Robot-assisted surgery with Senhance robotic system for colon cancer: our original single-incision plus 2-port procedure and a review of the literature

ObjectivesTo develop an interactive tool that estimates what potential benefits are needed for the robot to provide value for money when compared with endoscopic or open surgical interventions.DesignA generic online interactive tool was developed to analyze the (health) effects needed to compensate for the additional costs of using a surgical robotic system from a healthcare perspective. The application of the tool is illustrated with a hypothetical new surgical robotic platform. A synthesis of evidence from different sources was used combined with interviews with surgeons.SettingFlexible tool that can be adapted to flexible settings.ParticipantsAny hospital patient group for which robotic, endoscopic or open surgical procedures may be considered as appropriate treatment alternatives (eg, urology, gynecology, and so on).InterventionRobotically assisted surgical interventions.ComparatorEndoscopic or open surgical interventions.Main outcome measuresThresholds of how much (health) effect is needed for robot-assisted surgery to provide value for money and to become cost-effective.ResultsThe utilization rate of the surgical robotic system and a reduction in complications appeared to be important aspects in determining the value for money. To become cost-effective, it was deemed important for new surgical robotic systems to have added clinical benefit and become less costly than the current system.ConclusionsThis paper and its assisting interactive tool can be used by clinicians, researchers, and policymakers to gain insight in the benefit needed to provide value for money when using a (new) surgical robotic system or, when the effects are known or can be estimated, to assess the value for money for a specific indication. For robotic surgery to provide most value for money, we recommend assessing for each indication whether the necessary effects seem achievable.

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Systemic inflammatory response in robot-assisted and laparoscopic surgery for colon cancer (SIRIRALS): study protocol of a randomized controlled trial

BMC Surgery ◽

10.1186/s12893-021-01355-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Pedja Cuk ◽

Andreas Kristian Pedersen ◽

Kate Lykke Lambertsen ◽

Christian Backer Mogensen ◽

Michael Festersen Nielsen ◽

...

Keyword(s):

Colon Cancer ◽

Randomized Controlled Trial ◽

Laparoscopic Surgery ◽

Inflammatory Response ◽

Controlled Trial ◽

Robot Assisted ◽

Inflammatory Stress ◽

Randomized Controlled ◽

Robot Assisted Surgery ◽

Pro Inflammatory Cytokines

Abstract Background Robot-assisted surgery is being increasingly adopted in treating colorectal cancer, and the transition from laparoscopic surgery to robot-assisted surgery is a trend. The evidence of the benefits of robot-assisted surgery is sparse. However, findings are associated with improved patient-related outcomes and overall morbidity rates compared to laparoscopic surgery. This induction is unclear, considering both surgical modalities are characterized as minimally invasive. This study aims to evaluate the systemic and peritoneal inflammatory stress response induced by robot-assisted surgery compared with laparoscopic surgery for elective colon cancer resections in a prospective, randomized controlled clinical trial. Methods This study is a single-centre randomized controlled superiority trial with 50 colon cancer participants. The primary endpoint is the level of systemic inflammatory response expressed as serum C-reactive protein (CRP) and interleukin 6 (IL-6) levels between postoperative days one and three. Secondary endpoints include (i) levels of systemic inflammation in serum expressed by a panel of inflammatory and pro-inflammatory cytokines measured during the first three postoperative days, (ii) postoperative surgical and medical complications (30 days) according to Clavien-Dindo classification and Comprehensive Complication Index, (iii) intraoperative blood loss, (iv) conversion rate to open surgery, (v) length of surgery, (vi) operative time, (vii) the number of harvested lymph nodes, and (viii) length of hospital stay. The exploratory endpoints are (i) levels of peritoneal inflammatory response in peritoneal fluid expressed by inflammatory and pro-inflammatory cytokines between postoperative day one and three, (ii) patient-reported health-related quality of recovery-15 (QoR-15), (iii) 30 days mortality rate, (iv) heart rate variability and (v) gene transcript (mRNA) analysis. Discussion To our knowledge, this is the first clinical randomized controlled trial to clarify the inflammatory stress response induced by robot-assisted or laparoscopic surgery for colon cancer resections. Trial registration This trial is registered at Clinicaltrials.gov (Identifier: NCT04687384) on December, 29, 2020, Regional committee on health research ethics, Region of Southern Denmark (N75709) and Data Protection Agency, Hospital Sønderjylland, University Hospital of Southern Denmark (N20/46179).

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The early results of Robotic surgeryin treating pancreatic and hepatobiliarydiseases at Binh Dan Hospital

Vietnam Journal of Endolaparoscopic Surgery ◽

10.51199/vjsel.2018.3.4 ◽

2018 ◽

Vol 8 (3) ◽

Author(s):

Văn Hùng Võ ◽

Keyword(s):

Laparoscopic Surgery ◽

Da Vinci ◽

Robotic System ◽

Current Status ◽

Robot Assisted ◽

Intraoperative Complication ◽

Case Series Study ◽

Da Vinci Robotic System ◽

Hepatobiliary Diseases ◽

Robot Assisted Surgery

Tóm tắt Đặt vấn đề: Phẫu thuật nội soi đã được áp dụng phổ biến trong bệnh lý gan mật tụy. Gần đây, phẫu thuật nội soi robot hỗ trợ là một tiến bộ mới của phẫu thuật ống mật chủ, túi ít xâm lấn, cải thiện những bất lợi của phẫu thuật nội soi thông thường. Mục tiêu của chúng tôi là chia sẻ những kinh nghiệm sớm trong việc sử dụng Robot trong phẫu thuật gan mật tụy cũng như cập nhật vấn đề thời sự này. Phương pháp nghiên cứu: Nghiên cứu mô tả hàng loạt ca: 18 trường hợp (TH) bệnh lý gan mật tụy được phẫu thuật tại Bệnh viện Bình Dân từ tháng 01/2017 đến 09/2018 sử dụng hệ thống Robot da Vinci. Kết quả: Trong 18 TH bệnh lý gan mật tụy: 6 TH ung thư gan, 2 TH u thân đuôi tụy, 5 TH cắt tá tụy, 1 TH túi mật, và 4 TH nang ống mật chủ. Phẫu thuật thành công 17 TH, có 1 TH nang ống mật chủ chuyển mổ mở. Không có biến chứng trong phẫu thuật liên quan đến Robot. Không có biến chứng nặng. Không có tử vong. Kết luận: Sử dụng phẫu thuật nội soi có robot hỗ trợ trong bệnh lý gan mật tụy an toàn và khả thi Abstract Introduction: Laparoscopic surgery has been widely used in treating the pancreatic and hepatobiliary diseases. Recently, robot - assisted surgery was introduced as a new advance of minimally invasive surgery, could improve the disadvantages of conventional laparoscopic surgery. Aim of this study is to share early experiences in using robots in pancreatic and hepatobiliary surgery, as well as to update on the current status of robot - assisted surgery. Material and Methods: A descriptive case series study: (18) eighteen cases of pancreatic and hepatobiliary diseases were performed at Binh Dan hospital from 01/2017 to 09/2018 using the da Vinci robotic system. Results: In 18 patients: 6 hepatectomies, 2 spleen-preserving distal pancreatectomies, 5 pancreatoduodenectomies, 1 cholecystectomy, and 4 choledochal cystic resections. 17 were performed successful by robot - assisted surgery, 1 case of choledochal cystic resection converted to open surgery. There was no intraoperative complication related to the use of the da Vinci robotic system. No serious complications. No death was in this series. Conclusion: Using of robot - assisted surgery in pancreatic and hepatobiliary diseases is safe and feasible. Keyword: Robot – assisted surgery, da Vinci Surgical System, hepatectomy, distal pancreatectomy, pancreatoduodenectomy, cholecystectomy, choledochal cystic resection.

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Simulation-based Adaptive Training for Robot-Assisted Surgery: a Feasibility Study on Medical Residents

10.31256/hsmr2019.40 ◽

2019 ◽

Author(s):

A Mariani ◽

◽

E Pellegrini ◽

A Menciassi ◽

E De Momi ◽

...

Keyword(s):

Feasibility Study ◽

Medical Residents ◽

Robot Assisted ◽

Adaptive Training ◽

Simulation Based ◽

Robot Assisted Surgery

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Do People Trust in Robot-Assisted Surgery? Evidence from Europe (Preprint)

10.2196/preprints.23791 ◽

2020 ◽

Author(s):

Joan Torrent-Sellens ◽

Ana Jiménez-Zarco ◽

Francesc Saigí-Rubió

Keyword(s):

Technology Acceptance ◽

Surgical Intervention ◽

Negative Relationship ◽

Predictor Variable ◽

Major Change ◽

Ease Of Use ◽

The European Union ◽

Robot Assisted ◽

Surgical Interventions ◽

Robot Assisted Surgery

BACKGROUND Increasingly intelligent and autonomous robots are destined to have a huge impact on our society. Their adoption, however, represents a major change to the healthcare sector’s traditional practices, which, in turn, poses certain challenges. To what extent is it possible to foresee a near-future scenario in which minor routine surgery is directed by robots? And what are the patients’ or general public’s perceptions of having surgical procedures performed on them by robots, be it totally or partially? A patient’s trust in robots and AI may facilitate the spread and use of such technologies. OBJECTIVE The goal of our study was to establish the factors that influence how people feel about having a medical operation performed on them by a robot. METHODS We used data from a 2017 Flash Eurobarometer (number 460) of European Commission with 27,901 citizens aged 15 years and over in the 28 countries of the European Union. The research designs and tests a technology acceptance model (TAM). Logistic regression (odds ratios, OR) to model the predictors of trust in robot-assisted surgery was calculated through motivational factors, robots using experience and sociodemographic independent variables. RESULTS The negative relationship between most of the predictors of ease of use, expected benefits and attitude towards robots, and confidence in robot-assisted surgery was contrasted. The only non-sociodemographic predictor variable that has a positive relationship with trust in robots participating in a surgical intervention is previous experience in the use of robots. In this context, we analyze the confidence predictors for three different levels of robot use experience (zero use, average use, and high use). The results obtained indicate that, as the experience of using robots increases, the predictive coefficients related to information, attitude and perception of robots become more negative. Research results also determined that variables of a sociodemographic nature played an important predictive role. It was confirmed that the effect of experience on trust in robots for surgical interventions was greater among men, people between 40 and 54 years old, and those with higher educational levels. CONCLUSIONS Despite the considerable benefits for the patient that the use of robots can bring in a surgical intervention, the results obtained show that trust in robots goes beyond rational decision-making. By contrasting the reasons that generate trust and mistrust in robots, especially by highlighting the experience of use as a key element, the research makes a new contribution to the state of the art and draws practical implications of the use of robots for health policy and practice.

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Telemanipulation of an Articulated Robotic Arm using a Commercial Virtual Reality Controller

Current Directions in Biomedical Engineering ◽

10.1515/cdbme-2020-3033 ◽

2020 ◽

Vol 6 (3) ◽

pp. 127-130

Author(s):

Max B. Schäfer ◽

Kent W. Stewart ◽

Nico Lösch ◽

Peter P. Pott

Keyword(s):

Virtual Reality ◽

Real Time ◽

Robotic Arm ◽

Input Device ◽

Robot Assisted ◽

Promising Alternative ◽

Input Devices ◽

Current Input ◽

Current Systems ◽

Robot Assisted Surgery

AbstractAccess to systems for robot-assisted surgery is limited due to high costs. To enable widespread use, numerous issues have to be addressed to improve and/or simplify their components. Current systems commonly use universal linkage-based input devices, and only a few applicationoriented and specialized designs are used. A versatile virtual reality controller is proposed as an alternative input device for the control of a seven degree of freedom articulated robotic arm. The real-time capabilities of the setup, replicating a system for robot-assisted teleoperated surgery, are investigated to assess suitability. Image-based assessment showed a considerable system latency of 81.7 ± 27.7 ms. However, due to its versatility, the virtual reality controller is a promising alternative to current input devices for research around medical telemanipulation systems.

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Robot-Assisted Autism Therapy (RAAT). Criteria and Types of Experiments Using Anthropomorphic and Zoomorphic Robots. Review of the Research

Sensors ◽

10.3390/s21113720 ◽

2021 ◽

Vol 21 (11) ◽

pp. 3720

Author(s):

Barbara Szymona ◽

Marcin Maciejewski ◽

Robert Karpiński ◽

Kamil Jonak ◽

Elżbieta Radzikowska-Büchner ◽

...

Keyword(s):

Body Schema ◽

Autism Spectrum ◽

The Body ◽

Review Of The Literature ◽

Robot Assisted ◽

Social Contacts ◽

Joint Activities ◽

Autism Therapy ◽

Real Person ◽

Future Work

Supporting the development of a child with autism is a multi-profile therapeutic work on disturbed areas, especially understanding and linguistic expression used in social communication and development of social contacts. Previous studies show that it is possible to perform some therapy using a robot. This article is a synthesis review of the literature on research with the use of robots in the therapy of children with the diagnosis of early childhood autism. The review includes scientific journals from 2005–2021. Using descriptors: ASD (Autism Spectrum Disorders), Social robots, and Robot-based interventions, an analysis of available research in PubMed, Scopus and Web of Science was done. The results showed that a robot seems to be a great tool that encourages contact and involvement in joint activities. The review of the literature indicates the potential value of the use of robots in the therapy of people with autism as a facilitator in social contacts. Robot-Assisted Autism Therapy (RAAT) can encourage child to talk or do exercises. In the second aspect (prompting during a conversation), a robot encourages eye contact and suggests possible answers, e.g., during free conversation with a peer. In the third aspect (teaching, entertainment), the robot could play with autistic children in games supporting the development of joint attention. These types of games stimulate the development of motor skills and orientation in the body schema. In future work, a validation test would be desirable to check whether children with ASD are able to do the same with a real person by learning distrust and cheating the robot.

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