Application of intelligent robot system in teaching cervical spine manipulation / 国际生物医学工程杂志

Objective:To explore the application effect of an intelligent teaching robot system of lifting manipulation in cervical spine manipulation teaching.Methods:60 doctors were randomly divided into an experimental group ( n = 30) and a control group ( n = 30). The control group was taught by a certified chief physician using a combination of "PowerPoint presentations, video demonstrations, and operation demonstrations" . Each part is 5 min. The experimental group was taught by the intelligent teaching robot system with a spinning technique. The teaching time is 15 min for both groups. At the end of the two teaching sessions, the two groups were trained five times under different BMIs and passed the system assessment. The qualified rates of pre-traction force, lifting and pulling force, maximum force, pre-traction time, lifting and pulling time, rotation amplitude, and pitch amplitude were compared between the two groups. Results:In normal, there was significant differences between the qualified rates of pre-traction force, lifting and pulling force, maximum force, pre-traction time, lifting and pulling time, rotation amplitude, and pitch amplitude in two groups (all P<0.05). For overweight people, there were significant differences in pre-traction force, pulling force, maximum force, and rotation amplitude (all P <0.05), while there were no significant differences in pre-traction time, pulling time, or pitching amplitude (all P >0.05). In obesity, there were significant differences in pre-traction force, lifting and pulling force, maximum force, and pitch amplitude (all P <0.05), but no significant differences in pre-traction time, lifting and pulling time, or rotation amplitude (all P >0.05). Conclusions:The proposed system can improve the pass rate of spinning manipulation, especially by effectively controlling the pre-traction force, pulling force, and maximum force.

Feasibility and safety analysis of domestic single-port robot system-assisted laparoscopic partial nephrec-tomy / 实用医学杂志

Objective To study the feasibility of domestic single-port surgical robot assisted endoscopic system for partial nephrectomy,and analyze its safety in clinical partial nephrectomy based on experimental results Methods Three qualified experimental pigs were selected,two senior urological professors and a senior resident doctor used a domestic single-port surgical robot to perform partial nephrectomy on the left and right kidneys.Recorded the operation duration,hot ischemia duration,suture time,estimated blood loss,volume of renal parenchyma excision and other information.Results There were 8 wedge resection and 4 heminephrectomies.The kidney volume of wedge resection was(7.35±0.81)mL and the blood loss was(8.50±11.09)mL.The total operation time was(41.67±8.50)min,and the time of resection was(5.88±3.27)min and the stitching time was(11.75±2.82)min.The kidney volume of heminephrectomy was(24.30±2.18)mL,and the blood loss was(6.25±4.35)mL.The total operation time of heminephrectomy was(47.00±11.27)min,and the time of resection was(3.25±1.5)min and the stitching time was(10.00±5.25)min.No bleeding was observed on the wound after the Bull dog was released in all operations.There was no significant difference in operation time and blood loss between the heminephrectomy group and the wedge resection group.There was no significant difference in operation time or blood loss between the senior doctor group and the senior resident doctor group.The NASA-TLX scale was used to assess the degree of workload of the operator during surgical operations,and the results showed that none of the three surgeons had a high level of frustration.There were no adverse events related to the single-port surgical robot system during the operation.Conclusion It is safe and feasible for a domestic single-port surgical robot system to perform a partial nephrectomy.

Comparison of the learning curve of robot -assisted and laparoscopic -assisted gastrectomy / 中南大学学报(医学版)

OBJECTIVES@#Da Vinci robot technology is widely used in clinic,with minimally invasive surgery development. This study aims to explore the possible influence of advanced surgical robotics on the surgery learning curve by comparing the initial clinical learning curves of 2 different surgical techniques: robotic-assisted gastrectomy (RAG) and laparoscopic-assisted gastrectomy (LAG).@*METHODS@#From September 2017 to December 2020, a chief surgeon completed a total of 108 cases of radical gastric cancer from the initial stage, including 27 cases of RAG of the Da Vinci Si robotic system (RAG group) and 81 cases of LAG (LAG group). The lymph node of gastric cancer implemented by the Japanese treatment guidelines of gastric cancer. The surgical results, postoperative complications, oncology results and learning curve were analyzed.@*RESULTS@#There was no significant difference in general data, tumor size, pathological grade and clinical stage between the 2 groups (P>0.05). The incidence of serious complications in the RAG group was lower than the LAG group (P=0.003). The intraoperative blood loss in the RAG group was lower than that in the LAG group (P=0.046). The number of lymph nodes cleaned in the RAG group was more (P=0.003), among which there was obvious advantage in lymph node cleaning in the No.9 group (P=0.038) and 11p group (P=0.015). The operation time of the RAG group was significantly longer than the LAG group (P=0.015). The analysis of learning curve found that the cumulative sum analysis (CUSUM) value of the RAG group decreased from the 10th case, while the CUSUM of the LAG group decreased from the 28th case. The learning curve of the RAG group had fewer closing cases than that of the LAG group. The unique design of the surgical robot might help to improve the surgical efficiency and shorten the surgical learning curve.@*CONCLUSIONS@#Advanced robotics helps experienced surgeons quickly learn to master RAG skills. With the help of robotics, RAG are superior to LAG in No.9 and 11p lymph node dissection and surgical trauma reduction. RAG can clear more lymph nodes than LAG, and has better perioperative effect.

Experience of Thoracotomy and Robot-assisted Bronchial Sleeve Resection after Neoadjuvant Chemoimmunotherapy for Local Advanced Central Lung Cancer / 中国肺癌杂志

BACKGROUND@#Immunoneoadjuvant therapy opens a new prospect for local advanced lung cancer. The aim of our study was to explore the safety and feasibility of robotic-assisted bronchial sleeve resection in patients with locally advanced non-small cell lung cancer (NSCLC) after neoadjuvant chemoimmunotherapy.@*METHODS@#Data of 13 patients with locally advanced NSCLC that underwent bronchial sleeve resection after neoadjuvant chemoimmunotherapy during August 2020 and February 2021 were retrospectively included. According to the surgical methods, patients were divided into thoracotomy bronchial sleeve resection (TBSR) group and robot-assisted bronchial sleeve resection (RABSR) group. Oncology, intraoperative, and postoperative data in the two groups were compared.@*RESULTS@#The two groups of patients operated smoothly, the postoperative pathology confirmed that all the tumor lesions achieved R0 resection, and RABSR group no patient was transferred to thoracotomy during surgery. Partial remission (PR) rate and major pathological remissions (MPR) rate of patients in the TBSR group were 71.43% and 42.86%, respectively. Complete pathological response (pCR) was 28.57%. They were 66.67%, 50.00% and 33.33% in RABSR group, respectively. There were no significant differences in operative duration, number of lymph nodes dissected, intraoperative blood loss, postoperative drainage time and postoperative hospital stay between the two groups, but the bronchial anastomosis time of RABSR group was relatively short. Both groups of patients had a good prognosis. Successfully discharged from the hospital and post-operative 90-d mortality rate was 0.@*CONCLUSIONS@#In patients with locally advanced central NSCLC after neoadjuvant chemoimmunotherapy can achieve the tumor reduction, tumor stage decline and increase the R0 resection rate, bronchial sleeve resection is safe and feasible. Under the premise of following the two principles of surgical safety and realizing the tumor R0 resection, robot-assisted bronchial sleeve resection can be preferred.

da Vinci robot system for radical surgery of lung cancer in elderly patients / 中国胸心血管外科临床杂志

@#Objective    To evaluate the feasibility and safety of da Vinci robotic surgery for elderly patients with radical surgery of lung cancer. Methods    We retrospectively analyzed the clinical data of 59 patients aged over 70 years who underwent radical surgery of lung cancer in our hospital between 2016 and 2019. These patients were divided into two groups including a da Vinci robot group and a single-utility port video-assisted thoracoscopic surgery (VATS) group according to the patients’ selection of the treatments. There were 32 patients with 20 males and 12 females aged 73.1±2.3 years in the da Vinci robot group and 27 patients with 16 males and 11 females aged 71.2±1.3 years in the VATS group. The clinical data of the two groups were compared. Results    There was no statistical difference in surgery time between the two groups (t=–0.341, P=0.484). Compared with the VATS group, the da Vinci robot group had more number of lymph nodes dissected (t=1.635, P=0.015), less intraoperative blood loss (t=–2.569, P <0.001), less postoperative drainage amount within 3 days after surgery (t=–6.325, P=0.045), lower visual analogue scale (VAS) scores at postoperative 3rd day (t=–7.214, P=0.021). Conclusion    The da Vinci robot system is safe and efficient in the treatment for elderly patients with radical surgery of lung cancer with less trauma.

Perioperative efficacy and safety of da Vinci robot-assisted bronchial sleeve lobectomy / 中国胸心血管外科临床杂志

@#Objective    Through the perioperative outcome analysis of da Vinci robot-assisted sleeve lobectomy, to clarify its efficacy and safety. Methods    A retrospective analysis was performed on 10 patients with centrally located lung cancer undergoing robot-assisted sleeve lobectomy from March to December 2019 in our center, including 9 males and 1 female, aged 45-67 (55.0±8.9) years. Preoperative imaging and bronchoscopy showed central non-small cell lung cancer, involving the right upper lung in 3 patients, right lower lung in 2 patients, the left upper lung in 4 patients, and left lower lung in 1 patient. The operation time, Docking time, intraoperative blood loss volume, bronchial anastomosis time, number of dissected lymph nodes, drainage volume and postoperative hospital stay were analyzed. Results    The da Vinci robot-assisted bronchial sleeve lobectomy was completed smoothly on 10 patients. The operation time was 135-183 (157.8±14.3) min, Docking time 6-15 (10.0±2.9) min, intraoperative blood loss volume 55-250 (124.5±61.8) mL, bronchial anastomosis time 17-40 (27.7±7.3) min, the number of dissected lymph nodes 16-23 (19.7±2.8), the drainage volume 200-600 (348.0±148.4) mL and postoperative hospital stay 7-11 (8.7±1.6) d. All patients had no bronchopleural fistula, pulmonary infection or atelectasis, and there was no perioperative death. Postoperative pathological findings were all squamous cell carcinoma. Conclusion    Da Vinci robot-assisted sleeve lobectomy is safe and effective.

Da Vinci robot-assisted surgery versus video-assisted thoracoscopic surgery for resection of mediastinal tumors: A retrospective cohort study / 中国胸心血管外科临床杂志

@#Objective    To summarize the experience of minimally invasive anterior mediastinal tumor resection in our center, and compare the Da Vinci robotic and video-assisted thoracoscopic approaches in the treatment of mediastinal tumor. Methods    A retrospective cohort study was conducted to continuously enroll 102 patients who underwent minimally invasive mediastinal tumor resection between September 2014 and November 2019 by the single medical group in our department. They were divided into two groups: a robotic group (n=47, 23 males and 24 females, average age of 52 years) and a thoracoscopic group (n=55, 29 males and 26 females, average age of 53 years). The operation time, intraoperative blood loss, postoperative thoracic drainage volume, postoperative thoracic drainage time, postoperative hospital stay, hospitalization expense and other clinical data of two groups were compared and analyzed. Results    All the patients successfully completed the surgery and recovered from hospital, with no perioperative death. Myasthenia gravis occurred in 4 patients of the robotic group and 5 of the thoracoscopic group. The tumor size was 2.5 (0.8-8.7) cm in the robotic group and 3.0 (0.8-7.7) cm in the thoracoscopic group. Operation time was 62 (30-132) min in the robotic group and 60 (29-118) min in the thoracoscopic group. Intraoperative bleeding volume was 20 (2-50) mL in the robotic group and 20 (5-100) mL in the thoracoscopic group. The postoperative drainage volume was 240 (20-14 130) mL in the robotic group and 295 (20-1 070) mL in the thoracoscopic group. The postoperative drainage time was 2 (1-15) days in the robotic group and 2 (1-5) days in the thoracoscopic group. There was no significant difference between the two groups in the above parameters and postoperative complications (P>0.05). The postoperative hospital stay were 3 (2-18) days in the robotic group and 4 (2-14) in the thoracoscopic group (P=0.014). The hospitalization cost was 67 489 (26 486-89 570) yuan in the robotic group and 27 917 (16 817-67 603) yuan in the thoracoscopic group (P=0.000). Conclusion    Compared with the video-assisted thoracoscopic surgery, Da Vinci robot-assisted surgery owns the same efficacy and safety in the treatment of mediastinal tumor, with shorter postoperative hospital stay, but higher cost.

Preliminary application study of using tele-ultrasound robot system in volunteers / 中华超声影像学杂志

Objective To explore the accuracy of ultrasonic diagnosis using the tele-ultrasound robot system . Methods During the period from May to June 2018 ,42 volunteers were consecutive selected to participate in this study ,and their digestive system and urinary system were examined using the robot method manufactured by GI Tech Co . ,Ltd ,Shenzhen and the traditional method . The results including the ultrasound diagnosis and the inspection time of two methods in each patient were compared . The ultrasonographic diagnosis of each volunteer was obtained by two methods and the time was recorded . The ultrasound images of the two methods were mixed together ,and the quality of the images was evaluated double-blindly by two senior doctors . Results There were actually 25 positive lesions in 42 volunteers . In the ultrasonic diagnosis of the two methods ,22 lesions were positive detected by robot method ,with 5 lesions misdiagnosed . In the traditional method , 24 lesions were positive detected , with 1 lesions misdiagnosed . Using the Wilcoxon signed rank test of paired sample comparison ,the score obtained by the robot method was 4 .79 ± 0 .57 ,and the score obtained by the traditional method was 4 .81 ± 0 .54 ( Z =0 .775 ,P= 0 .439) ,the difference was not statistically significant . There was no statistically significant difference in the images'qulity between the robot method and the traditional method using the chi-square test of the four-grid data( P >0 .05) . The check time for volunteers with negative result was ( 8 .64 ± 2 .95) min in robotic method and ( 2 .55 ± 0 .74 ) min in the traditional method ,the difference was statistically significant ( t =15 .161 , P =0 .000) . Conclusions The robot method has high value in common disease diagnosis and high quality in image acquisition ,and can be used in real-time diagnosis of the remote areas or community medical .

Da Vinci robot system in the surgical treatment of mediastinal lesions: A case control study / 中国胸心血管外科临床杂志

@#Objective     To summarize the clinical data about mediastinal lesions, then to analyze the treatment effect of da Vinci robot system in the surgical treatment of mediastinal lesions. Methods     We retrospectively analyzed the clinical data of 49 patients with mediastinal lesions in our hospital between January 2016 and October 2017. These patients were divided into two groups including a da Vinci robot group and a video-assisted thoracoscopic surgery (VATS) group according to the selection of the treatments. There were 25 patients with 14 males and 11 females at age of 56.5±17.9 years in the da Vinci group and 24 patient with 15 males and 11 females at age of 53.0±17.8 years in the VATS group. Results     There was no statistical difference in surgery time between the two groups (t=–0.365, P=0.681). Less intraoperative blood loss ( t=–2.569, P<0.001), less postoperative drainage amount within three days after surgery ( t= – 6.325, P=0.045), shorter period of bearing drainage tubes after surgery ( t=–1.687, P=0.024), shorter hospital stays ( t= – 3.689, P=0.021), lower visual analogue scale (VAS) scores of postoperative 48 hours (t=–7.214, P=0.014) with a statistical difference in the da Vinci robot group compared with the VATS group. Conclusion     The da Vinci robot system is safe and efficient in the treatment of mediastinal lesions compared with video-assisted thoracoscopic approach.

Roles of Stereotactic Surgical Robot Systems in Neurosurgery / 한양의대학술지

An important trend of surgical procedure is minimally invasive surgery (MIS). Neurosurgery is an important part of the surgical field that may lead in trends. The MIS provides surgeons use of a variety of techniques to operate with less injury to the body than with open surgery. In general, it is safer than open surgery and allows patients to recover faster and heal with less pain and scarring. There are various techniques and medical devices for improving the MIS. Recently, robotic surgery was introduced to MIS. Advanced robotic systems give doctors greater control and vision during surgery, allowing them to perform safe, less invasive, and precise surgical procedures. On the one hand, several robotic systems have been developed for use in neurosurgery. Some of those neurosurgical robots have been commercialized and used in clinical practice while others have not been used because of safety and ethical issues. This paper provides a brief review on robotic systems for neurosurgery, primarily focusing on commercially available systems.

Surgical Outcomes of Congenital Atrial Septal Defect Using da VinciTM Surgical Robot System

BACKGROUND: Minimally invasive cardiac surgery has emerged as an alternative to conventional open surgery. This report reviews our experience with atrial septal defect using the da VinciTM surgical robot system. MATERIALS AND METHODS: This retrospective study included 50 consecutive patients who underwent atrial septal defect repair using the da VinciTM surgical robot system between October 2007 and May 2011. Among these, 13 patients (26%) were approached through a totally endoscopic approach and the others by mini-thoracotomy. Nineteen patients had concomitant procedures including tricuspid annuloplasty (n=10), mitral valvuloplasty (n=9), and maze procedure (n=4). The mean follow-up duration was 16.9+/-10.4 months. RESULTS: No remnant interatrial shunt was detected by intraoperative or postoperative echocardiography. The atrial septal defects were mainly repaired by Gore-Tex patch closure (80%). There was no operative mortality or serious surgical complications. The aortic cross clamping time and cardiopulmonary bypass time were 74.1+/-32.2 and 157.6+/-49.7 minutes, respectively. The postoperative hospital stay was 5.5+/-3.3 days. CONCLUSION: The atrial septal defect repair with concomitant procedures like mitral valve repair or tricuspid valve repair using the da VinciTM system is a feasible method. In addition, in selected patients, complete port access can be helpful for better cosmetic results and less musculoskeletal injury.

Arranging transient process used in iterative learning control system / 西安交通大学学报·英文版

Considering the same initial state error in each repetitive operation in the iterative learning system, a method of arranging the transient process is given. During the current iteration, the system will track the transient function firstly, and then the expected trajectory. After several iterations, the learning system output will trend to the arranged curve, which has avoided the effect of the initial error on the controller. Also the transient time can be changed as you need, which makes the designing simple and the operation easy. Then the detailed designing steps are given via the robot system. At last the simulation of the robot system is given, shows the validity of the method.

STATICS ANALYSIS AND OPENGL BASED 3D SIMULATION OF COLLABORATIVE RECONFIGURABLE PLANETARY ROBOTS / 药物分析学报

Objective To study mechanics characteristics of two cooperative reconfigurable planetary robots when they get across an obstacle, and to find out the relationship between the maximum height of a stair with the configuration of the two-robot, and to find some restrictions of kinematics for the cooperation. Methods Multirobot cooperation theory is used in the whole study process. Inverse kinematics of the robot is used to form a desired configuration in the cooperation process. Static equations are established to analyze the relations between the friction factor, the configuration of robots and the maximum height of a stair. Kinematics analysis is used to find the restrictions of the two collaborative robots in position, velocity and acceleration. Results 3D simulation shows that the two cooperative robots can climb up a stair under the condition of a certain height and a certain friction factor between robot wheel and the surface of the stair. Following the restrictions of kinematics, the climbing mission is fulfilled successfully and smoothly. Conclusion The maximum height of a stair, which the two cooperative robots can climb up, is involved in the configuration of robots, friction factor between the stair and the robots. The most strict restriction of the friction factor does not appear in the horizontal position. In any case, the maximum height is smaller than half of the distance between the centroid of robot1 with the centroid of robot2. However, the height can be higher than the radius of one robot wheel, which profit from the collaboration.

An experimental study of cannulated screw fixation of femoral neck fractures aided by the bi-planar navigation robot system / 中华创伤骨科杂志

Objective To investigate clinical feasibility, security, and effects of cannulated screw fixation of femoral neck fractures aided by the bi-planar navigation robot system. Methods Under the guidance of the robot system which was developed jointly by Beijing Aeronautics and Space University and our hospital, 15 pins were inserted into the femoral necks of 5 Synbone models. The difference between the distance of any 2 points at the entry point and that at the outlet point was measured in the 5 cases. The ratio (P) of the difference to the length of the pin within the femoral neck of the Synbone models was calculated to evaluate how parallel the 2 pins were. The fluoroscopic times and the radiation exposure time in the robot-aided treatment were recorded and compared with those in the 12 cases of conventional operations which were conducted in our department from June to September, 2005. Results P was about 0.003 7 to 0.018 1, and the X-ray exposure time in robot aided system was 2.32 s vs 28.30 s in the conventional operations. The average fluoroscopic times in robot aided system were 4.4 vs 54.3 in the conventional operations. Conclusion As the bi-planar navigation robot system can provide accurate space orientation and stable navigation route, and can decrease the X-ray radiation to the patient and staff, it has a significant value in clinical application.

The bi-planar navigation robot system: application for insertion of sacroiliac screws / 中华创伤骨科杂志

Objective To assess effects and security of the insertion of sacroiliac screws by the bi-planar navigation robot system. Methods In a simulated surgical setup, 12 AO cannulated screws were placed into the S1 vertebral bodies of 4 human pelvic bone under the guidance of the bi-planar navigation robot system which was developed jointly by Beijing Aeronautics and Space University and our hospital. To compare this new technique with the conventional technique, another 12 cannulated screws were placed into 4 Synbone pelvic models under fluoroscopic control. The fluoroscopic times, the radiation exposure time and operation time between image acquisition and guide-wire insertion were recorded. Results With the guidance of the bi-planar navigation robot system, the average fluoroscopic times were 2.5, the average radiation exposure time was 1.5 seconds, and the average operation time was 253 seconds. All the screws were in the safe area. Under the fluoroscopic control, the average fluoroscopic times were 20.3, the average radiation exposure time was 13.7 seconds, and the average operation time was 246 seconds. Two screws (16.7%) were misplaced. The fluoroscopic times and the radiation exposure time were reduced significantly when the bi-planar navigation robot system was used (P0.05). Conclusions The bi-planar navigation robot system can provide precise navigation for insertion of sacroiliac screws within several minutes, and reduce the radiation exposure to the patient and the staff significantly. The results of this prospectively controlled experimental study are encouraging for further clinical trials.