Dynamic Gesture Recognition Using a Smart Glove in Hand-Assisted Laparoscopic Surgery

This paper presents a methodology for movement recognition in hand-assisted laparoscopic surgery using a textile-based sensing glove. The aim is to recognize the commands given by the surgeon’s hand inside the patient’s abdominal cavity in order to guide a collaborative robot. The glove, which incorporates piezoresistive sensors, continuously captures the degree of flexion of the surgeon’s fingers. These data are analyzed throughout the surgical operation using an algorithm that detects and recognizes some defined movements as commands for the collaborative robot. However, hand movement recognition is not an easy task, because of the high variability in the motion patterns of different people and situations. The data detected by the sensing glove are analyzed using the following methodology. First, the patterns of the different selected movements are defined. Then, the parameters of the movements for each person are extracted. The parameters concerning bending speed and execution time of the movements are modeled in a prephase, in which all of the necessary information is extracted for subsequent detection during the execution of the motion. The results obtained with 10 different volunteers show a high degree of precision and recall

Hacia un asistente robótico quirúrgico cognitivo

[Resumen] Este trabajo presenta una arquitectura cognitiva para un asistente robótico camarógrafo, cuyo objetivo consiste en ofrecer el mejor punto de vista durante la intervención quirúrgica de forma autónoma. Este sistema está formado por un minirobot cámara que se encuentra en el interior de la cavidad abdominal y un brazo robótico externo que maneja dicha cámara mediante una interacción magnética. La arquitectura cognitiva dota al asistente robótico con una memoria a largo plazo, que almacena el conocimiento quirúrgico, los comportamientos de la cámara y los mecanismos de aprendizaje, y una memoria de corto plazo que reconoce el estado actual de la tarea y lanza el comportamiento correspondiente de la cámara. Para obtener el punto de vista más apropiado de la cámara, cada estado de la tarea se caracteriza por un Foco de Atención (FA), definido por un objeto, la posición de ese objeto en la imagen y un factor de zoom. La arquitectura también incluye un mecanismo de aprendizaje que tiene en cuenta las preferencias particulares de los cirujanos durante la tarea quirúrgica y se ha validado con un conjunto de experimentos in-vitro.https://doi.org/10.17979/spudc.978849749808

Smart Camera Robotic Assistant for Laparoscopic Surgery

The cognitive architecture also includes learning mechanisms to adapt the behavior of the robot to the different ways of working of surgeons, and to improve the robot behavior through experience, in a similar way as a human assistant would do. The theoretical concepts of this dissertation have been validated both through in-vitro experimentation in the labs of medical robotics of the University of Malaga and through in-vivo experimentation with pigs in the IACE Center (Instituto Andaluz de Cirugía Experimental), performed by expert surgeons.In the last decades, laparoscopic surgery has become a daily practice in operating rooms worldwide, which evolution is tending towards less invasive techniques. In this scenario, robotics has found a wide field of application, from slave robotic systems that replicate the movements of the surgeon to autonomous robots able to assist the surgeon in certain maneuvers or to perform autonomous surgical tasks. However, these systems require the direct supervision of the surgeon, and its capacity of making decisions and adapting to dynamic environments is very limited. This PhD dissertation presents the design and implementation of a smart camera robotic assistant to collaborate with the surgeon in a real surgical environment. First, it presents the design of a novel camera robotic assistant able to augment the capacities of current vision systems. This robotic assistant is based on an intra-abdominal camera robot, which is completely inserted into the patient’s abdomen and it can be freely moved along the abdominal cavity by means of magnetic interaction with an external magnet. To provide the camera with the autonomy of motion, the external magnet is coupled to the end effector of a robotic arm, which controls the shift of the camera robot along the abdominal wall. This way, the robotic assistant proposed in this dissertation has six degrees of freedom, which allow providing a wider field of view compared to the traditional vision systems, and also to have different perspectives of the operating area. On the other hand, the intelligence of the system is based on a cognitive architecture specially designed for autonomous collaboration with the surgeon in real surgical environments. The proposed architecture simulates the behavior of a human assistant, with a natural and intuitive human-robot interface for the communication between the robot and the surgeon

Patterns of injury and violence in Yaoundé Cameroon: an analysis of hospital data.

BackgroundInjuries are quickly becoming a leading cause of death globally, disproportionately affecting sub-Saharan Africa, where reports on the epidemiology of injuries are extremely limited. Reports on the patterns and frequency of injuries are available from Cameroon are also scarce. This study explores the patterns of trauma seen at the emergency ward of the busiest trauma center in Cameroon's capital city.Materials and methodsAdministrative records from January 1, 2007, through December 31, 2007, were retrospectively reviewed; information on age, gender, mechanism of injury, and outcome was abstracted for all trauma patients presenting to the emergency ward. Univariate analysis was performed to assess patterns of injuries in terms of mechanism, date, age, and gender. Bivariate analysis was used to explore potential relationships between demographic variables and mechanism of injury.ResultsA total of 6,234 injured people were seen at the Central Hospital of Yaoundé's emergency ward during the year 2007. Males comprised 71% of those injured, and the mean age of injured patients was 29 years (SD = 14.9). Nearly 60% of the injuries were due to road traffic accidents, 46% of which involved a pedestrian. Intentional injuries were the second most common mechanism of injury (22.5%), 55% of which involved unarmed assault. Patients injured in falls were more likely to be admitted to the hospital (p < 0.001), whereas patients suffering intentional injuries and bites were less likely to be hospitalized (p < 0.001). Males were significantly more likely to be admitted than females (p < 0.001)DiscussionPatterns in terms of age, gender, and mechanism of injury are similar to reports from other countries from the same geographic region, but the magnitude of cases reported is high for a single institution in an African city the size of Yaoundé. As the burden of disease is predicted to increase dramatically in sub-Saharan Africa, immediate efforts in prevention and treatment in Cameroon are strongly warranted

Improving Suturing Skills for Surgical Residents and Advancing Prosthesis Control for Amputees.

Proper suturing technique is one of the most important skills a surgical resident should acquire. However, current methods for teaching it rely on subjective performance evaluations. An instrumented training apparatus for abdominal closure could be used to define objective assessments that directly relate to closure quality. I identify a synthetic material that models abdominal fascia using porcine and cadaveric data and design a means to mount the material so that it mimics abdominal closure. Digital images are used to quantify material deformations and provide real-time objective measures regarding the effect of suture placement and tension in the abdominal tissue. In parallel, I develop a finite element model of abdominal fascia and its closure with suture to deduce stresses in the material and forces in the sutures. I find that despite uniform suture spacing, the forces in suture are unevenly distributed along the closure. These findings motivate the development of a surgical learning tool that objectively relays information about suture placement and tension. In a second body of work, I address the development of a novel interface between an amputee’s peripheral nervous system and a motorized prosthetic device. Conventional myoelectric control cannot produce a sufficient number of independent signals for actuation of modern computerized upper limb prostheses. A compact construct involving grafted muscle surgically prepared at the end of a transected peripheral nerve is envisioned for transducing a nervous signal with fine specificity and sensitivity. Up to 20 such constructs can be prepared in a human arm, and epimysial electrodes on each construct can be used to relay signals encoding 20 independent channels of motor intent. I develop a means of evaluating this construct in awake rats, and demonstrate that the transduced signals suffer minimal crosstalk and are correlated with gait. A decoder is able to reconstruct data produced by motion tracking, and I show that adjacent constructs placed proximal to one another provide the same signals as anatomically intact muscle-nerve antagonist-pair analogs. The correlation between the signals transduced, the walking kinematics, and analogous out of phase activation obtained from adjacent constructs indicates that this technology holds promise for human translation.PHDMechanical EngineeringUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttps://deepblue.lib.umich.edu/bitstream/2027.42/147635/1/danursu_1.pd

Design and development of simulated signals of brain activity for endoscopic endonasal surgery

En el presente trabajo se describe el diseño de un simulador de la actividad cerebral para cirugía endonasal mediante señales EEG, las cuales se generan en distintas posiciones de un modelo de cavidad intracraneal. Las mediciones son obtenidas mediante una sonda que podrá ser manejada por un neurocirujano en prácticas, o bien por un robot autónomo que localice el sensor en los puntos de interés. Con esta información, se propone el desarrollo de un generador del mapa neurológico que muestre y clasifique de forma gráfica la actividad cerebral del paciente. Para la realización de este trabajo se va a emplear como dispositivos hardware un Arduino Mega ADK y un circuito eléctrico a través del cual el neurocirujano o el robot autónomo medirán las señales EEG modeladas. Como paquetes de software se ha empleado Matlab para la generación y procesado de señales EEG, así como el sistema ROS para las comunicaciones entre Arduino/Matlab. De este modo, el sistema desarrollado pueda integrarse en la plataforma robótica del grupo de Robótica Médica del departamento de Ingeniería de Sistemas y Automática, que ya dispone de una arquitectura basada en ROS. El trabajo concluye con la presentación de resultados experimentales para, por un lado, validar las señales generadas con el simulador, y por otro lado verificar la precisión obtenida por el algoritmo de clasificación de las señales EEG que permite presentar de forma gráfica el mapa de la actividad cerebral

Recent Advances in Minimally Invasive Surgery

Minimally invasive surgery has become a common term in visceral as well as gynecologic surgery. It has almost evolved into its own surgical speciality over the past 20 years. Today, being firmly established in every subspeciality of visceral surgery, it is now no longer a distinct skillset, but a fixed part of the armamentarium of surgical options available. In every indication, the advantages of a minimally invasive approach include reduced intraoperative blood loss, less postoperative pain, and shorter rehabilitation times, as well as a marked reduction of overall and surgical postoperative morbidity. In the advent of modern oncologic treatment algorithms, these effects not only lower the immediate impact that an operation has on the patient, but also become important key steps in reducing the side-effects of surgery. Thus, they enable surgery to become a module in modern multi-disciplinary cancer treatment, which blends into multimodular treatment options at different times and prolongs and widens the possibilities available to cancer patients. In this quickly changing environment, the requirement to learn and refine not only open surgical but also different minimally invasive techniques on high levels deeply impact modern surgical training pathways. The use of modern elearning tools and new and praxis-based surgical training possibilities have been readily integrated into modern surgical education,which persists throughout the whole surgical career of modern gynecologic and visceral surgery specialists