Dataset Information

Housing design and testing of a surgical robot developed for orthopaedic surgery.

ABSTRACT:

Background/objective

Surgical technology has advanced rapidly with the introduction of robot technology. Apart from mechanical and electronic elements, housing design is an essential component that must be thoughtfully considered, bearing in mind the general requirements for medical devices used in operating theatres. The aim of this study was to design a modern and safe housing for a surgical robotic system for orthopaedic applications in Hong Kong that would meet the general requirements for obtaining local regulatory body approval.

Methods

Based on the general requirements for Class II Medical Devices, industrial product designers worked in close collaboration with a robot research team formed by engineers and orthopaedic surgeons to design a modern and safe housing for the HybriDot ^® Surgical Robotic System that performs computer-assisted surgery.

Results

The design received local regulatory body approval for its application in operating theatres and was approved for orthopaedic surgery in Hong Kong after fulfilling the general requirements for safety, accuracy, movability and operability.

Conclusion

This project demonstrated a good model of multidisciplinary R&D of surgical robotics led by orthopaedic surgeons, in collaboration with mechanical and electronic engineers and industrial designers.

SUBMITTER: Qin LY

PROVIDER: S-EPMC5987043 | biostudies-literature | 2016 Apr

REPOSITORIES: biostudies-literature

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Publications

Housing design and testing of a surgical robot developed for orthopaedic surgery.

Qin Lai-Yin LY Wen Jing Zhou JZ Chui Chun-Sing CS Leung Kwok-Sui KS

Journal of orthopaedic translation 20160311

<h4>Background/objective</h4>Surgical technology has advanced rapidly with the introduction of robot technology. Apart from mechanical and electronic elements, housing design is an essential component that must be thoughtfully considered, bearing in mind the general requirements for medical devices used in operating theatres. The aim of this study was to design a modern and safe housing for a surgical robotic system for orthopaedic applications in Hong Kong that would meet the general requiremen ...[more]

PMID: 30035077

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Project description:BackgroundSurgical site infections (SSIs) after elective orthopaedic surgery are very stressful for patients due to frequent rehospitalizations with reoperations and poorer functional outcomes. Prevention of such events is therefore crucial. Although an evidence-based consensus is still lacking, preoperative decolonization could decrease SSI. Specifically, more information is needed about the effect of a preoperative decolonization procedure on SSI proportions in both Staphylococcus aureus carriers and non-S. aureus carriers after general orthopaedic surgery.Questions/purposesOur study addressed the following questions: (1) Does preoperative decolonization reduce the risk of SSI after general elective orthopaedic surgery in patients colonized with S. aureus? (2) Does preoperative decolonization reduce the risk of SSI among patients who are not colonized with S. aureus?MethodsIn this prospective, randomized, single-blinded trial, we recruited patients undergoing general elective orthopaedic surgery in one tertiary care center in Switzerland. Between November 2014 and September 2017, 1318 of 1897 screened patients were enrolled. Patients were allocated into either the S. aureus carrier group (35%, 465 of 1318 patients) or the noncarrier group (65%, 853 of 1318 patients) according to screening culture results. In the S. aureus group, 232 patients were allocated to the intervention arm and 233 were allocated to the control arm. Intervention was 5 days of daily chlorhexidine showers and mupirocin nasal ointment twice a day. Of the 853 noncarriers, 426 were allocated to the intervention arm and 427 were allocated to the control arm. All patients in both groups were analyzed in an intention-to-treat manner. The primary endpoint was SSI occurrence at 90 days postoperative and the secondary endpoint was SSI occurrence at 30 days postoperative.The initial sample size calculation was made for the S. aureus carrier group. Based on the literature review, a 4% proportion of SSI was expected in the control group. Thus, 726 carriers would have been needed to detect a relative risk reduction of 80% with a power of 80% at a two-sided α-error of 0.048 (adjusted for interim analysis). Assuming carrier prevalence of 27%, 2690 patients would have been needed in total. An interim analysis was performed after including half of the targeted S. aureus carriers (363 of 726). Based on the low infection rate in the control group (one of 179), a new sample size of 15,000 patients would have been needed. This was deemed not feasible and the trial was stopped prematurely.ResultsAmong carriers, there was no difference in the risk of SSI between the intervention and control arms (decolonized SSI risk: 0.4% [one of 232], control SSI risk: 0.4% [one of 233], risk difference: 0.0% [95% CI -1.2% to 1.2%], stratified for randomization stratification factors; p > 0.999). For noncarriers, there was no difference in risk between the intervention and control arms (decolonized SSI risk: 0.2% [one of 426], control SSI risk: 0.2% [one of 247], stratified risk difference: -0.0% [95% CI -0.7 to 0.6]; p = 0.973).ConclusionsWe found no difference in the risk of SSI between the decolonization and control groups, both in S. aureus carriers and noncarriers. Because of the low event numbers, no definite conclusion about efficacy of routine preoperative decolonization can be drawn. The results, however, may be helpful in future meta-analyses.Level of evidenceLevel II, therapeutic study.

Project description:PurposeThe purpose of this study is to determine the safety of elective, outpatient orthopaedic sports procedures during the Coronavirus (COVID-19) pandemic at a high-volume orthopaedic practice.MethodsAll patients who were scheduled for elective, outpatient orthopaedic sports medicine procedures at 1 of 2 of outpatient surgical centers between July 1, 2020, and December 31, 2020, were asked to complete a custom survey during a postoperative clinic visit or phone call at a minimum of 2 weeks or were subject to a routine screening questionnaire and temperature screening at the time of the first postoperative follow-up visit. The survey questionnaire assessed for any COVID-19-related symptoms. Surgical case logs were retrieved to review for any cancelled surgeries due to a positive preoperative COVID-19 test.ResultsIn total, 3.5% of patients (n = 39/1119) scheduled for surgery were diagnosed with COVID-19 during preoperative testing, resulting in surgical cancellation. Patients with a positive preoperative COVID-19 test result were found to be significantly younger (46 ± 20 years) when compared to all other patients with a negative test (51 ± 21 years; P = .002). No patient was diagnosed with COVID-19, reported symptoms concerning for COVID infection, underwent additional testing, or reported close contact with another individual with a positive test or possessed symptoms concerning for COVID-19 at a minimum of 2 weeks after surgery.ConclusionThis study found that 3.5% of patients tested positive for COVID-19 and were significantly younger when compared with patients testing negative. No patient investigated for potential infection after surgery reported the development of any symptoms related to COVID-19 or reported a positive test result after surgery. Using current protocols for preoperative screening, elective outpatient orthopaedic surgery performed in an Ambulatory Surgical Center is safe with no documented cases of COVID-19 transmission in this cohort.Level of evidenceLevel IV, prognostic case series.

Project description:ObjectiveWe surveyed Orthopaedic Surgery Residency (OSR) programs to determine international opportunities by the academic institutional region within the United States, location of the international experience, duration, residency program year (PGY), funding source, and resident participation to date.DesignWe emailed a survey to all OSR programs in the United States to inquire about global opportunities in their residency programs. Further contact was made through an additional e-mail and up to three telephone calls. Data were analyzed using descriptive and chi-square statistics. This study was institutional review board exempt.SettingThis research study was conducted at the University of Nebraska Medical Center, a tertiary care facility in conjunction with the University of Nebraska Medical Center College of Medicine.ParticipantsThe participants of this research study included program directors and coordinators of all OSR programs (185) across the United States.ResultsA total of 102 OSR programs completed the survey (55% response rate). Notably, 50% of the responding programs offered a global health opportunity to their residents. Of the institutions that responded, those in the Midwest or South were more likely to offer the opportunity than institutions found in other US regions, although regional differences were not significant. Global experiences were most commonly: in Central or South America (41%); 1 to 2 weeks in duration (54%); and during PGY4 or PGY5 (71%). Furthermore, half of the programs provided full funding for the residents to participate in the global experience. In 33% of the programs, 10 or more residents had participated to date.ConclusionsInterest in global health among medical students is increasing. OSR programs have followed this trend, increasing their global health opportunities by 92% since 2015. Communicating the availability of and support for international opportunities to future residents may help interested students make informed decisions when applying to residency programs.

Dataset Information

Housing design and testing of a surgical robot developed for orthopaedic surgery.

Background/objective

Methods

Results

Conclusion

Publications

Housing design and testing of a surgical robot developed for orthopaedic surgery.

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