions Endoscopic/robotic surgery is a safe and feasible surgical modality and a complement to traditional open breast surgery.
Brain-computer interface (BCI) has great potential to replace lost upper limb function. Thus, there has been great interest in the development of BCI-controlled robotic arm. However, few studies have attempted to use noninvasive electroencephalography (EEG)-based BCI to achieve high-level control of a robotic arm. In this paper, a high-level control architecture combining augmented reality (AR) BCI and computer vision was designed to control a robotic arm for performing a pick and place task. A steady-state visual evoked potential (SSVEP)-based BCI paradigm was adopted to realize the BCI system. Microsoft's HoloLens was used to build an AR environment and served as the visual stimulator for eliciting SSVEPs. The proposed AR-BCI was used to select the objects that need to be operated by the robotic arm. The computer vision was responsible for providing the location, color and shape information of the objects. According to the outputs of the AR-BCI and computer vision, the robotic arm could autonomously pick the object and place it to specific location. Online results of 11 healthy subjects showed that the average classification accuracy of the proposed system was 91.41%. These results verified the feasibility of combing AR, BCI and computer vision to control a robotic arm, and are expected to provide new ideas for innovative robotic arm control approaches.
Objective
To summarize the computer assisted navigation and robotics in the classification of knee surgery, and the development, surgical indications and contraindication, effectiveness, and the research progress of computer assisted navigation and robotics in unicompartmental knee arthroplasty (UKA).
Methods
The related literature on computer assisted navigation and robotics in UKA was extensively reviewed, summarized, and analyzed.
Results
Recently, satisfactory results have been achieved in UKA for the treatment of single compartmental knee osteoarthritis. With the rapid development of computer navigation and robotic technology gradually combined with clinical practice, the great precision and accuracy of implant have been improved in computer navigation and robotics in UKA surgery. Postoperative function is well recovered, meanwhile, prosthesis survival can be significantly increased.
Conclusion
Computer assisted navigation and robotics in UKA can greatly improve the accuracy of the implant when compared with traditional UKA. The early effectiveness is satisfactory, but the long-term effectiveness still needs to be further observed.
ObjectiveTo compare and analyze the therapeutic effect of robotic and laparoscopic radical resection of rectal cancer for obese patients with rectal adenocarcinoma. MethodsThe retrospective cohort study was conducted. The clinicopathologic data of 217 obese patients with rectal adenocarcinoma who were treated in the First Affiliated Hospital of Zhengzhou University from October 2017 to January 2020 were collected, 104 patients received radical resection of rectal cancer assisted by Da Vinci robotic surgical system and were assigned to the robot group, 113 patients underwent laparoscopic-assisted radical resection of rectal cancer and were assigned to the laparoscope group. The perioperative indexes, pathological examination, and postoperative recovery of urogenital function were compared. ResultsThere were no significant differences between the two groups in the gender, age, body mass index, distance from lower edge of tumor to anal edge, tumor diameter, American Association of Anesthesiologists classification, preoperative complications, preoperative carcinoembryonic antigen level, tumor differentiation, and TNM stage (P>0.05). The operations were successfully completed in all patients and there was no conversion to laparotomy and perioperative death. There were no significant differences between the two groups in the operation time, first exhaust time, first eating liquid food time, first getting out of bed activity time, drainage tube placement time, prophylactic stoma rate, and postoperative complications (P>0.05). The intraoperative blood loss and total hospital stay in the robot group were less than those of the laparoscope group (P<0.05). The International Prostate Symptom Score of the robot group was lower than that of the laparoscope group at 3, 6, and 12 months after operation (P<0.05). The International Index of Erectile Function-15 score of male patients and Female Sexual Function Index-19 score of female patients in the robot group were higher than those in the laparoscope group at 3, 6, and 12 months after operation (P<0.05). ConclusionsRobotic surgery is safe and effective in treatment of obese patients with rectal adenocarcinoma. Compared with laparoscopic surgery, robotic surgery could benefit patients more in protecting postoperative genitourinary function.
In conventional open breast surgery, the surgical trauma is significant and the postoperative scar is often noticeable. Endoscopic and robot-assisted breast surgery is increasingly attracting attention due to the advantages such as smaller incisions, lower complication rate, and improved aesthetic outcomes. However, the lack of natural cavities in the breast has become a primary challenge in establishing and maintaining the necessary surgical space for endoscopic breast surgery. We reviewed the research progress of endoscopic and robot-assisted breast surgery, summarized the the innovations and challenges of existing techniques, and focused on introducing the application value of physical and biological properties of gas and liquid in endoscopic breast surgery.
Objective
To compare three surgical treatments for mediastinal mass with myasthenia gravis.
Methods
Retrospective analysis was performed on the clinical data of 53 patients who underwent extended thymectomy between January 2010 and December 2017 in our hospital. There were 29 males and 24 females, aged 17-73 years. Patients were divided into three groups according to the surgical methods: a group A (video-assisted thoracoscopic surgery with the da Vinci robotic system, n=22), a group B (video-assisted thoracoscopic surgery, n=12) and a group C (median sternotomy, n=19). The gender distribution, age, intraoperative blood loss, operation time, postoperative extubation time, postoperative hospital stay, Osserman classification of myasthenia gravis, postoperative myasthenic remission rate, etc were compared in three groups.
Results
No perioperative death was observed in 53 patients. One patient in the group C suffered from postoperative myasthenic crisis and improved after active treatment. One patient with video-assisted thoracoscopic surgery was converted to median sternotomy due to the intraoperative injury of the left brachiocephalic vein. Compared with the group B and group C, the group A had shorter operation time, less intraoperative blood loss and drainage on the first postoperative day and fewer days of extubation. Postoperative hospital stay was less in the group A than that in the group C (P<0.05). The postoperative myasthenic remission rate was higher in the group A than that in the other two groups, but there was no statistical difference.
Conclusion
Because of the robot’s unique minimally invasive advantage, in this study, the outcome of patients with myasthenia gravis treated with Da Vinci robots and thymectomy is better than that of the remaining two groups in terms of perioperative outcomes and myasthenic remission rate. But long-term results and a large of number matching experiments are needed to confirm. However, it is undeniable that robotic surgery must be the future of the minimally invasive surgery.
ObjectiveThe aim of this study was to evaluate the safety and feasibility of robot-assisted surgery in pancreatic cancer.MethodRecent literatures related to robot-assisted surgery in treatment of pancreatic cancer compared with traditional open surgery or traditional laparoscopic surgery were collected to make an review.ResultsCompared with the traditional laparoscopic surgery, the robot-assisted surgery was expensive, with the obvious advantages in terms of anastomosis and reconstruction. Compared with the open operation, both robot-assisted pancreaticoduodenectomy and robot-assisted distal pancreatectomy had longer operation time, but the length of hospital stay and intraoperative blood loss were obviously shortened, robot-assisted distal pancreatectomy also had higher spleen preservation rate. Compared with the traditional laparoscopic distal pancreatectomy, the number of lymph node retrieved, R0 resection rate, and splenic preservation rate were also higher in the robot-assisted group. Simultaneously, robot-assisted total pancreatectomy and midsection pancreatectomy were deemed as safe in some high-volume centers.ConclusionsRobot-assisted pancreatic cancer surgery is safe and feasible, but many surgeries are restricted to a small number of high-volume medical centers, and most cases selected to undergo robot-assisted surgery are often early stage patients with small tumor size. A lot of efforts should be made and problems should be solved.
The kinematic model parameter deviation is the main factor affecting the positioning accuracy of neurosurgical robots. To obtain more realistic kinematic model parameters, this paper proposes an automatic parameters identification and accuracy evaluation method. First, an identification equation contains all robot kinematics parameter was established. Second, a multiple-pivot strategy was proposed to find the relationship between end-effector and tracking marker. Then, the relative distance error and the inverse kinematic coincidence error were designed to evaluate the identification accuracy. Finally, an automatic robot parameter identification and accuracy evaluation system were developed. We tested our method on both laboratory prototypes and real neurosurgical robots. The results show that this method can realize the neurosurgical robot kinematics model parameters identification and evaluation stably and quickly. Using the identified parameters to control the robot can reduce the robot relative distance error by 33.96% and the inverse kinematics consistency error by 67.30%.
