Challenging Residual Contamination of Instruments for Robotic Surgery in Japan

2016 ◽  
Vol 38 (2) ◽  
pp. 143-146 ◽  
Author(s):  
Yuhei Saito ◽  
Hiroshi Yasuhara ◽  
Satoshi Murakoshi ◽  
Takami Komatsu ◽  
Kazuhiko Fukatsu ◽  
...  
Keyword(s):  
Robotic Surgery ◽  
Complex Structure ◽  
Structural Complexity ◽  
Complete Removal ◽  
Surgical Instruments ◽  
Limited Information ◽  
Residual Protein ◽  
Instrument Type ◽  
Robotic Instruments ◽  
Serial Measurements

BACKGROUNDRecently, robotic surgery has been introduced in many hospitals. The structure of robotic instruments is so complex that updating their cleaning methods is a challenge for healthcare professionals. However, there is limited information on the effectiveness of cleaning for instruments for robotic surgery.OBJECTIVETo determine the level of residual contamination of instruments for robotic surgery and to develop a method to evaluate the cleaning efficacy for complex surgical devices.METHODSSurgical instruments were collected immediately after operations and/or after in-house cleaning, and the level of residual protein was measured. Three serial measurements were performed on instruments after cleaning to determine the changes in the level of contamination and the total amount of residual protein. The study took place from September 1, 2013, through June 30, 2015, in Japan.RESULTSThe amount of protein released from robotic instruments declined exponentially. The amount after in-house cleaning was 650, 550, and 530 µg/instrument in the 3 serial measurements. The overall level of residual protein in each measurement was much higher for robotic instruments than for ordinary instruments (P<.0001).CONCLUSIONSOur data demonstrated that complete removal of residual protein from surgical instruments is virtually impossible. The pattern of decline differed depending on the instrument type, which reflected the complex structure of the instruments. It might be necessary to establish a new standard for cleaning using a novel classification according to the structural complexity of instruments, especially for those for robotic surgery.Infect Control Hosp Epidemiol 2017;38:143–146

scholarly journals Surgical Audio Guidance: Feasibility Check for Robotic Surgery Procedures

2020 ◽  
Vol 6 (3) ◽  
pp. 571-574
Author(s):  
Anna Schaufler ◽  
Alfredo Illanes ◽  
Ivan Maldonado ◽  
Axel Boese ◽  
Roland Croner ◽  
...  
Keyword(s):  
Robotic Surgery ◽  
Haptic Feedback ◽  
Acoustic Emissions ◽  
Surgical Instruments ◽  
Additional Information ◽  
Tissue Interactions ◽  
Haptic Interactions ◽  
Visual Clues ◽  
To Receive ◽  
Expected Signal

AbstractIn robot-assisted procedures, the surgeon controls the surgical instruments from a remote console, while visually monitoring the procedure through the endoscope. There is no haptic feedback available to the surgeon, which impedes the assessment of diseased tissue and the detection of hidden structures beneath the tissue, such as vessels. Only visual clues are available to the surgeon to control the force applied to the tissue by the instruments, which poses a risk for iatrogenic injuries. Additional information on haptic interactions of the employed instruments and the treated tissue that is provided to the surgeon during robotic surgery could compensate for this deficit. Acoustic emissions (AE) from the instrument/tissue interactions, transmitted by the instrument are a potential source of this information. AE can be recorded by audio sensors that do not have to be integrated into the instruments, but that can be modularly attached to the outside of the instruments shaft or enclosure. The location of the sensor on a robotic system is essential for the applicability of the concept in real situations. While the signal strength of the acoustic emissions decreases with distance from the point of interaction, an installation close to the patient would require sterilization measures. The aim of this work is to investigate whether it is feasible to install the audio sensor in non-sterile areas far away from the patient and still be able to receive useful AE signals. To determine whether signals can be recorded at different potential mounting locations, instrument/tissue interactions with different textures were simulated in an experimental setup. The results showed that meaningful and valuable AE can be recorded in the non-sterile area of a robotic surgical system despite the expected signal losses.

scholarly journals The Financial Burden of Setting up a Pediatric Robotic Surgery Program

Medicina ◽  
2019 ◽  
Vol 55 (11) ◽  
pp. 739 ◽  
Author(s):  
Boia ◽  
David
Keyword(s):  
Robotic Surgery ◽  
Surgical Procedure ◽  
Pediatric Surgery ◽  
Pathological Condition ◽  
Financial Burden ◽  
Insurance Company ◽  
Pediatric Treatment ◽  
Cost Efficient ◽  
Robotic Instruments ◽  
Mean Cost

Background and Objectives: Robotic surgery is currently at the forefront of both adult and pediatric treatment. The main limit in the wide adoption of this technology is the high cost of purchasing and running the robotic system. This report will focus on the costs assessment of running a robotic program in a pediatric surgery center in Romania. Materials and Methods: In 12 months we performed 40 robot-assisted procedures in children. We recorded and analyzed data regarding their age, gender, pathological condition and comorbidities, surgical procedure, time of surgery, complications, hospital stay and related costs, medication, robotic instruments and consumables, additional cost, and income per case received from the National Insurance Company (NIC). Results: Mean cost per case was €3260.63 (€1880.07 to €9851.78) and was influenced by type of the procedure, intraoperative incidents, postoperative complication, and non-scheduled reinterventions (p < 0.05). The direct costs for operating the surgical robot were relatively constant, regardless of the surgical procedure (mean €1579.81). The reimbursement from the NIC ranged from 5% to 56% (mean 16.9%) of the total cost per case. Conclusion: In Romania, a pediatric surgery robotic program is not cost-efficient and cannot operate relying solely onto the health insurance system.

Mathematical modeling of fluid movement inside the eyeball during intravitreal injection

2021 ◽  
pp. 106-109
Author(s):  
D.V. Lipatov ◽  
◽  
S.A. Skladchikov ◽  
N.P. Savenkova ◽  
V.V. Novoderezkin ◽  
...  
Keyword(s):  
Mathematical Modeling ◽  
Mathematical Model ◽  
Residence Time ◽  
Complex Structure ◽  
Posterior Vitreous Detachment ◽  
Vitreous Body ◽  
Complete Removal ◽  
Intravitreal Injections ◽  
The World

Background. The avalanche-like growth of intravitreal injections in the world has significantly increased interest in the hemodynamics of the processes that occur in the eye when a drug is injected into the vitreous cavity. Every year, the number of intravitreally used drugs and promising areas in which they can be used is growing. This also applies to the creation of new combined medicines and the development of drugs with a long-term therapeutic effect. Aims. Create mathematical model of eyeball to evaluate the movement of the drug substance in it; to estimate the time of the drug's presence in the eye cavity before its complete removal, to characterize the ways of its removal from the eye cavity; to assess the significance of posterior vitreous detachment during the time when the drug is present in the eye cavity; to evaluate the effect on the hydrodynamics of the depth of drug administration. Results. When the drug is administered closer to the center of the eyeball, its residence time increases in comparison with the parietal administration. With a complete posterior detachment of the vitreous body, the time of finding the drug in the eye is prolonged compared to its absence. The obtained results of mathematical modeling of the movement of the drug administered intravitreally cannot be mechanically transferred to the human eye, due to the more complex structure of the latter. Key words: intravitreal injections, vitreous body, mathematic computing.

Extended endoscopic transorbital approach with superior-lateral orbital rim osteotomy: cadaveric feasibility study and clinical implications (SevEN-007)

2021 ◽  
pp. 1-14
Author(s):  
*Jaejoon Lim ◽  
Kyoung Su Sung ◽  
Woohyun Kim ◽  
Jihwan Yoo ◽  
In-Ho Jung ◽  
...  
Keyword(s):  
Skull Base ◽  
Complete Removal ◽  
Vertical Movement ◽  
Anterior Skull Base ◽  
Cadaveric Study ◽  
Surgical Instruments ◽  
Anterior Clinoidectomy ◽  
Endoscopic Transorbital ◽  
Surgical Corridor ◽  
Orbital Rim

OBJECTIVE The endoscopic transorbital approach (ETOA) has been developed, permitting a new surgical corridor. Due to the vertical limitation of the ETOA, some lesions of the anterior cranial fossa are difficult to access. The ETOA with superior-lateral orbital rim (SLOR) osteotomy can achieve surgical freedom of vertical as well as horizontal movement. The purpose of this study was to confirm the feasibility of the ETOA with SLOR osteotomy. METHODS Anatomical dissections were performed in 5 cadaveric heads with a neuroendoscope and neuronavigation system. ETOA with SLOR osteotomy was performed on one side of the head, and ETOA with lateral orbital rim (LOR) osteotomy was performed on the other side. After analysis of the results of the cadaveric study, the ETOA with SLOR osteotomy was applied in 6 clinical cases. RESULTS The horizontal and vertical movement range through ETOA with SLOR osteotomy (43.8° ± 7.49° and 36.1° ± 3.32°, respectively) was improved over ETOA with LOR osteotomy (31.8° ± 5.49° and 23.3° ± 1.34°, respectively) (p < 0.01). Surgical freedom through ETOA with SLOR osteotomy (6025.1 ± 220.1 mm3) was increased relative to ETOA with LOR osteotomy (4191.3 ± 57.2 mm3) (p < 0.01); these values are expressed as the mean ± SD. Access levels of ETOA with SLOR osteotomy were comfortable, including anterior skull base lesion and superior orbital area. The view range of the endoscope for anterior skull base lesions was increased through ETOA with SLOR osteotomy. After SLOR osteotomy, the space for moving surgical instruments and the endoscope was widened. Anterior clinoidectomy could be achieved successfully using ETOA with SLOR osteotomy. The authors performed ETOA with SLOR osteotomy in 6 cases of brain tumor. In all 6 cases, complete removal of the tumor was successfully accomplished. In the 3 cases of anterior clinoidal meningioma, anterior clinoidectomy was performed easily and safely, and manipulation of the extended dural margin and origin dura mater was possible. There was no complication related to this approach. CONCLUSIONS The authors evaluated the clinical feasibility of ETOA with SLOR osteotomy based on a cadaveric study. ETOA with SLOR osteotomy could be applied to more diverse disease groups that do not permit conventional ETOA or to cases in which surgical application is challenging. ETOA with SLOR osteotomy might serve as an opportunity to broaden the indication for the ETOA.

scholarly journals Micro-FTIR and EPMA Characterisation of Charoite from Murun Massif (Russia)

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Maria Lacalamita
Keyword(s):  
Single Crystal ◽  
Complex Structure ◽  
Structural Complexity ◽  
Adsorbed Water ◽  
Bending Vibration ◽  
Structural Water ◽  
Stretching Vibration ◽  
Vibrational Features ◽  
Polytype Structure ◽  
Insight Into

Combined micro-Fourier transform infrared (micro-FTIR) and electron probe microanalyses (EPMA) were performed on a single crystal of charoite from Murun Massif (Russia) in order to get a deeper insight into the vibrational features of crystals with complex structure and chemistry. The micro-FTIR study of a single crystal of charoite was collected in the 6000–400 cm−1 at room temperature and after heating at 100°C. The structural complexity of this mineral is reflected by its infrared spectrum. The analysis revealed a prominent absorption in the OH stretching region as a consequence of band overlapping due to a combination of H2O and OH stretching vibrations. Several overtones of the O-H and Si-O stretching vibration bands were observed at about 4440 and 4080 cm−1 such as absorption possibly due to the organic matter at about 3000–2800 cm−1. No significant change due to the loss of adsorbed water was observed in the spectrum obtained after heating. The occurrence of well-resolved water bending vibration bands at about 1595 and 1667 cm−1 accounts for more than one structural water molecule as expected by charoite-90 polytype structure model from literature. The chemical composition of the studied crystal is close to the literature one.

Transoral robotic surgery for large mixed laryngocoele

2013 ◽  
Vol 127 (4) ◽  
pp. 435-437 ◽  
Author(s):  
P G Ciabatti ◽  
G Burali ◽  
L D'Ascanio
Keyword(s):  
Robotic Surgery ◽  
Da Vinci ◽  
Surgical Excision ◽  
Complete Removal ◽  
Transoral Robotic Surgery ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Direct Communication ◽  
Post Operation ◽  
Cervical Approach

AbstractBackground:A laryngocoele is an abnormal dilatation of Morgagni's ventricle in direct communication with the laryngeal lumen. Surgical excision through a cervical approach is traditionally considered the treatment of choice for large (external and mixed) laryngocoeles. This paper describes the first reported case of a large mixed laryngocoele treated with transoral robotic surgery without cervical incisions.Method:A 69-year-old female underwent transoral robotic surgery for the excision of a large mixed left laryngocoele. The surgery was performed using the da Vinci S surgical robotic system (Intuitive Surgical, Sunnyvale, California, USA).Results:No complications were observed and the patient was discharged 2 days post-operation.Conclusion:Transoral robotic surgery enabled accurate dissection with complete removal of the large mixed laryngocoele via a minimally invasive approach. The advantages of transoral robotic surgery over other techniques for laryngocoele excision are discussed.

scholarly journals COGNITIVE ASPECT OF ANALYSIS OF MODERN ENGLISH PHRASEOLOGICAL UNITS

2020 ◽  
pp. 80-87
Author(s):  
Елена Юрьевна Белозёрова
Keyword(s):  
Cognitive Linguistics ◽  
English Language ◽  
Complex Structure ◽  
Structural Complexity ◽  
Communication Process ◽  
Semantic Features ◽  
Cognitive Aspect ◽  
Continuous Sampling ◽  
The World ◽  
Derivatives Of

Введение. Проведен анализ 475 современных фразеологических единиц, которые способствуют формированию фразеологической картины мира. Рассматривается взаимосвязь семантики и формы фразеологических единиц, обусловленной ситуацией общения. Фразеология языка как часть языковой картины мира входит в рамки исследования когнитивной лингвистики. Цель статьи – выявить и описать современные фразеологические единицы как пример иносказательного выражения в процессе коммуникации для достижения определенных когнитивных целей. Материал и методы. Материалом исследования послужили современные художественные тексты (Under My Skin, The Door That Led To Where, End Game, Liccle Bit, The Art of Being Normal, 2015 г.). Примеры были получены при прочтении художественной прозы современных британских авторов (J. Dawson, S. Gardner, A. Gibbons, A. Wheatle, L. Williamson) методом сплошной выборки. Результаты и обсуждение. Проведенный анализ позволил рассмотреть когнитивный аспект фразеологических единиц. Установлено, что широкий подход к изучению фразеологии расширяет границы фразеологического учения и позволяет рассмотреть больше структурно-семантических форм фразеологических единиц. Рассмотрены и проанализированы следующие современные фразеологические единицы: фразеологизмы, дериваты фразеологизмов и авторские образования. Семантические особенности дериватов фразеологизмов и авторских образований анализируются в рамках современной фразеологии английского языка. Показано, что структурная сложность фразеологизма основывается на когнитивном аспекте его семантической структуры. Заключение. Проведенный анализ позволил выявить структурный диапазон фразеологизмов и рассмотреть их преобразовательные процессы согласно семантики и ситуативного употребления. Исследование показывает, что модификация фразеологических структур и введение в употребление новых оборотов идиоматического характера (дериватов фразеологизмов и авторских образований) обусловлены лингвокультурными потребностями в выражении социума. Все анализируемые современные фразеологические единицы английского языка рассматриваются как оперативные единицы мышления настоящего времени и являются средством отражения языковой картины в целом. Языковая картина мира представляется отражением внешнего и внутреннего мира человека, его мышлением и речью. Современная фразеология английского языка отражает изменения человеческого осмысления, понимания и интерпретации внешнего мира. Фразеологическая единица имеет сложную структуру и относится к особой лингвистической категории, что обусловливает повышение интереса когнитивного исследования. Таким образом, изучение фразеологии на настоящем этапе следует фокусировать на соотношении: фразеологическая единица – значение – употребление. Introduction. The given analysis is about 475 modern phraseological units that contribute to the formation of the phraseological picture of the world. The study examines the relationship of semantics and the form of phraseological units, due to the situation of communication. The phraseology of a language as part of the linguistic picture of the world is included in the framework of the study of cognitive linguistics. Aim. This study is aimed at identifying and describing modern phraseological units, as an example of allegorical expression in the communication process to achieve certain cognitive goals. Material and methods. The presented empirical material in the article is an actual selection from a modern literary text (Under My Skin, The Door That Led To Where, End Game, Liccle Bit, The Art of Being Normal – 2015 publication). Examples were obtained by reading fiction of modern British authors (J. Dawson, S. Gardner, A. Gibbons, A. Wheatle, L. Williamson), by the method of continuous sampling. Results and discussion. The analysis allowed us to consider the cognitive aspect of phraseological units. It is established that a broad approach to the study of phraseology expands the boundaries of phraseological doctrine and allows you to consider more structural and semantic forms of phraseological units. The following modern phraseological units are considered and analyzed in the article: phraseological units, phraseological units derivatives and author formations. The semantic features of derivatives of phraseological units and copyright formations are analyzed in the framework of modern phraseology of the English language. It is shown that the structural complexity of phraseology is based on the cognitive aspect of its semantic structure. Conclusion. The analysis made it possible to identify the structural range of phraseological units and consider their transformative processes according to semantics and situational use. The study shows that the modification of phraseological structures and the introduction of new idiomatic phrases (derivatives of phraseological units and author’s idiomatic expressions) are due to linguistic and cultural needs in the expression of society. All analyzed modern phraseological units of the English language are considered as operational units of thinking of the present time and are a means of reflecting the linguistic picture as a whole. The linguistic picture of the world is a reflection of the external and internal world of a person, his thinking and speech. The modern phraseology of the English language reflects changes in human comprehension, understanding and interpretation of the outside world. The phraseological unit has a complex structure and belongs to a special linguistic category, which leads to an increase in the interest of cognitive research. Thus, the study of phraseology at this stage should be focused on the phraseological unit, its meaning and its usage.

scholarly journals STRUCTURAL COMPLEXITY OF ARTIFICIAL HABITAT AND THE FEEDING SUCCESS OF PREDATORY DRAGONFLY AND DAMSELFLY

2013 ◽  
Vol 13 (2) ◽  
Author(s):  
Khairuddin, Lalu Japa Dan Nur Lestari
Keyword(s):  
Habitat Complexity ◽  
Habitat Structure ◽  
Simple Structure ◽  
Complex Structure ◽  
Structural Complexity ◽  
Artificial Habitat ◽  
Artificial Habitats ◽  
Feeding Success ◽  
Structure Complexity

AbstractThe effect of different habitat complexity structure on the feeding success of predatoryDragonfly and Damselfly over the four of three hours trials was tested using an artificialhabitat complexity structure. Complexity of artificial habitat structure was performed usingwoody bamboo stick of 5 cm in length and 2 mm in diameter. The artificial habitats were setin plastic tank with length and wide of 17 cm and 11.5 cm, respectively and 5.5 cm high. Thedeep of water colom was about 4.5 cm. Preys were larvae of mosquitoes. There was highlysignificant of feeding success of predators in simple structure of habitats and significantenough in complex structure of habitats. In other words, feeding success of predatoryDragonfly and Damselfly was much higher in the simple habitats structure compared to thatof the complex one.Key Words : Artificial Habitat, Damselfly, Dragonfly, Feeding, and PredatoryAbstrakPengaruh kompleksitas struktur habitat terhadap keberhasilan pemangsaan predator Dragonflydan Damselfly selama empat kali tiga jam perlakuan diteliti di laboratorium menggunakanhabitat buatan. Kompleksitas struktur habitat dibuat dengan tongkat dari bambu berukuranpanjang 5 cm dengan diameter 2 mm. Habitat buatan dibuat di bak plastik berukuran panjangdan lebar masing-masing 17 cm dan 11,5 cm, dan tinggi 5,5 cm dengan kedalaman kolom airsekitar 4,5 cm. Larva nyamuk digunakan sebagai pangsa dalam penelitian ini. Setiapperlakuan terdiri dari dua ulangan. Setiap perlakuan berlangsung empat kali masing-masingselama tiga jam. Hasil memperlihatkan, keberhasilan pemangsaan Dragonfly dan Damselflysangat signifikan pada habitat stuktur sederhana, dan cukup signifikan pada habitat yangkompleks. Dengan kata lain, keberhasilan pemangsaan Dragonfly dan Damselfly jauh lebihtinggi pada habitat berstruktur sederhana dibanding dengan pada habitat berstrukturkompleks.Kata Kunci : Damselfly, Draggonfly, Habitat Buatan, Pemangsaan, Pemangsa (Predator)

Decommissioning of Offshore Monopiles, Occuring Problems and Alternative Solutions

2018 ◽  
Author(s):  
Nils Hinzmann ◽  
Philipp Stein ◽  
Jörg Gattermann
Keyword(s):  
Wind Farm ◽  
Complex Structure ◽  
Complete Removal ◽  
Offshore Wind ◽  
Offshore Wind Turbine ◽  
Offshore Wind Farm ◽  
Narrow View ◽  
Alternative Solutions ◽  
German Offshore Wind Industry ◽  
Offshore Wind Industry

The German offshore wind industry has historically grown since the first offshore wind farm (OWF) “alpha ventus” was completed in 2010. Since the end of 2017 a total number of 18 OWF with a capacity of about 5 GW have been operating in the German Exclusive Economic Zone (EEZ) [1]. While the majority of the population and the industry focus on new projects, it appears the life cycle observation and especially the decommissioning phase remain largely unattended. This narrow view can lead to unexpected and expensive consequences in the future. The decommissioning of a complex structure as an offshore wind turbine (OWT) needs to be planned well in advance. There are numerous aspects that make the decommissioning a challenge, such as the federal regulations, the marine environment and the technical limitations of offshore operations. This article gives an overview of the problematic matter of dealing with monopiles after the predicted lifetime, the geotechnical condition, analyses of the current decommissioning options and identification of issues in regards to the decommissioning method. Furthermore, other promising decommissioning methods for a complete removal of offshore monopiles, such as vibratory extraction, internal dredging, external jet drilling and the use of buoyancy force, are presented and compared concerning a possible combination. Some of the presented methods are highly experimental, others are commonly used in other industries.

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