Principles of laparoscopic and robotic urological surgery

2017 ◽  
Author(s):  
Mark Sullivan ◽  
Nilay Patel ◽  
Inderbir Gill
Keyword(s):  
Robotic Surgery ◽  
Three Dimensional ◽  
Small Diameter ◽  
Skills Training ◽  
Range Of Movement ◽  
Urological Surgery ◽  
Video Systems ◽  
High Resolution Images ◽  
Surgical Field ◽  
Three Dimensional Vision

The development of laparoscopic and consequently robotic urological surgery have improved the visual field for the urological surgeon and led to reductions in postoperative pain, reduced convalescence, and improved cosmesis for the patient. Laparoscopy and robotics require video systems and telescopes to produce high-resolution images. Trocars have been developed to access the surgical field together with devices to deliver the insufflating gases. Instruments have been developed to allow for tissue dissection and incision together with haemostatic devices and sealants for control of small diameter vessel bleeding. Clips and staplers are used to control larger diameter vessels. Methods of access and skills training are discussed. Robotic surgery provides three-dimensional vision, greater range of movement, and the lack of tremor. Whether these are real benefits in terms of patient outcome is not yet clear, but the learning curve for robotic surgery does appear to be shorter than for pure laparoscopy.

scholarly journals Robotics in Urology: No More Shadows?

Uro ◽  
2021 ◽  
Vol 1 (4) ◽  
pp. 254-265
Author(s):  
Lorenzo Giuseppe Luciani ◽  
Daniele Mattevi ◽  
Tommaso Cai ◽  
Gianni Malossini
Keyword(s):  
Robotic Surgery ◽  
Three Dimensional ◽  
Standard Of Care ◽  
Oncologic Outcomes ◽  
Operative Outcomes ◽  
The World ◽  
Robotic Assisted Radical Prostatectomy ◽  
Three Dimensional Vision ◽  
Urologic Procedure ◽  
Over Time

Robotic surgery saw unprecedented success throughout the world, with urology as a key discipline. Robotic-assisted radical prostatectomy (RARP) and partial nephrectomy (RAPN) were the frontline procedures. Many other urologic procedures have since been standardized over time. However, there is no universal consensus in current research on the recognition of robotics as the standard of care. Although better operative outcomes have been reported for most robotic procedures compared to open and laparoscopic surgery, no superiority has been proven as far as oncologic outcomes are concerned. This review aims to describe current research on robotic surgery concerning each urologic procedure, showing its applications and limits. The non-classic parameters in part responsible for the planetary success of robotics, such as the shorter learning curve, improved ergonomics, and surgeon’s comfort, as well immersive three-dimensional vision, are further areas of focus.

scholarly journals Application of Photoacoustic Imaging for Lymphedema Treatment

2021 ◽  
Author(s):  
Yushi Suzuki ◽  
Hiroki Kajita ◽  
Shiho Watanabe ◽  
Keisuke Okabe ◽  
Hisashi Sakuma ◽  
...  
Keyword(s):  
High Resolution ◽  
Imaging System ◽  
Photoacoustic Imaging ◽  
Three Dimensional ◽  
Lymphatic Vessels ◽  
Small Diameter ◽  
Detailed Structure ◽  
High Resolution Images ◽  
Major Application ◽  
Lymph Fluid

Abstract Background Lymphatic vessels are difficult to identify using existing modalities as because of their small diameter and the transparency of the lymph fluid flowing through them. Methods Here, we introduce photoacoustic lymphangiography (PAL), a new modality widely used for lymphedema treatment, to observe limb lymphatic vessels. The photoacoustic imaging system used in this study can simultaneously visualize lymphatic vessels and veins with a high resolution (0.2 mm) and can also observe their three-dimensional relationship with each other. Results High-resolution images of the lymphatic vessels, detailed structure of the dermal back flow, and the three-dimensional positional relationship between the lymphatic vessels and veins were observed by PAL. Conclusion The clear image provided by PAL could have a major application in pre- and postoperative use during lymphaticovenular anastomosis for lymphedema treatment.

Dry box training with three-dimensional vision for the assistant surgeon in robot-assisted urological surgery

2013 ◽  
pp. n/a-n/a ◽  
Author(s):  
Nobuyuki Hinata ◽  
Hideto Iwamoto ◽  
Shuichi Morizane ◽  
Katsuya Hikita ◽  
Akihisa Yao ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Robot Assisted ◽  
Urological Surgery ◽  
Three Dimensional Vision

Electron crystallographic determination of the 3-D structure of staurolite at atomic resolution

1991 ◽  
Vol 49 ◽  
pp. 540-541
Author(s):  
Kenneth H. Downing ◽  
Hu Meisheng ◽  
Hans-Rudolf Went ◽  
Michael A. O'Keefe
Keyword(s):  
High Resolution ◽  
Three Dimensional ◽  
High Resolution Electron Microscopy ◽  
Atomic Resolution ◽  
Dimensional Structure ◽  
Structure Information ◽  
Resolution Electron ◽  
Scattering Effects ◽  
High Resolution Images ◽  
Effects Of Radiation

With current advances in electron microscope design, high resolution electron microscopy has become routine, and point resolutions of better than 2Å have been obtained in images of many inorganic crystals. Although this resolution is sufficient to resolve interatomic spacings, interpretation generally requires comparison of experimental images with calculations. Since the images are two-dimensional representations of projections of the full three-dimensional structure, information is invariably lost in the overlapping images of atoms at various heights. The technique of electron crystallography, in which information from several views of a crystal is combined, has been developed to obtain three-dimensional information on proteins. The resolution in images of proteins is severely limited by effects of radiation damage. In principle, atomic-resolution, 3D reconstructions should be obtainable from specimens that are resistant to damage. The most serious problem would appear to be in obtaining high-resolution images from areas that are thin enough that dynamical scattering effects can be ignored.

Conformational Transitions in Escherichia coli Ribosomal RNAs as Visualized by Dedicated STEM

1988 ◽  
Vol 46 ◽  
pp. 176-177
Author(s):  
J.S. Wall ◽  
V. Maridiyan ◽  
S. Tumminia ◽  
J. Hairifeld ◽  
M. Boublik
Keyword(s):  
Ionic Strength ◽  
Three Dimensional ◽  
Conformational Transitions ◽  
Dark Field ◽  
Dimensional Structure ◽  
Ribosomal Rnas ◽  
Field Mode ◽  
Freeze Dried ◽  
High Resolution Images ◽  
Low Ionic Strength

The high contrast in the dark-field mode of dedicated STEM, specimen deposition by the wet film technique and low radiation dose (1 e/Å2) at -160°C make it possible to obtain high resolution images of unstained freeze-dried macromolecules with minimal structural distortion. Since the image intensity is directly related to the local projected mass of the specimen it became feasible to determine the molecular mass and mass distribution within individual macromolecules and from these data to calculate the linear density (M/L) and the radii of gyration.2 This parameter (RQ), reflecting the three-dimensional structure of the macromolecular particles in solution, has been applied to monitor the conformational transitions in E. coli 16S and 23S ribosomal RNAs in solutions of various ionic strength.In spite of the differences in mass (550 kD and 1050 kD, respectively), both 16S and 23S RNA appear equally sensitive to changes in buffer conditions. In deionized water or conditions of extremely low ionic strength both appear as filamentous structures (Fig. la and 2a, respectively) possessing a major backbone with protruding branches which are more frequent and more complex in 23S RNA (Fig. 2a).

Students’ perceptions of an in-house developed pharmacy serious game for professional skills training

2020 ◽  
Vol 6 (5) ◽  
pp. 293-296
Author(s):  
Kevin Yi-Lwern Yap ◽  
Shawn Ignatius Boon Heng Tan ◽  
Kai Zhen Yap ◽  
John Yin Gwee Yap
Keyword(s):  
Student Learning ◽  
Three Dimensional ◽  
Skills Training ◽  
Role Playing ◽  
Clinical Practices ◽  
Professional Skills ◽  
Role Playing Game ◽  
Game Engagement ◽  
Self Administered Questionnaire ◽  
Enhance Student Learning

BackgroundAn in-house three-dimensional (3D) multiplayer online role-playing game was developed for professional skills training of pharmacy students. Students play the game in a post-apocalyptic world to save humankind from zombies. They solve virtual patient encounters through visual and motion-capture technologies. Their gaming perceptions and experiences were investigated.MethodA self-administered questionnaire obtained participants’ demographics, gaming interests, perceptions of game effectiveness, preferences on gaming elements and gameplay experience through the Game Engagement Questionnaire (GEQ). Pre-gameplay and post-gameplay assessments were tracked to assess student learning. Descriptive statistics and paired sample t-tests were used for analysis.ResultsFifty-five students were recruited. Two-thirds of the gameplay group (67.9%) liked the post-apocalyptic fantasy settings and heroic storyline (66.0%). Three quarters liked the modern setting (73.1%), authentic plots (73.5%) and plot animations (72.3%). Participants felt the game was effective in training health communication and patient history-taking skills (81.8%). Participants’ test scores for counselling increased from 66.1%±7.6% (pre-gameplay) to 70.3%±8.0% (post-gameplay, p=0.004). The highest scoring GEQ dimension was sensory and imaginative immersion (2.92±0.74).ConclusionStudents found the game useful for pharmacy professional skills training. With proper implementation, this game can become a useful tool to enhance student learning and gear them towards clinical practices.

scholarly journals A Novel Suture Training System for Open Surgery Replicating Procedures Performed by Experts Using Augmented Reality

2021 ◽  
Vol 45 (5) ◽  
Author(s):  
Yuri Nagayo ◽  
Toki Saito ◽  
Hiroshi Oyama
Keyword(s):  
Augmented Reality ◽  
Motion Capture ◽  
Open Surgery ◽  
Three Dimensional ◽  
Training System ◽  
Surgical Skills ◽  
Surgical Instruments ◽  
Interrupted Suture ◽  
Education Environment ◽  
Surgical Field

AbstractThe surgical education environment has been changing significantly due to restricted work hours, limited resources, and increasing public concern for safety and quality, leading to the evolution of simulation-based training in surgery. Of the various simulators, low-fidelity simulators are widely used to practice surgical skills such as sutures because they are portable, inexpensive, and easy to use without requiring complicated settings. However, since low-fidelity simulators do not offer any teaching information, trainees do self-practice with them, referring to textbooks or videos, which are insufficient to learn open surgical procedures. This study aimed to develop a new suture training system for open surgery that provides trainees with the three-dimensional information of exemplary procedures performed by experts and allows them to observe and imitate the procedures during self-practice. The proposed system consists of a motion capture system of surgical instruments and a three-dimensional replication system of captured procedures on the surgical field. Motion capture of surgical instruments was achieved inexpensively by using cylindrical augmented reality (AR) markers, and replication of captured procedures was realized by visualizing them three-dimensionally at the same position and orientation as captured, using an AR device. For subcuticular interrupted suture, it was confirmed that the proposed system enabled users to observe experts’ procedures from any angle and imitate them by manipulating the actual surgical instruments during self-practice. We expect that this training system will contribute to developing a novel surgical training method that enables trainees to learn surgical skills by themselves in the absence of experts.

scholarly journals Three-dimensional printing in urological surgery: What are the possibilities?

2015 ◽  
Vol 22 (4) ◽  
pp. 423-423 ◽  
Author(s):  
Angela W. Yu ◽  
Hamid Abboudi ◽  
Erik Mayer ◽  
Justin Vale
Keyword(s):  
Three Dimensional ◽  
Three Dimensional Printing ◽  
Urological Surgery ◽  
Dimensional Printing

Three Dimensional Video Imaging for Endoscopic Sinus Surgery and Diagnosis

1995 ◽  
Vol 9 (4) ◽  
pp. 197-202 ◽  
Author(s):  
Anthony J. Reino ◽  
William Lawson ◽  
Baxter J. Garcia ◽  
Robert J. Greenstein
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Three Dimensional ◽  
Small Diameter ◽  
Image Distortion ◽  
Sinus Surgery ◽  
Depth Of Field ◽  
Visual Fatigue ◽  
Video Imaging ◽  
Video Cameras ◽  
Technological Advances

Technological advances in video imaging over the last decade have resulted in remarkable additions to the armamentarium of instrumentation for the otolaryngologist. The use of video cameras and computer generated imaging in the operating room and office is invaluable for documentation and teaching purposes. Despite the obvious advantages of these systems, problems are evident, the most serious of which include image distortion and inability to judge depth of field. For more than 6 decades 3D imaging has been neither technically nor commercially successful. Reasons include alignment difficulties and image distortion. The result is “visual fatigue,” usually in about 15 minutes. At its extreme, this may be characterized by headache, nausea, and even vomiting. In this study, we employed the first 3D video imager to electronically manipulate a single video source to produce 3D images; therefore, neither alignment nor image distortions were produced. Of interest to the clinical surgeon, “visual fatigue” does not seem to occur; however, with prolonged procedures (greater than 2 hours) there exists the potential for physical intolerance for some individuals. This is the first unit that is compatible with any rigid or flexible videoendoscopic system and the small diameter endoscopes available for endoscopic sinus surgery. Moreover, prerecorded 2D tapes may be viewed in 3D on an existing VCR. The 3D image seems to provide enhanced anatomic awareness with less image distortion. We have found this system to be optically superior to the 2D video imagers currently available.

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