A minimally invasive surgery robotic assistant for HALS-SILS techniques.

This paper is focused in the design and implementation of a robotic surgical motion controller. The proposed control scheme addresses the issues related to the application of a robot assistant in novel surgical scenario, which combines hand assisted laparoscopic surgery (HALS) with the single incision laparoscopic surgery (SILS) techniques. It is designed for collaborating with the surgeon in a natural way, by performing autonomous movements, in order to assist the surgeon during a surgical maneuver. In this way, it is implemented a hierarchical architecture which includes an upper auto-guide velocity planner connected to a low-level force feedback controller. The first one, based on a behavior approach, computes a collision free trajectory of the surgical instrument tip, held by the robot, for reaching a goal location inside of the abdominal cavity. On the other hand, the force feedback controller uses this trajectory for performing the instrument displacement by taking into account the holonomic movement constraints introduced by the fulcrum point. The aim of this controller is positioning the surgical instrument by minimizing the forces exerted over the abdominal wall due to the fulcrum location uncertainty. The overall system has been integrated in the control architecture of the surgical assistant CISOBOT, designed and developed at the University of Malaga. The whole architecture performance has been tested by means of in vitro trials.

Prevention of the endoleaks after evar with the induction of the trombosis of the aneurysn sac with radiofrequency

SUMMARY: This was an experimental study of endovascular aortic surgery for endovascular evaluation of the effect of thrombosis producedfor coagulation of the blood of the aneurysm sac with radiofrequency method. PURPOSE. To determine the efficacy of the induction to thrombosis of the aneurysm sac as prevention of endoleaks after endovascular treatment. MATERIALS AND METHODS. Six dogs with induction for radiofrequency clotting blood sac of performed aneurysm and treated with stent-graft was used in the experiments in comparison with historical group of 4 dogs only with abdominal aneurysm treated with stent-graft. Radio frequency was applied to each nodule for 1 minutes at 127 mA ± 33 (mean ± SD) (tip temperature, 92°C ± 2). Color Dupplex ultrasonography and histology study are used for the evaluation of the method. RESULTS. The results show the efficacy of the radiofrequency system and it is possible the discussion of the standard clinical application DISCUSSION AND CONCLUSIONS. Endovascular repair of abdominal aortic aneurysms is dependent on the successful exclusion of the aneurysm from arterial circulation. Type II endoleaks originate from retrograde flow into the aneurysm sac. This study demonstrates the use of radiofrequency induce thrombosis in a canine model of a type II endoleak. A Ultrasound Dupplex enabled the immediate and a month detection of coagulation blood after radio-frequency treatment in dog aneurysm sac. This approach may be a strategy for future prevention of endoleaks (AU)

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