Laparoscopic Camera Based on an Orthogonal Magnet Arrangement

In this letter, we present for the first time a magnetic anchoring-actuation link with an auto-flip feature. This orthogonal magnetic arrangement relies on the placement of two permanent magnets such that their magnetic moments are respectfully orthogonal. Though the arrangement may have many applications, in this study we integrate it in a small factor magnetic camera for minimally invasive procedures. Upon insertion through a trocar incision, the 5.5 mm diameter and 35 mm length magnetic camera is coupled with an external robotic controller and displaced from the port thus preventing clutter of the surgical workspace. The device allows for manual lateral translation as well as robotically controlled tilt and pan, resulting in four degrees of freedom. The auto-flip feature prevents the need for image adjustment in software as the camera tilts through its hemispherical workspace. A static model that relates an input external control tilt and output camera tilt has been developed and validated. Favorable results during bench and canine cadaver evaluation suggest promise for the proposed magnetic camera to improve the state of art in minimally invasive surgical procedures

Sensorless Estimation of the Planar Distal Shape of a Tip-Actuated Endoscope

Traditional endoscopes consist of a flexible body and a steerable tip with therapeutic capability. Although prior endoscopes have relied on operator pushing for actuation, recent robotic concepts have relied on the application of a tip force for guidance. In such case, the body of the endoscope can be passive and compliant; however, the body can have significant effect on mechanics of motion and may require modeling. As the endoscope body's shape is often unknown, we have developed an estimation method to recover the approximate distal shape, local to the endoscope's tip, where the tip position and orientation are the only sensed parameters in the system. We leverage a planar dynamic model and extended Kalman filter to obtain a constant-curvature shape estimate of a magnetically guided endoscope. We validated this estimator in both dynamic simulations and on a physical platform. We then used this estimate in a feed-forward control scheme and demonstrated improved trajectory following. This methodology can enable the use of inverse-dynamic control for the tip-based actuation of an endoscope, without the need for shape sensing

Sensitivity Ellipsoids for Force Control of Magnetic Robots With Localization Uncertainty

The navigation of magnetic medical robots typically relies on localizing an actuated, intracorporeal, ferromagnetic body and back-computing a necessary field and gradient that would result in a desired wrench on the device. Uncertainty in this localization degrades the precision of force transmission. Reducing applied force uncertainty may enhance tasks such as in vivo navigation of miniature robots, actuation of magnetically guided catheters, tissue palpation, as well as simply ensuring a bound on forces applied on sensitive tissue. In this paper, we analyze the effects of localization noise on force uncertainty by using sensitivity ellipsoids of the magnetic force Jacobian and introduce an algorithm for uncertainty reduction. We validate the algorithm in both a simulation study and in a physical experiment. In simulation, we observe reductions in estimated force uncertainty by factors of up to 2.8 and 3.1 when using one and two actuating magnets, respectively. On a physical platform, we demonstrate a force uncertainty reduction by a factor of up to 2.5 as measured using an external sensor. Being the first consideration of force uncertainty resulting from noisy localization, this paper provides a strategy for investigators to minimize uncertainty in magnetic force transmission

Enhanced real-time pose estimation for closed-loop robotic manipulation of magnetically actuated capsule endoscopes

Pose estimation methods for robotically guided magnetic actuation of capsule endoscopes have recently enabled trajectory following and automation of repetitive endoscopic maneuvers. However, these methods face significant challenges in their path to clinical adoption including the presence of regions of magnetic field singularity, where the accuracy of the system degrades, and the need for accurate initialization of the capsule's pose. In particular, the singularity problem exists for any pose estimation method that utilizes a single source of magnetic field if the method does not rely on the motion of the magnet to obtain multiple measurements from different vantage points. We analyze the workspace of such pose estimation methods with the use of the point-dipole magnetic field model and show that singular regions exist in areas where the capsule is nominally located during magnetic actuation. Since the dipole model can approximate most magnetic field sources, the problem discussed herein pertains to a wider set of pose estimation techniques. We then propose a novel hybrid approach employing static and time-varying magnetic field sources and show that this system has no regions of singularity. The proposed system was experimentally validated for accuracy, workspace size, update rate and performance in regions of magnetic singularity. The system performed as well or better than prior pose estimation methods without requiring accurate initialization and was robust to magnetic singularity. Experimental demonstration of closed-loop control of a tethered magnetic device utilizing the developed pose estimation technique is provided to ascertain its suitability for robotically guided capsule endoscopy. Hence, advances in closed-loop control and intelligent automation of magnetically actuated capsule endoscopes can be further pursued toward clinical realization by employing this pose estimation system

Managing Carbon Aspirations: The Influence of Corporate Climate Change Targets on Environmental Performance

Addressing climate change is among the most challenging ethical issues facing contemporary business and society. Unsustainable business activities are causing significant distributional and procedural injustices in areas such as public health and vulnerability to extreme weather events, primarily because of a distinction between primary emitters and those already experiencing the impacts of climate change. Business, as a significant contributor to climate change and beneficiary of externalizing environmental costs, has an obligation to address its environmental impacts. In this paper, we explore the role of firms’ climate change targets in shaping their emissions trends in the context of a large multi-country sample of companies. We contrast two intentions for setting emissions reductions targets: symbolic attempts to manage external stakeholder perceptions via “greenwashing” and substantive commitments to reducing environmental impacts. We argue that the attributes of firms’ climate change targets (their extent, form, and time horizon) are diagnostic of firms’ underlying intentions. Consistent with our hypotheses, while we find no overall effect of setting climate change targets on emissions, we show that targets characterized by a commitment to more ambitious emissions reductions, a longer target time frame, and absolute reductions in emissions are associated with significant reductions in firms’ emissions. Our evidence suggests the need for vigilance among policy-makers and environmental campaigners regarding the underlying intentions that accompany environmental management practices and shows that these can to some extent be diagnosed analytically

The Role of Short-Termism and Uncertainty Avoidance in Organizational Inaction on Climate Change: A Multi-Level Framework

Despite increasing pressure to deal with climate change, firms have been slow to respond with effective action. This article presents a multi-level framework for a better understanding of why many firms are failing to reduce their absolute greenhouse gas emissions, which contribute to climate change. The concepts of short-termism and uncertainty avoidance from research in psychology, sociology, and organization theory can explain the phenomenon of organizational inaction on climate change. Antecedents related to short-termism and uncertainty avoidance reinforce one another at three levels—individual, organizational, and institutional—and result in organizational inaction on climate change. The article also discusses the implications of this multi-level framework for research on corporate sustainability

Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy

Background A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise description of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets. Methods Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendall’s tau for dichotomous variables, or Jonckheere–Terpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis. Results A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both p < 0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROC = 0.903, 0.822, respectively). On multivariable analysis, the Nassar operative difficultly scale was found to be a significant independent predictor of operative duration, conversion to open surgery, 30-day complications and 30-day reintervention (all p < 0.001). Conclusion We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty

Constructing a Distant Future: Imaginaries in Geoengineering

We develop the concept of the distant future as a new way of seeing the future in collective efforts. While a near future is represented in practical terms and concerned with forming expectations and goals under conditions of uncertainty, a distant future is represented in stylized terms and concerned with imagining possibilities under conditions of ambiguity. Management research on future-oriented action has developed around problems of the near future. To explore distant futures, we analyze the case of geoengineering, a set of planetary-scale technologies that have been proposed as solutions to the threat of climate change. Geoengineering has increasingly been treated as if it were a reality, despite continued controversy and in the absence of any implementation. We find that societal-level imaginaries that were built on deeply-held moral bases and cosmologies underpinned the conception of geoengineering, and that a dialectic process of discursive attempts to reconcile oppositional imaginaries increased the concreteness and credibility of geoengineering so that it increasingly has been treated as an ‘as-if’ reality. We suggest that distant futures orient collective efforts in distinctive ways, not as concrete guides for action but by expressing critiques and alternatives, that can become treated as ‘as-if’ realities

Cognitive frames in corporate sustainability: managerial sensemaking with paradoxical and business case frames

Corporate sustainability confronts managers with tensions between complex economic, environmental, and social issues. Drawing on the literature on managerial cognition, corporate sustainability, and strategic paradoxes, we develop a cognitive framing perspective on corporate sustainability. We propose two cognitive frames—a business case frame and a paradoxical frame—and explore how differences between them in cognitive content and structure influence the three stages of the sensemaking process—that is, managerial scanning, interpreting, and responding with regard to sustainability issues. We explain how the two frames lead to differences in the breadth and depth of scanning, differences in issue interpretations in terms of sense of control and issue valence, and different types of responses that managers consider with regard to sustainability issues. By considering alternative cognitive frames, our argument contributes to a better understanding of managerial decision making regarding ambiguous sustainability issues, and it develops the underlying cognitive determinants of the stance that managers adopt on sustainability issues. This argument offers a cognitive explanation for why managers rarely push for radical change when faced with complex and ambiguous issues, such as sustainability, that are characterized by conflicting yet interrelated aspects