A Cost-Effective and Smart Sensing Tissue-like Testbed for Surgical Training

A low-cost tissue-like testbed with six nodes of varying stiffness was developed for surgical training to provide pressure and force feedback data through image reception to human operators. Using SolidWorks, a 3D model of the box trainer housing was created. A pad for the distribution of smartsensing nodes and microcontroller connections was designed with open spaces for the respective components. The pad was 3D-printed with PLA filament. Flat piezoelectric pressure sensors were fabricated with conductive materials and velostat sensor material. Using static and dynamic analyses, three top sensors were chosen to be used in three pressure sensing nodes. A calibration process was performed on the pressure sensors to find the linear relationship between voltage and pressure, which was then used to create a conversion equation for each sensor. These equations were used to collect data at the three pressure sensing nodes on the silicone testbed pad. Conductive TPU filament was used to 3D-print vertical force sensors, which were designed using SolidWorks. The force sensors were calibrated with a squeezing mechanism to find a relationship between voltage and force and to subsequently develop a conversion equation for each sensor. We used these equations to collect force data from the three force sensing nodes on the testbed pad. Through static and dynamic analyses, the force sensors were found to be functional, but to need improvements in accuracy. The mechatronic system was designed and developed to integrate all six sensors and to collect data from the testbed pad using an Arduino microcontroller. The flat pressure and vertical force sensors were embedded in each node to measure the pressure and force that occurs during the deformation of the six nodes. Data was collected and imported into MATLAB. This data was used in displaying pressure and force mapping of the nodes over a live video of the silicone pad. Pressure and force mapping was realized by drawing color-coded circles on each of the six nodes that correspond to a range of force or pressure values. From this development, the surgical testbed provides multi-stiffness tissue training with live pressure and force mapping overlaid on a live video of the emulated surgical field

Mastering Endo-Laparoscopic and Thoracoscopic Surgery

This is an open access book. The book focuses mainly on the surgical technique, OR setup, equipments and devices necessary in minimally invasive surgery (MIS). It serves as a compendium of endolaparoscopic surgical procedures. It is an official publication of the Endoscopic and Laparoscopic Surgeons of Asia (ELSA). The book includes various sections covering basic skills set, devices, equipments, OR setup, procedures by area. Each chapter cover introduction, indications and contraindications, pre-operative patient’s assessment and preparation, OT setup (instrumentation required, patient’s position, etc.), step by step description of surgical procedures, management of complications, post-operative care. It includes original illustrations for better understanding and visualization of specific procedures. The book serves as a practical guide for surgical residents, surgical trainees, surgical fellows, junior surgeons, surgical consultants and anyone interested in MIS. It covers most of the basic and advanced laparoscopic and thoracoscopic surgery procedures meeting the curriculum and examination requirements of the residents

Advances in Minimally Invasive Surgery

The minimally invasive approach in medicine is one of the most common areas of interest in surgery.Advances in Minimally Invasive Surgery describes the latest trends, indications, techniques, and approaches in minimally invasive surgery. It provides step-by-step instructions for both routine and diagnostic procedures via illustrations and video collection

Mastering Endo-Laparoscopic and Thoracoscopic Surgery

This is an open access book. The book focuses mainly on the surgical technique, OR setup, equipments and devices necessary in minimally invasive surgery (MIS). It serves as a compendium of endolaparoscopic surgical procedures. It is an official publication of the Endoscopic and Laparoscopic Surgeons of Asia (ELSA). The book includes various sections covering basic skills set, devices, equipments, OR setup, procedures by area. Each chapter cover introduction, indications and contraindications, pre-operative patient’s assessment and preparation, OT setup (instrumentation required, patient’s position, etc.), step by step description of surgical procedures, management of complications, post-operative care. It includes original illustrations for better understanding and visualization of specific procedures. The book serves as a practical guide for surgical residents, surgical trainees, surgical fellows, junior surgeons, surgical consultants and anyone interested in MIS. It covers most of the basic and advanced laparoscopic and thoracoscopic surgery procedures meeting the curriculum and examination requirements of the residents

Gesture Recognition and Control for Semi-Autonomous Robotic Assistant Surgeons

The next stage for robotics development is to introduce autonomy and cooperation with human agents in tasks that require high levels of precision and/or that exert considerable physical strain. To guarantee the highest possible safety standards, the best approach is to devise a deterministic automaton that performs identically for each operation. Clearly, such approach inevitably fails to adapt itself to changing environments or different human companions. In a surgical scenario, the highest variability happens for the timing of different actions performed within the same phases. This thesis explores the solutions adopted in pursuing automation in robotic minimally-invasive surgeries (R-MIS) and presents a novel cognitive control architecture that uses a multi-modal neural network trained on a cooperative task performed by human surgeons and produces an action segmentation that provides the required timing for actions while maintaining full phase execution control via a deterministic Supervisory Controller and full execution safety by a velocity-constrained Model-Predictive Controller

Medical Robotics

The first generation of surgical robots are already being installed in a number of operating rooms around the world. Robotics is being introduced to medicine because it allows for unprecedented control and precision of surgical instruments in minimally invasive procedures. So far, robots have been used to position an endoscope, perform gallbladder surgery and correct gastroesophogeal reflux and heartburn. The ultimate goal of the robotic surgery field is to design a robot that can be used to perform closed-chest, beating-heart surgery. The use of robotics in surgery will expand over the next decades without any doubt. Minimally Invasive Surgery (MIS) is a revolutionary approach in surgery. In MIS, the operation is performed with instruments and viewing equipment inserted into the body through small incisions created by the surgeon, in contrast to open surgery with large incisions. This minimizes surgical trauma and damage to healthy tissue, resulting in shorter patient recovery time. The aim of this book is to provide an overview of the state-of-art, to present new ideas, original results and practical experiences in this expanding area. Nevertheless, many chapters in the book concern advanced research on this growing area. The book provides critical analysis of clinical trials, assessment of the benefits and risks of the application of these technologies. This book is certainly a small sample of the research activity on Medical Robotics going on around the globe as you read it, but it surely covers a good deal of what has been done in the field recently, and as such it works as a valuable source for researchers interested in the involved subjects, whether they are currently “medical roboticists” or not

An Underactuated Flexible Instrument for Single Incision Laparoscopic Surgery

More and more patients and surgeons have switched from open surgery to minimally invasive surgery over these years. This exciting advancement has brought massive benefits to patients. Researchers and institutions have proposed robot assisted surgery which combines the advantage of developed robot system and human experience. This thesis reviews state of the art in this area and analyze some advanced surgical instrument for single incision laparoscopic instrument, then propose a design of robotic instrument for single incision laparoscopic surgery which can be integrated with collaborative robot manipulator to construct a surgical robot system.Single-incision laparoscopic surgery (SILS) has its own features and advantages compare to other minimally invasive surgery techniques which also lead to special design requirements for SILS instruments, among which increased flexibility compare to multi-incision surgery instruments is an important part. So we want to design a robotic surgical instrument that has increased flexibility compare to traditional instruments for other MIS techniques. As a laparoscopic robotic instrument compactness and light weight are also our considerations.Single incision laparoscopic surgery (SILS) inserts multiple instruments and laparoscopes through a single trocar which reduces trauma. But this improvement for patients caused difficulty in operation because of instruments triangulation, laparoscope field-of-view, etc. That brings up our challenges in designing a robotic instruments. Designing a highly flexible robotic instrument that provides sufficient workspace and good triangulation in order to relieve the difficulties introduced by narrow instrument trocars.We want to implement a highly recognized surgical instrument with a designed robotic instrument actuation pack. These two parts compose a robotic surgical instrument for single incision laparoscopic surgery. And we want to analyze the performance and viability of our design approach for SILS application

Imaging skins: stretchable and conformable on-organ beta particle detectors for radioguided surgery

While radioguided surgery (RGS) traditionally relied on detecting gamma rays, direct detection of beta particles could facilitate the detection of tumour margins intraoperatively by reducing radiation noise emanating from distant organs, thereby improving the signal-to-noise ratio of the imaging technique. In addition, most existing beta detectors do not offer surface sensing or imaging capabilities. Therefore, we explore the concept of a stretchable scintillator to detect beta-particles emitting radiotracers that would be directly deployed on the targeted organ. Such detectors, which we refer to as imaging skins, would work as indirect radiation detectors made of light-emitting agents and biocompatible stretchable material. Our vision is to detect scintillation using standard endoscopes routinely employed in minimally invasive surgery. Moreover, surgical robotic systems would ideally be used to apply the imaging skins, allowing for precise control of each component, thereby improving positioning and task repeatability. While still in the exploratory stages, this innovative approach has the potential to improve the detection of tumour margins during RGS by enabling real-time imaging, ultimately improving surgical outcomes

Gastrostomy

The gastrostomy placement is a method of providing nutrition to the patients who are unable to eat. In this book you can find chapters focused on the use of gastrostomy in children, patients with neurological impairment and patients with head and neck tumours. Home enteral nutrition is suitable for all of these groups of patients and is far easier with gastrostomy. The new indications (especially in very young children) required new techniques such as: laparoscopic gastrostomy, laparoscopy assisted endoscopic gastrostomy with/without fundoplication, ultrasonography assisted gastronomy. All information about these techniques can be found in this book. This book does not serve as a basic textbook, but as an interesting reading material and as an aid for physicians who are already familiar with the indication for gastrostomy and want to know more