Automating Endoscope Motion in Robotic Surgery: A Usability Study on da Vinci-Assisted Ex Vivo Neobladder Reconstruction.
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SUBMITTER: Da Col T
PROVIDER: S-EPMC8656430 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:The development of autonomous or semi-autonomous surgical robots stands to improve the performance of existing teleoperated equipment, but requires fine hand-eye calibration between the free-moving endoscopic camera and patient-side manipulator arms (PSMs). A novel method of solving this problem for the da Vinci® robotic surgical system and kinematically similar systems is presented. First, a series of image-processing and optical-tracking operations are performed to compute the coordinate transformation between the endoscopic camera view frame and an optical-tracking marker permanently affixed to the camera body. Then, the kinematic properties of the PSM are exploited to compute the coordinate transformation between the kinematic base frame of the PSM and an optical marker permanently affixed thereto. Using these transformations, it is then possible to compute the spatial relationship between the PSM and the endoscopic camera using only one tracker snapshot of the two markers. The effectiveness of this calibration is demonstrated by successfully guiding the PSM end effector to points of interest identified through the camera. Additional tests on a surgical task, namely grasping a surgical needle, are also performed to validate the proposed method. The resulting visually-guided robot positioning accuracy is better than the earlier hand-eye calibration results reported in the literature for the da Vinci® system, while supporting intraoperative update of the calibration and requiring only devices that are already commonly used in the surgical environment.
| S-EPMC7978174 | biostudies-literature
Project description:Robotic rectal surgery is becoming increasingly more popular among colorectal surgeons. However, time spent on robotic platform docking, arm clashing and undocking of the platform during the procedure are factors that surgeons often find cumbersome and time consuming. The newest surgical platform, the da Vinci Xi, coupled with integrated table motion can help to overcome these problems. This technical note aims to describe a standardised operative technique of single docking robotic rectal surgery using the da Vinci Xi system and integrated table motion. A stepwise approach of the da Vinci docking process and surgical technique is described accompanied by an intra-operative video that demonstrates this technique. We also present data collected from a prospectively maintained database. 33 consecutive rectal cancer patients (24 male, 9 female) received robotic rectal surgery with the da Vinci Xi during the preparation of this technical note. 29 (88%) patients had anterior resections, and four (12%) had abdominoperineal excisions. There were no conversions, no anastomotic leaks and no mortality. Median operation time was 331 (249-372) min, blood loss 20 (20-45) mls and length of stay 6.5 (4-8) days. 30-day readmission rate and re-operation rates were 3% (n = 1). This standardised technique of single docking robotic rectal surgery with the da Vinci Xi is safe, feasible and reproducible. The technological advances of the new robotic system facilitate the totally robotic single docking approach.
| S-EPMC6096689 | biostudies-other
Project description:BackgroundRobotic pancreatoduodenectomy (RPD) technology is developing rapidly, but there is still a lack of a specific and objective difficulty evaluation system in the field of application and training of RPD surgery.MethodsThe clinical data of patients who underwent RPD in our hospital from November 2014 to October 2020 were analyzed retrospectively. Univariate and multivariate logistic regression analyses were used to determine the predictors of operation difficulty and convert into a scoring system.ResultsA total of 72 patients were enrolled in the group. According to the operation time (25%), intraoperative blood loss (25%), conversion to laparotomy, and major complications, the difficulty of operation was divided into low difficulty (0-2 points) and high difficulty (3-4 points). The multivariate logistic regression model included the thickness of mesenteric tissue (P1) (P = 0.035), the thickness of the abdominal wall (B1) (P = 0.017), and the preoperative albumin (P = 0.032), and the nomogram was established. AUC = 0.773 (0.645-0.901).ConclusionsThe RPD difficulty evaluation system based on the specific anatomical relationship between da Vinci's laparoscopic robotic arm and tissues/organs in the operation area can be used as a predictive tool to evaluate the surgical difficulty of patients before operation and guide clinical practice.
| S-EPMC9200290 | biostudies-literature
Project description:Currently, over 80% of radical prostatectomies have been performed with the da Vinci Surgical System. In order to improve the aesthetic outlook and decrease the morbidity of the operation, the new da Vinci Single Port (SP) system was developed in 2018. However, one major problem is the SP system is still not available in most countries. We aim to present our initial experience and show the safety and feasibility of the single-site robotic-assisted radical prostatectomy (LESS-RP) using the da Vinci Single-Site platform. From June 2017 to January 2020, 120 patients with localized prostate cancer (stage T1-T3b) at Kaohsiung Medical University Hospital were included in this study. We describe our technique and report our initial results of LESS-RP using the da Vinci Si robotic system. Preoperative, intraoperative and postoperative patient variables were recorded. Prostate-specific antigen (PSA)-free survival was also analyzed. A total of 120 patients were enrolled in the study. The median age of patients was 68 years (IQR 63-71), with a median body mass index of 25 kg/m2 (IQR 23-27). The median PSA value before operation was 10.7 ng/mL (IQR 7.9-21.1). The median setup time for creat-ing the extraperitoneal space and ports document was 25 min (IQR 18-34). The median robotic console time and operation time were 135 min (IQR 110-161) and 225 min (IQR 197-274), respectively. Median blood loss was 365 mL (IQR 200-600). There were 11 (9.2%) patients who experienced complications (Clavien-Dindo classification Gr II). The me-dian catheter duration was 8 days (IQR 7-9), with a median of 10 days (IQR 7-11) of hospital stay. The PSA free-survival rate was 86% at a median 19 months (IQR 6-28) of follow up. Robotic radical prostatectomy using the da Vinci Single-Site platform system is safe and feasible, with acceptable outcomes.
| S-EPMC8068145 | biostudies-literature
Project description:PurposeRobotic-assisted minimally invasive esophagectomy (RAMIE) has become one standard approach for the operative treatment of esophageal tumors at specialized centers. Here, we report the results of a prospective multicenter registry for standardized RAMIE.MethodsThe German da Vinci Xi registry trial included all consecutive patients who underwent RAMIE at five tertiary university centers between Oct 17, 2017, and Jun 5, 2020. RAMIE was performed according to a standard technique using an intrathoracic circular stapled esophagogastrostomy.ResultsA total of 220 patients were included. The median age was 64 years. Total minimally invasive RAMIE was accomplished in 85.9%; hybrid resection with robotic-assisted thoracic approach was accomplished in an additional 11.4%. A circular stapler size of ≥28 mm was used in 84%, and the median blood loss and operative time were 200 (IQR: 80-400) ml and 425 (IQR: 335-527) min, respectively. The rate of anastomotic leakage was 13.2% (n=29), whereas the two centers with >70 cases each had rates of 7.0% and 12.0%. Pneumonia occurred in 19.5% of patients, and the 90-day mortality was 3.6%. Cumulative sum analysis of the operative time indicated the end of the learning curve after 22 cases.ConclusionsHigh-quality multicenter registry data confirm that RAMIE is a safe procedure and can be reproduced with acceptable leak rates in a multicenter setting. The learning curve is comparably low for experienced robotic surgeons.
| S-EPMC9283356 | biostudies-literature
Project description:ImportanceStrabismus is a binocular vision disorder characterized by the partial or complete inability to maintain eye alignment on the object that is the target of fixation, usually accompanied by suppression of the deviating eye and consequent 2-dimensional monocular vision. This cue has been used to infer the presence of strabismus in a substantial number of famous artists.ObjectiveTo provide evidence that Leonardo da Vinci had strabismus.Design, setting, and participantsIn exotropia, the divergent eye alignment is typically manifested as an outward shift in the locations of the pupils within the eyelid aperture. The condition was assessed by fitting circles and ellipses to the pupils, irises, and eyelid apertures images identified as portraits of Leonardo da Vinci and measuring their relative positions.Main outcomes and measuresGeometric angle of alignment of depicted eyes.ResultsThis study assesses 6 candidate images, including 2 sculptures, 2 oil paintings, and 2 drawings. The mean relative alignments of the pupils in the eyelid apertures (where divergence is indicated by negative numbers) showed estimates of -13.2° in David, -8.6° in Salvator Mundi, -9.1° in Young John the Baptist, -12.5° in Young Warrior, 5.9° in Vitruvian Man, and -8.3° in an elderly self-portrait. These findings are consistent with exotropia (t5 = 2.69; P = .04, 2-tailed).Conclusions and relevanceThe weight of converging evidence leads to the suggestion that da Vinci had intermittent exotropia with the resulting ability to switch to monocular vision, which would perhaps explain his great facility for depicting the 3-dimensional solidity of faces and objects in the world and the distant depth-recession of mountainous scenes.
| S-EPMC6439801 | biostudies-literature
Project description:PurposeThis study aims (1) to investigate the feasibility of robot-assisted penetrating keratoplasty (PK) using the new Da Vinci Xi Surgical System and (2) to report what we believe to be the first use of this system in experimental eye surgery.MethodsRobot-assisted PK procedures were performed on human corneal transplants using the Da Vinci Xi Surgical System. After an 8-mm corneal trephination, four interrupted sutures and one 10.0 monofilament running suture were made. For each procedure, duration and successful completion of the surgery as well as any unexpected events were assessed. The depth of the corneal sutures was checked postoperatively using spectral-domain optical coherence tomography (SD-OCT).ResultsRobot-assisted PK was successfully performed on 12 corneas. The Da Vinci Xi Surgical System provided the necessary dexterity to perform the different steps of surgery. The mean duration of the procedures was 43.4 ± 8.9 minutes (range: 28.5-61.1 minutes). There were no unexpected intraoperative events. SD-OCT confirmed that the sutures were placed at the appropriate depth.ConclusionsWe confirm the feasibility of robot-assisted PK with the new Da Vinci Surgical System and report the first use of the Xi model in experimental eye surgery. Operative time of robot-assisted PK surgery is now close to that of conventional manual surgery due to both improvement of the optical system and the presence of microsurgical instruments.Translational relevanceExperimentations will allow the advantages of robot-assisted microsurgery to be identified while underlining the improvements and innovations necessary for clinical use.
| S-EPMC5482186 | biostudies-literature
Project description:STUDY OBJECTIVE:To present a series of robotic laparoendoscopic single-site surgery (LESS) and reduced-port hysterectomy cases and discuss the surgical technique required for successful use on this new platform. DESIGN:Retrospective case series. SETTING:Academic medical center. PATIENTS:All patients undergoing robotic LESS or reduced-port hysterectomy with the SP1098 da Vinci SP Surgical System (Intuitive Surgical, Sunnyvale, CA) from December 2019 to March 2020. INTERVENTIONS:Robotic LESS or reduced-port hysterectomy. MEASUREMENTS AND MAIN RESULTS:A total of 8 cases of hysterectomy were performed successfully. Four cases included concomitant resection of endometriosis. Five cases required placement of an additional port. The average uterine weight was 136.1 g ± 61.5 g (range 87-246). The average estimated blood loss was 37.5 mL ± 27 mL (range 20-100). The average operative time was 86.5 minutes ± 27.1 minutes (range 60-132). The time required for vaginal cuff closure was available for patients 5 to 8, and ranged from 10 minutes to 13 minutes. All patients had same-day discharge. There were no conversions to alternative surgical modality, complications, or readmissions. CONCLUSION:Our preliminary experience with the SP1098 da Vinci SP Surgical System demonstrated the technical feasibility and safety of this surgical modality for gynecologic surgery. Additional studies examining postoperative outcomes and prospective studies comparing this modality with traditional robotic surgery are indicated.
| S-EPMC7438228 | biostudies-literature
Project description:BackgroundThis study sought to evaluate the impact of a da Vinci Xi surgical robot on perioperative outcomes after pulmonary resections.MethodsA retrospective analysis of prospectively collected STS data was performed at a single institution for patients who underwent elective lung resections from 2012 to 2019. Patient outcomes were compared at three different time periods: before the adoption of the robot technology (predominately VATS), during the initial robot experience (the first 18 months), and after the mature robot experience (the second 18 months). Univariate and multivariate logistic regression modeling was performed to determine the factors associated with perioperative complications.ResultsFive hundred and four patients underwent pulmonary resection between the three time periods: 220 patients (43.7%) had surgery prior to the first use of the robot (predominately VATS), 126 patients (25%) had surgery during the initial experience with robot, and 158 patients (31.1%) had surgery during the mature robot experience. There were significantly less post-operative complications (15.2% vs. 34.9% vs. 39.1%, P<0.001), shorter median length of stay (2 vs. 3 vs. 4 days, P<0.001), and lower hospital readmission rates (1.9% vs. 4% vs. 11.8%, P<0.001) in the mature robot period compared to the initial robot period and the predominately VATS period, respectively. Multivariate analysis showed that the robot was associated with a decrease in post-operative complications (OR 0.36; 95% CI, 0.23-0.57, P<0.001).ConclusionsThe adoption of a da Vinci Xi robot in our institution was associated with improved outcomes in patients having pulmonary resections.
| S-EPMC7399389 | biostudies-literature
Project description:Purpose:We developed a technique of totally-robotic right colectomy with D3 lymphadenectomy and intracorporeal anastomosis via a suprapubic transverse linear port. This article aimed to introduce our novel robotic surgical technique and assess the short-term outcomes in a series of five patients. Methods:All colectomies were performed using the da Vinci Xi system. Four robot trocars were placed transversely in the supra pubic area. Totally-robotic right colectomy was performed, including colonic mobilization, D3 lymphadenectomy, and intra corporeal stapled functional anastomosis. The 2 middle suprapubic trocar incisions were then extended to retrieve the specimen. Results:Five robotic right colectomies via the suprapubic approach were performed between August 2015 and February 2016. The mean operation time was 183 ± 29.37 minutes, and the mean estimated blood loss was 27 ± 9.75 mL. The time to clear liquid intake was 3 days in all patients, and the mean length of stay after surgery was 6.2 ± 0.55 days. No patient required conversion to conventional laparoscopic surgery. There were no perioperative complications. According to the pathology report, the mean number of harvested lymph nodes was 36.6 ± 4.45. Four patients were stage III, and 1 patient was stage II according to the 7th edition of the American Joint Committee on Cancer system. Conclusion:Totally-robotic right colectomy via the suprapubic approach can be performed successfully in selected patients. Further comparative studies are required to verify the clinical advantages of our technique over conventional robotic surgery.
| S-EPMC5801332 | biostudies-literature