1,852 research outputs found
Computer- and robot-assisted urological surgery
The author reviews the computer and robotic tools available to urologists to
help in diagnosis and technical procedures. The first part concerns the
contribution of robotics and presents several systems at various stages of
development (laboratory prototypes, systems under validation or marketed
systems). The second part describes image fusion tools and navigation systems
currently under development or evaluation. Several studies on computerized
simulation of urological procedures are also presented
Medical image computing and computer-aided medical interventions applied to soft tissues. Work in progress in urology
Until recently, Computer-Aided Medical Interventions (CAMI) and Medical
Robotics have focused on rigid and non deformable anatomical structures.
Nowadays, special attention is paid to soft tissues, raising complex issues due
to their mobility and deformation. Mini-invasive digestive surgery was probably
one of the first fields where soft tissues were handled through the development
of simulators, tracking of anatomical structures and specific assistance
robots. However, other clinical domains, for instance urology, are concerned.
Indeed, laparoscopic surgery, new tumour destruction techniques (e.g. HIFU,
radiofrequency, or cryoablation), increasingly early detection of cancer, and
use of interventional and diagnostic imaging modalities, recently opened new
challenges to the urologist and scientists involved in CAMI. This resulted in
the last five years in a very significant increase of research and developments
of computer-aided urology systems. In this paper, we propose a description of
the main problems related to computer-aided diagnostic and therapy of soft
tissues and give a survey of the different types of assistance offered to the
urologist: robotization, image fusion, surgical navigation. Both research
projects and operational industrial systems are discussed
Outcomes of a virtual-reality simulator-training programme on basic surgical skills in robot-assisted laparoscopic surgery
Background The utility of the virtual-reality robotic simulator in training
programmes has not been clearly evaluated. Our aim was to evaluate the
impact of a virtual-reality robotic simulator-training programme on basic
surgical skills.
Methods A simulator-training programme in robotic surgery, using the da
Vinci Skills Simulator, was evaluated in a population including junior and seasoned
surgeons, and non-physicians. Their performances on robotic dots and
suturing-skin pod platforms before and after virtual-simulation training were
rated anonymously by surgeons experienced in robotics.
Results 39 participants were enrolled: 14 medical students and residents in
surgery, 14 seasoned surgeons, 11 non-physicians. Junior and seasoned
surgeons’ performances on platforms were not significantly improved after
virtual-reality robotic simulation in any of the skill domains, in contrast to
non-physicians.
Conclusions The benefits of virtual-reality simulator training on several
tasks to basic skills in robotic surgery were not obvious among surgeons
in our initial and early experience with the simulator
The availability, cost, limitations, learning curve and future of robotic systems in urology and prostate cancer surgery
Robot-assisted surgical systems (RASS) have revolutionised the management of many urological conditions over the last two decades with robot-assisted radical prostatectomy (RARP) now being considered by many to be the preferred surgical approach. Intuitive Surgical has dominated the market during this time period with successive iterations of the da Vinci model. The expiration of patents has opened the RASS market and several new contenders have become available or are currently in development. This comprehensive narrative review aims to explore the merits of each robotic system as well as the evidence and barriers to their use. The newly developed RASS have increased the versality of robotic surgical systems to a wider range of settings through advancement in technology. The increased competition may result in an overall reduction in cost, broadening the accessibility of RASS. Learning curves and training remain a barrier to their use, but the situation appears to be improving through dedicated training programmes. Outcomes for RARP have been well investigated and tend to support improved early functional outcomes. Overall, the rapid developments in the field of robot-assisted surgery indicate the beginning of a promising new era to further enhance urological surgery
Role of Robot-Assisted Pelvic Surgery
The purpose of this study was to assess the current role of robot-assisted urological surgery in the female pelvis. The recently published English literature was reviewed to evaluate this role, with special emphasis on reconstructive procedures. These included colposuspension for genuine female stress urinary incontinence, repair of female genitourinary fistulas, ureterosciatic hernias, sacrocolpopexy for vault prolapse, ureterolysis and omental wrap for retroperitoneal fibrosis, ureteric reimplantation, and bladder surgery. To date, a wide spectrum of urogynecological reconstructive procedures have been performed with the assistance of the surgical robot and have been reported worldwide. Currently, a number of female pelvic ablative and reconstructive procedures are technically feasible with the aid of the surgical robot. While the role of robot-assisted surgery for bladder cancer, ureterolysis, ureteric reimplantation, repair of genitourinary fistulas, colposuspension, and sacrocolpopexy is nearly established among urologists, other procedures, such as myomectomy, simple hysterectomy, trachelectomy, and Wertheim's hysterectomy, are still evolving with gynecologists. The advantages of robot assistance include better hand-eye coordination, three-dimensional magnified stereoscopic vision with depth perception, intuitive movements with increased precision, and filtering of hand tremors. For most of the currently performed procedures in selected patients, the robot-assisted surgical outcomes appear to be relatively superior as compared to an open and purely laparoscopic surgical procedure
Current status of robot-assisted surgery
The introduction of robot-assisted surgery, and specifically the da Vinci Surgical System, is one of the biggest breakthroughs in surgery since the introduction of anaesthesia, and represents the most significant advancement in minimally invasive surgery of this decade. One of the first surgical uses of the robot was in orthopaedics, neurosurgery, and cardiac surgery. However, it was the use in urology, and particularly in prostate surgery, that led to its widespread popularity. Robotic surgery, is also widely used in other surgical specialties including general surgery, gynaecology, and head and neck surgery. In this article, we reviewed the current applications of robot-assisted surgery in different surgical specialties with an emphasis on urology. Clinical results as compared with traditional open and/or laparoscopic surgery and a glimpse into the future development of robotics were also discussed. A short introduction of the emerging areas of robotic surgery were also briefly reviewed. Despite the increasing popularity of robotic surgery, except in robot-assisted radical prostatectomy, there is no unequivocal evidence to show its superiority over traditional laparoscopic surgery in other surgical procedures. Further trials are eagerly awaited to ascertain the long-term results and potential benefits of robotic surgery.published_or_final_versio
Robotic approach to the uretero-vesical junction in children: An international multicentric retrospective study
BackgroundRobot-assisted approach to UVJ is getting more and more used in pediatric patients. MethodsIn this retrospective study 26 patients affected by nephro-urological malformations, robotic-surgically treated from 2016 and 2021 at 3 Pediatric Surgery Department were included: 3 (11.5%) primary obstructive megaureter, 2 (7.7%) dysplastic kidneys, 3 (11.5%) duplex collecting system, 18 (69.2%) primary vescico-ureteral reflux (VUR). ResultsMean age at surgery was 6 years old. 22 (84.6%) underwent Lich Gregoire extravesical ureteral reimplantation, 4 (15.4%) total nephroureterectomy. Mean operative time was 230 min. No conversions or intraoperative complications. Median hospital stay was 4 days. There were 4 (15.38%) postoperative complications: 3 (11.54%) persistent VUR and 1 (3.84%) refluxing megaureter. 2 (7.7%) redo-surgery. ConclusionsRobotic Surgery should be considered a safe and effective technique for treatment of UVJ anomalies in children, because it firstly allows surgeons to approach both upper and lower ureteral ends without modifying trocars' placement
Clarifying Techniques for Unique Robotic Surgeries
My thesis, Clarifying Techniques for Unique Robotic Surgeries, is a teaching tool comprised of surgical video paired with medical illustrations. The intended learner is robot-asstisted surgeons who are looking to expand their skills by learning new techniques and procedures that have previously been done without robot assistance. This tool is originally the brainchild of Dr. Khurshid Guru, a urology surgeon at Roswell Park Cancer Institute, whose skills are renowned world-wide in the robotic surgery community. Dr. Guru has developed and used these techniques with great success for urological cancer treatment. As a leader in his field, he was eager to share these new methods with his colleagues via a visual teaching tool. It was the objective of my thesis to accomplish this for two different procedures: Robot-assisted Small Bowel/Neo-Bladder Fistula Repair and Robot-assisted Uretero-ileal Anastomosis of a Duplicated Ureter. This written portion of my thesis discusses the details of both surgeries as well as my process of creating clarifying illustrations for them
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