Hardware Sequencing of Inflatable Nonlinear Actuators for Autonomous Soft Robots

Soft robots are an interesting alternative for classic rigid robots in appli-cations requiring interaction with organisms or delicate objects. Elastic inflatable actuators are one of the preferred actuation mechanisms for soft robots since they are intrinsically safe and soft. However, these pneumatic actuators each require a dedicated pressure supply and valve to drive and control their actuation sequence. Because of the relatively large size of pres-sure supplies and valves compared to electrical leads and electronic control-lers, tethering pneumatic soft robots with multiple degrees of freedom is bulky and unpractical. Here, a new approach is described to embed hardware intelligence in soft robots where multiple actuators are attached to the same pressure supply, and their actuation sequence is programmed by the inter-action between nonlinear actuators and passive flow restrictions. How to model this hardware sequencing is discussed, and it is demonstrated on an 8-degree-of-freedom walking robot where each limb comprises two actua-tors with a sequence embedded in their hardware. The robot is able to carry pay loads of 800 g in addition to its own weight and is able to walk at travel speeds of 3 body lengths per minute, without the need for complex on-board valves or bulky tethers.ERC starting gran

Mesh-related complications and recurrence after ventral mesh rectopexy with synthetic versus biologic mesh:a systematic review and meta-analysis

BACKGROUND: Ventral mesh rectopexy (VMR) is a widely accepted surgical treatment for rectal prolapse. Both synthetic and biologic mesh are used. No consensus exists on the preferred type of mesh material. The aim of this systematic review and meta-analysis was to establish an overview of the current literature on mesh-related complications and recurrence after VMR with synthetic or biologic mesh to aid evidence-based decision making in preferred mesh material. METHODS: A systematic search of the electronic databases of PubMed, Embase and Cochrane was performed (from inception until September 2020). Studies evaluating patients who underwent VMR with synthetic or biologic mesh were eligible. The MINORS score was used for quality assessment. RESULTS: Thirty-two studies were eligible after qualitative assessment. Eleven studies reported on mesh-related complications including 4001 patients treated with synthetic mesh and 762 treated with biologic mesh. The incidence of mesh-related complications ranged between 0 and 2.4% after synthetic versus 0–0.7% after biologic VMR. Synthetic mesh studies showed a pooled incidence of mesh-related complications of 1.0% (95% CI 0.5–1.7). Data of biologic mesh studies could not be pooled. Twenty-nine studies reported on the risk of recurrence in 2371 synthetic mesh patients and 602 biologic mesh patients. The risk of recurrence varied between 1.1 and 18.8% for synthetic VMR versus 0–15.4% for biologic VMR. Cumulative incidence of recurrence was found to be 6.1% (95% CI 4.3–8.1) and 5.8% (95% CI 2.9–9.6), respectively. The clinical and statistical heterogeneity was high. CONCLUSIONS: No definitive conclusions on preferred mesh type can be made due to the quality of the included studies with high heterogeneity amongst them

Intestinal motility distal of a deviating ileostomy after rectal resection with the construction of a primary anastomosis:results of the prospective COLO-MOVE study

Purpose No consensus exists regarding the use of preoperative bowel preparation for patients undergoing a low anterior resection (LAR). Several comparative studies show similar outcomes when a single time enema (STE) is compared with mechanical bowel preparation (MBP). It is hypothesized that STE is comparable with MBP due to a decrease in intestinal motility distal of a newly constructed diverting ileostomy (DI). Methods In this prospective single-centre cohort study, patients undergoing a LAR with primary anastomosis and DI construction were given a STE 2 h pre-operatively. Radio-opaque markers were inserted in the efferent loop of the DI during surgery, and plain abdominal X-rays were made during the first, third, fifth and seventh postoperative day to visualize intestinal motility. Results Thirty-nine patients were included. Radio-opaque markers were situated in the ileum or right colon in 100%, 100% and 97.1% of the patients during respectively the first, third and fifth postoperative day. One patient had its most distal marker situated in the left colon during day five. In none of the patients, the markers were seen distal of the anastomosis. Conclusion Intestinal motility distally of the DI is decreased in patients who undergo a LAR resection with the construction of an anastomosis and DI, while preoperatively receiving a STE