Proficiency-based training of medical students using virtual simulators for laparoscopy and robot-assisted surgery: results of a pilot study

2018 ◽  
Vol 70 (3) ◽  
pp. 401-405 ◽  
Author(s):  
Andrea Moglia ◽  
Sara Sinceri ◽  
Vincenzo Ferrari ◽  
Mauro Ferrari ◽  
Franco Mosca ◽  
...  
2019 ◽  
Vol 71 (2) ◽  
pp. 397-398
Author(s):  
Gregorio Di Franco ◽  
Desirée Gianardi ◽  
Raffaella Berchiolli

2013 ◽  
Vol 471 (3) ◽  
pp. 851-859 ◽  
Author(s):  
Fazel Khan ◽  
Andrew Pearle ◽  
Christopher Lightcap ◽  
Patrick J. Boland ◽  
John H. Healey

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e046132
Author(s):  
Antara Satchidanand ◽  
Jeff Higginbotham ◽  
Ann Bisantz ◽  
Naif Aldhaam ◽  
Ahmed Elsayed ◽  
...  

IntroductionDuring robot-assisted surgery (RAS), changes to the operating room configuration pose challenges to communication by limiting team members’ ability to see one another or use gesture. Referencing (the act of pointing out an object or area in order to coordinate action around it), may be susceptible to miscommunication due to these constraints.ObjectivesExplore the use of microanalysis to describe and evaluate communicative efficiency in RAS through examination of referencing in surgical tasks.MethodsAll communications during ten robot-assisted pelvic surgeries (radical cystectomies and prostatectomies) were fully transcribed. Forty-six referencing events were identified within these and subjected to a process of microanalysis. Microanalysis employs detailed transcription of speech and gesture along with their relative timing/sequencing to describe and analyse interactions. A descriptive taxonomy for referencing strategies was developed with categories including references reliant exclusively on speech (anatomic terms/directional language and context dependent words (CD)); references reliant exclusively on gesture or available aspects of the environment (point/show, camera focus/movement in the visual field and functional movement); and references reliant on the integrated use of speech and gesture/environmental support (integrated communication (IC)). Frequency of utilisation and number/percent ‘miscommunication’, were collated within each category when miscommunication was defined as any reference met with incorrect or no identification of the target.ResultsIC and CD were the most frequently used strategies (45% and 26%, respectively, p≤0.01). Miscommunication was encountered in 22% of references. The use of IC resulted in the fewest miscommunications, while CD was associated with the most miscommunications (42%). Microanalysis provided insight into the causes and nature of successful referencing and miscommunication.ConclusionsIn RAS, surgeons complete referencing tasks in a variety of ways. IC may provide an effective means of referencing, while other strategies may not be adequately supported by the environment.


2020 ◽  
Author(s):  
Joan Torrent-Sellens ◽  
Ana Jiménez-Zarco ◽  
Francesc Saigí-Rubió

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.


Author(s):  
M. Tasdik Hasan ◽  
Sahadat Hossain ◽  
Rajat Das Gupta ◽  
Vivek Podder ◽  
Naima Afroz Mowri ◽  
...  

2020 ◽  
Vol 6 (3) ◽  
pp. 127-130
Author(s):  
Max B. Schäfer ◽  
Kent W. Stewart ◽  
Nico Lösch ◽  
Peter P. Pott

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.


BMC Urology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Clemens Wiesinger ◽  
Dominik Stefan Schoeb ◽  
Mathias Stockhammer ◽  
Emir Mirtezani ◽  
Lukas Mitterschiffthaler ◽  
...  

Abstract Background Within the last decade, robotically-assisted laparoscopic prostatectomy (RALP) has become the standard for treating localized prostate cancer, causing a revival of the 45° Trendelenburg position. In this pilot study we investigated effects of Trendelenburg position on hemodynamics and cerebral oxygenation in patients undergoing RALP. Methods We enrolled 58 patients undergoing RALP and 22 patients undergoing robot-assisted partial nephrectomy (RAPN) (control group) in our study. Demographic patient data and intraoperative parameters including cerebral oxygenation and cerebral hemodynamics were recorded for all patients. Cerebral function was also assessed pre- and postoperatively via the Mini Mental Status (MMS) exam. Changes in parameters during surgery were modelled by a mixed effects model; changes in the MMS result were evaluated using the Wilcoxon signed rank test. Results Preoperative assessment of patient characteristics, standard blood values and vital parameters revealed no difference between the two groups. Conclusions Applying a 45° Trendelenburg position causes no difference in postoperative brain function, and does not alter cerebral oxygenation during a surgical procedure lasting up to 5 h. Further studies in larger patient cohorts will have to confirm these findings. Trial registration German Clinical Trial Registry; DRKS00005094; Registered 12th December 2013—Retrospectively registered; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00005094.


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