Аnalysis and anthropometric study of port placement in robotic rectal cancer surgery

Robotic surgery is an innovative, minimally invasive technique, which has already proved its advantages in the operative-technical field by providing ergonomics, three dimensional (3D) visualization of the operative field, more precise dissection in narrow spaces, etc. The additional time needed for docking of the console and collision (internal and external) between the robotic hands is a part of the specific difficulties related to this type of surgery. The aim of this study was to analyze the position of ports and their efficiency in robotic rectal surgery based on our initial experience with this type of surgery in the University Hospital of Pleven- Bulgaria as well as to seek for additional anatomical landmarks to improve the work process. The initial experience with robotic rectal resections for rectal cancer revealed that the recommended distance of 8 cm between the ports doesn`t provide sufficient efficacy. Additional topography anatomical landmarks are required for personalized preoperative planning of port positions and enhanced effectiveness of the robotic system in rectal cancer treatment. Further studies in this field are necessary

Assessment of vocal cord nodules: A case study in speech processing by using Hilbert-Huang Transform

Vocal cord nodules represent a pathological condition for which the growth of unnatural masses on vocal folds affects the patients. Among other effects, changes in the vocal cords' overall mass and stiffness alter their vibratory behaviour, thus changing the vocal emission generated by them. This causes dysphonia, i.e. abnormalities in the patients' voice, which can be analysed and inspected via audio signals. However, the evaluation of voice condition through speech processing is not a trivial task, as standard methods based on the Fourier Transform, fail to fit the non-stationary nature of vocal signals. In this study, four audio tracks, provided by a volunteer patient, whose vocal fold nodules have been surgically removed, were analysed using a relatively new technique: the Hilbert-Huang Transform (HHT) via Empirical Mode Decomposition (EMD); specifically, by using the CEEMDAN (Complete Ensemble EMD with Adaptive Noise) algorithm. This method has been applied here to speech signals, which were recorded before removal surgery and during convalescence, to investigate specific trends. Possibilities offered by the HHT are exposed, but also some limitations of decomposing the signals into so-called intrinsic mode functions (IMFs) are highlighted. The results of these preliminary studies are intended to be a basis for the development of new viable alternatives to the softwares currently used for the analysis and evaluation of pathological voice

Method for Horizontal Calibration of Laser-Projection Transnasal Fiberoptic High-Speed Videoendoscopy

Objective: Calibrated horizontal measurements (e.g., mm) from endoscopic procedures could be utilized for advancement of evidence-based practice and personalized medicine. However, the size of an object in endoscopic images is not readily calibrated and depends on multiple factors, including the distance between the endoscope and the target surface. Additionally, acquired images may have significant non-linear distortion that would further complicate calibrated measurements. This study used a recently developed in vivo laser-projection fiberoptic laryngoscope and proposes a method for calibrated spatial measurements. Method: A set of circular grids was recorded at multiple working distances. A statistical model was trained that would map from pixel length of the object, the working distance, and the spatial location of the target object into its mm length. Result: A detailed analysis of the performance of the proposed method is presented. The analyses have shown that the accuracy of the proposed method does not depend on the working distance and length of the target object. The estimated average magnitude of error was 0.27 mm, which is three times lower than the existing alternative. Conclusion: The presented method can achieve sub-millimeter accuracy in horizontal measurement. Significance: Evidence-based practice and personalized medicine could significantly benefit from the proposed method. Implications of the findings for other endoscopic procedures are also discussed