Smart Camera Robotic Assistant for Laparoscopic Surgery

The cognitive architecture also includes learning mechanisms to adapt the behavior of the robot to the different ways of working of surgeons, and to improve the robot behavior through experience, in a similar way as a human assistant would do. The theoretical concepts of this dissertation have been validated both through in-vitro experimentation in the labs of medical robotics of the University of Malaga and through in-vivo experimentation with pigs in the IACE Center (Instituto Andaluz de Cirugía Experimental), performed by expert surgeons.In the last decades, laparoscopic surgery has become a daily practice in operating rooms worldwide, which evolution is tending towards less invasive techniques. In this scenario, robotics has found a wide field of application, from slave robotic systems that replicate the movements of the surgeon to autonomous robots able to assist the surgeon in certain maneuvers or to perform autonomous surgical tasks. However, these systems require the direct supervision of the surgeon, and its capacity of making decisions and adapting to dynamic environments is very limited. This PhD dissertation presents the design and implementation of a smart camera robotic assistant to collaborate with the surgeon in a real surgical environment. First, it presents the design of a novel camera robotic assistant able to augment the capacities of current vision systems. This robotic assistant is based on an intra-abdominal camera robot, which is completely inserted into the patient’s abdomen and it can be freely moved along the abdominal cavity by means of magnetic interaction with an external magnet. To provide the camera with the autonomy of motion, the external magnet is coupled to the end effector of a robotic arm, which controls the shift of the camera robot along the abdominal wall. This way, the robotic assistant proposed in this dissertation has six degrees of freedom, which allow providing a wider field of view compared to the traditional vision systems, and also to have different perspectives of the operating area. On the other hand, the intelligence of the system is based on a cognitive architecture specially designed for autonomous collaboration with the surgeon in real surgical environments. The proposed architecture simulates the behavior of a human assistant, with a natural and intuitive human-robot interface for the communication between the robot and the surgeon

Arquitectura de Control de una Plataforma Robótica sin Realimentación de Posición Articular para Cirugía Minimamente Invasiva

Rivas-Blanco, I.; Muñoz, V.F.; García-Morales, I.; Tortora, G.; Menciassi, A., "Arquitectura de Control de una Plataforma Robótica sin Realimentación de Posición Articular para Cirugía Minimamente Invasiva," Actas de las XXXVI Jornadas de Automática, Bilbao, Spain, pp.793-800, Sep. 2015Este trabajo presenta una plataforma robótica para cirugía mínimamente invasiva (CMI) compuesta por diferentes unidades robóticas miniaturizadas ancladas a una estructura magnética. El artículo describe las características hardware de la plataforma, así como la arquitectura de control maestro/esclavo que permite el manejo de dos unidades robóticas. El acoplamiento cinemático entre el maestro y el esclavo hace más intuitivo el sistema, haciendo posible que se maneje con destreza mediante dos dispositivos Phantoms Omni. Con el objeto de evaluar la viabilidad del esquema de control propuesto, se han llevado a cabo experimentos de “pick and place” y, a través de sesiones experimentales con cinco usuarios diferentes, se ha determinado la curva de aprendizaje del sistema. Debido a que las unidades robóticas miniaturizadas no están provistas de sensores, se ha desarrollado un método de autocalibración inicial basado en análisis de imagen con el objeto de evitar errores de posición de las articulaciones. La arquitectura de control propuesta muestra un adecuado funcionamiento en términos de control de velocidad.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tec

Hacia un asistente robótico quirúrgico cognitivo

[Resumen] Este trabajo presenta una arquitectura cognitiva para un asistente robótico camarógrafo, cuyo objetivo consiste en ofrecer el mejor punto de vista durante la intervención quirúrgica de forma autónoma. Este sistema está formado por un minirobot cámara que se encuentra en el interior de la cavidad abdominal y un brazo robótico externo que maneja dicha cámara mediante una interacción magnética. La arquitectura cognitiva dota al asistente robótico con una memoria a largo plazo, que almacena el conocimiento quirúrgico, los comportamientos de la cámara y los mecanismos de aprendizaje, y una memoria de corto plazo que reconoce el estado actual de la tarea y lanza el comportamiento correspondiente de la cámara. Para obtener el punto de vista más apropiado de la cámara, cada estado de la tarea se caracteriza por un Foco de Atención (FA), definido por un objeto, la posición de ese objeto en la imagen y un factor de zoom. La arquitectura también incluye un mecanismo de aprendizaje que tiene en cuenta las preferencias particulares de los cirujanos durante la tarea quirúrgica y se ha validado con un conjunto de experimentos in-vitro.https://doi.org/10.17979/spudc.978849749808

A surgical dataset from the da Vinci Research Kit for task automation and recognition

The use of datasets is getting more relevance in surgical robotics since they can be used to recognise and automate tasks. Also, this allows to use common datasets to compare different algorithms and methods. The objective of this work is to provide a complete dataset of three common training surgical tasks that surgeons perform to improve their skills. For this purpose, 12 subjects teleoperated the da Vinci Research Kit to perform these tasks. The obtained dataset includes all the kinematics and dynamics information provided by the da Vinci robot (both master and slave side) together with the associated video from the camera. All the information has been carefully timestamped and provided in a readable csv format. A MATLAB interface integrated with ROS for using and replicating the data is also provided.Comment: Submitted to The International Journal of Robotics Research (IJRR). 6 Pages. 4 Figue

Cyber-physical framework for laparoscopic surgery

[EN] This work develops the implementation of a cyber-physical framework for laparoscopic surgery that allows for the use of a surgical simulator with a robotic arm, in order to facilitate learning and research with this type of systems. A configuration for every element in the operation room that allows all the functional restrictions to be fulfilled is proposed and validated. An inverse kinematic model for the redundant robotic arm is also implemented, which returns the most appropriate solution that ensures compliance with these restrictions. Finally, an interface is developed in MATLAB that allows future work to be carried out using this framework, presenting a simple application as an example of use.[ES] Este trabajo desarrolla la implantación de un entorno de trabajo cíber-físico para cirugía laparoscópica que permite utilizar un simulador quirúrgico con un brazo robótico, para así facilitar el aprendizaje y la investigación con este tipo de sistemas. Se propone y valida una configuración para cada uno de los elementos del quirófano que permite cumplir todas las restricciones funcionales. También se implanta un Modelo Cinemático Inverso para el brazo robótico redundante que devuelve la solución más adecuada que asegura el cumplimiento de estas restricciones. El entorno de trabajo se ha implementado haciendo uso de ROS y MATLAB, realizando una serie de pruebas a fin de validar el desarrollo de aplicaciones utilizando este framework.Proyecto Sistema quirúrgico ciberfísico para abordaje laparoscópico" (PY20-00738), grupo de investigación de Robótica Médica del Dpto de Ingeniería de Sistemas y Automática de la Universidad de MálagaHerrera-López, JM.; Galán-Cuenca, Á.; García-Morales, I.; Rollón, M.; Rivas-Blanco, I.; Muñoz, VF. (2023). Entorno de trabajo cíber-físico para cirugía laparoscópica. Revista Iberoamericana de Automática e Informática industrial. 21(1):69-80. https://doi.org/10.4995/riai.2023.18753698021

Diseño mecánico de un asistente robótico camarógrafo con aprendizaje cognitivo

[Resumen] Este artículo describe el diseño mecánico y la arquitectura cognitiva de un asistente robótico camarógrafo que combina las ventajas de los dispositivos intra-abdominales y la navegación autónoma. El asistente robótico está compuesto por un robot cámara intra-abdominal con acople magnético y con dos grados de libertad. La inteligencia del robot se basa en una arquitectura cognitiva basada en memoria a largo plazo para almacenar el conocimiento del robot y capacidades de aprendizaje para mejorar el comportamiento del mismo. La estrategia de navegación del robot cámara combina un control reactivo basado en el seguimiento del instrumental quirúrgico; junto con un control proactivo basado en comportamientos predefinidos dependientes del estado actual de la tarea. Tanto la arquitectura cognitiva como el diseño mecánico han sido validados con una serie de experimentos que se detallan en el artículo. Previamente, todo el diseño e implementación son descritos

The presence of both HLA-DRB1[*]04:01 and HLA-B[*]15:01 increases the susceptibility to cranial and extracranial giant cell arteritis.

Objectives: To determine if patients with the predominant extracranial large-vessel-vasculitis (LVV) pattern of giant cell arteritis (GCA) have a distinctive HLA-B association, different from that reported in biopsy-proven cranial GCA patients. In a further step we assessed if the combination of HLA-B and HLA-DRB1 alleles confers an increased risk for GCA susceptibility, either for the cranial and extracranial LVV phenotypes. Methods: A total of 184 patients with biopsy-proven cranial GCA, 105 with LVV-GCA and 486 healthy controls were included in our study. We compared HLA-B phenotype frequencies between the three groups. Results: HLA-B*15 phenotype was significantly increased in patients with classic cranial GCA compared to controls (14.7% versus 5.8%, respectively; p<0.01; OR [95% CI] =2.81 [1.54-5.11]). It was mainly due to the HLA-B*15:01 allele (12.5% versus 4.0%, respectively; p<0.01; OR [95% CI] =3.51 [1.77-6.99]) and remained statistically significant after Bonferroni correction. Similar HLA-B*15 association was observed in patients with the LVV-GCA (11.4% versus 5.8%, p=0.04, OR [95% CI] =2.11 [1.04-4.30]). This association was also mainly due to the HLA-B*15:01 allele (10.5% versus 4.0%, respectively; p=0.0054; OR [95% CI] =2.88 [1.19-6.59]). Noteworthy, the presence of HLA-B*15:01 together with HLA-DRB1*04:01 led to an increased risk of developing both cranial and extracranial LVV-GCA. Conclusions: Susceptibility to GCA is strongly related to the HLA region, regardless of the clinical phenotype of expression of the disease.This work was partially supported by RETICS Programs, RD08/0075 (RIER), RD12/0009/0013 and RD16/0012 from ‘‘Instituto de Salud Carlos III’’ (ISCIII) (Spain). However, this research did not receive any specific grant from funding agencies in the commercial or not-for-profit sectors

CiTiEs (Ciudades: Tiempo + Espacio) Diseño e implementación de materiales didácticos para la enseñanza virtual del Patrimonio cultural de Madrid a través de la flipped classroom

Se han diseñado e implementado materiales digitales para la Educación patrimonial de Madrid, dirigidos a estudiantes de varias asignaturas. Para su utilización, se ha utilizado preferentemente el "aula invertida" (flipped classroom), adaptándose a las circunstancias excepcionales del curso académico 2020-21

Association Between Preexisting Versus Newly Identified Atrial Fibrillation and Outcomes of Patients With Acute Pulmonary Embolism

Background Atrial fibrillation (AF) may exist before or occur early in the course of pulmonary embolism (PE). We determined the PE outcomes based on the presence and timing of AF. Methods and Results Using the data from a multicenter PE registry, we identified 3 groups: (1) those with preexisting AF, (2) patients with new AF within 2 days from acute PE (incident AF), and (3) patients without AF. We assessed the 90-day and 1-year risk of mortality and stroke in patients with AF, compared with those without AF (reference group). Among 16 497 patients with PE, 792 had preexisting AF. These patients had increased odds of 90-day all-cause (odds ratio [OR], 2.81; 95% CI, 2.33-3.38) and PE-related mortality (OR, 2.38; 95% CI, 1.37-4.14) and increased 1-year hazard for ischemic stroke (hazard ratio, 5.48; 95% CI, 3.10-9.69) compared with those without AF. After multivariable adjustment, preexisting AF was associated with significantly increased odds of all-cause mortality (OR, 1.91; 95% CI, 1.57-2.32) but not PE-related mortality (OR, 1.50; 95% CI, 0.85-2.66). Among 16 497 patients with PE, 445 developed new incident AF within 2 days of acute PE. Incident AF was associated with increased odds of 90-day all-cause (OR, 2.28; 95% CI, 1.75-2.97) and PE-related (OR, 3.64; 95% CI, 2.01-6.59) mortality but not stroke. Findings were similar in multivariable analyses. Conclusions In patients with acute symptomatic PE, both preexisting AF and incident AF predict adverse clinical outcomes. The type of adverse outcomes may differ depending on the timing of AF onset.info:eu-repo/semantics/publishedVersio