First in Man Pilot Feasibility Study in Extracranial Carotid Robotic-Assisted Endovascular Intervention

Neurosurgery ◽  
2020 ◽  
Author(s):  
Virendra R Desai ◽  
Jonathan J Lee ◽  
Trevis Sample ◽  
Neal S Kleiman ◽  
Alan Lumsden ◽  
...  
Keyword(s):  
Endovascular Intervention ◽  
Inclusion Criteria ◽  
Robotic Technology ◽  
Robotic Assisted ◽  
Diagnostic Angiography ◽  
Fluoroscopic Time ◽  
Carotid Circulation ◽  
Anesthesia Time ◽  
Pilot Feasibility Study ◽  
Clinical Deficits

Abstract BACKGROUND Robotic-assistance in endovascular intervention represents a nascent yet promising innovation. OBJECTIVE To present the first human experience utilizing robotic-assisted angiography in the extracranial carotid circulation. METHODS Between March 2019 and September 2019, patients with extracranial carotid circulation pathology presenting to Houston Methodist Hospital were enrolled. RESULTS A total of 6 patients met inclusion criteria: 5 underwent diagnostic angiography only with robotic-assisted catheter manipulation, while 1 underwent both diagnostic followed by delayed therapeutic intervention. Mean age was 51 +/− 17.5 yr. Mean anesthesia time was 158.7 +/− 37.9 min, mean fluoroscopic time was 22.0 +/− 7.3 min, and mean radiation dose was 815.0 +/− 517.0 mGy. There were no technical complications and no clinical deficits postprocedure. None of the cases required conversion to manual neurovascular intervention (NVI). CONCLUSION Incorporating robotic technology in NVI can enhance procedural technique and diminish occupational hazards. Its application in the coronary and peripheral vascular settings has established safety and efficacy, but in the neurovascular setting, this has yet to be demonstrated. This study presents the first in human feasibility experience of robotic-assisted NVI in the extracranial carotid circulation.

scholarly journals Robotic-Assisted Surgery for Benign Urological Conditions

2006 ◽  
Vol 6 ◽  
pp. 2573-2580 ◽  
Author(s):  
Declan G. Murphy ◽  
Ben J. Challacombe ◽  
Lail-U-Mah Zaheer ◽  
M. Shamim Khan ◽  
Prokar Dasgupta
Keyword(s):  
Radical Prostatectomy ◽  
Da Vinci ◽  
Robotic Assistance ◽  
Robotic Technology ◽  
Robotic Assisted ◽  
The Past ◽  
Robotic Assisted Surgery ◽  
Urological Procedures ◽  
Robotic Assisted Radical Prostatectomy ◽  
Surgical System

Robotic technology for use in surgery has advanced considerably in the past 10 years. This has become particularly apparent in urology where robotic-assisted radical prostatectomy using the da VinciTMsurgical system (Intuitive Surgical, CA) has become very popular. The use of robotic assistance for benign urological procedures is less well documented. This article considers the current robotic technology and reviews the situation with regard to robotic surgery for benign urological conditions.

scholarly journals Does the use of Robotic Technology Improve Surgeon Ergonomic Safety during TKA?

10.29007/xjjm ◽  
2019 ◽  
Author(s):  
Laura Scholl ◽  
Emily Hampp ◽  
Vincent Alipit ◽  
Antonia Chen ◽  
Michael Mont ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
High Risk ◽  
Operating Room ◽  
Knee Arthroplasty ◽  
Overuse Injuries ◽  
Robotic Technology ◽  
Robotic Assisted ◽  
Work Related ◽  
Lower Back ◽  
Total Knee

Surgeon physical stress in the operating room is a known potential cause of musculoskeletal overuse injuries, specifically in surgeons who perform total knee arthroplasty (TKA). Injuries have been attributed to ergonomically challenging postures. This study compared surgeon lower back and shoulder posture between manual TKA (MTKA) and robotic assisted TKA (RATKA).Two surgeons performed a total six MTKA and six RATKA on a set of cadaveric knees. Movement and EMG sensors were secured to each surgeon to monitor lower back and shoulder movements, as well as muscle activities. Data was analyzed and activities were assessed as low, medium, or high risk, providing a score between 0-lowest and 16-highest. Risk data was compared between MTKA and RATKA for three separate surgical tasks: 1-bone cut preparation & cutting (MTKA = placement of cutting jigs, bone cutting, RATKA = array placement, bone registration, bone cutting), 2-knee balancing and 3-trialing.Overall, there were more high-risk shoulder than lower back activities in MTKA and RATKA. More high-risk movement and EMG stimulation were measured in the dominant shoulder than the non-dominant. When lower back and shoulder data were combined, highest risk task was bone cut preparation & cutting (MTKA: 13 vs. 6 vs. 6 and RATKA: 11 vs. 8 vs. 6), with a higher risk for MTKA than RATKA.Poor posture can be a potential cause for surgeon work-related injuries. This study evaluated which tasks presented highest risk to surgeon ergonomic safety while performing TKA, and found lower overall ergonomics risk for performing RATKA vs. MTKA. Although this study provides data indicating reduced ergonomic risk with RATKA, additional studies in the operating room need to be performed.

scholarly journals IMPLEMENTATION OF GYN ROBOTIC SURGERY IN OUR PRACTICE

2020 ◽  
Vol 62 (2) ◽  
Author(s):  
Antony Brignoni ◽  
◽  
Oksana Mudra ◽  
Keyword(s):  
Laparoscopic Surgery ◽  
Robotic Surgery ◽  
Length Of Stay ◽  
Minimally Invasive ◽  
High Precision ◽  
Gynecologic Surgery ◽  
Robotic Technology ◽  
High Definition ◽  
Robotic Assisted ◽  
Conventional Laparoscopic

Middle East has launched its first comprehensive robotic surgery programme, Known as one of the most sophisticated laparoscopic surgical technologies available, the device – created by Intuitive – is part of the new programme aimed at enhancing the group’s “current comprehensive general surgery and laparoscopic surgery services”. American Hospital was selected as the hub for this robotic programme as it is already considered a market leader in advanced laparoscopic surgery. According to the manufacturer, the da Vinci Xi HD 4 works by combining conventional laparoscopic techniques with high precision robotic technology that uses four robotic arms controlled by the surgeon from a console. Through the console, the surgeon is also able to access a 3D high-definition view of the surgical area. Robotic surgery is a state of the art surgical procedure in which the conventional laparoscopic technique is combined with high precision robotic technology. Articulated instruments allow the same movement capacity as the human wrist and the tremor filter eliminates any small uncontrollable movement in the surgeon's hands. We would like to share our experience in implementation of Robotic Assisted surgery in gynecological practice of out hospital. Commencement of our program coincided with very difficult period for all World. Regardless COVID pandemic, we started successfully our robo- surgical journey, and within 6 months we performed 150 Robotic assisted surgeries, 50 of them- gynecological. Gynecologic surgery has been transformed in the last three decades in the western world, from mostly open abdominal surgeries with increased length of stay and morbidity to today with minimally invasive surgeries with short length of stay, decreased morbidity, faster return to normal activities and work. Long past the days of doing laparoscopic surgery with direct viewing through a scope, later poor quality imaging monitors to our current High definition 2D and 3D imaging. In the last decade the introduction of Robotics to our surgical armamentarium has steadily increase the likelihood that patients will have minimally invasive procedure instead of an open laparotomy.

scholarly journals First-in-human, robotic-assisted neuroendovascular intervention

2020 ◽  
Vol 12 (4) ◽  
pp. 338-340 ◽  
Author(s):  
Vitor Mendes Pereira ◽  
Nicole Mariantonia Cancelliere ◽  
Patrick Nicholson ◽  
Ivan Radovanovic ◽  
Kaitlyn E Drake ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Minimally Invasive ◽  
Cerebral Angiography ◽  
Stent Placement ◽  
Peripheral Vascular ◽  
Robotic Technology ◽  
Robotic Assisted ◽  
Technical Accuracy ◽  
Percutaneous Coronary ◽  
Potential Benefits

Robotic-assisted technology has been used as a tool to enhance open and minimally invasive surgeries as well as percutaneous coronary and peripheral vascular interventions. It offers many potential benefits, including increased procedural and technical accuracy as well as reduced radiation dose during fluoroscopic procedures. It also offers the potential for truly “remote” procedures. Despite these benefits, robotic technology has not yet been used in the neuroendovascular field, aside from diagnostic cerebral angiography. Here, we report the first robotic-assisted, therapeutic, neuroendovascular intervention performed in a human. This was a stent-assisted coiling procedure to treat a large basilar aneurysm. All intracranial steps, including stent placement and coil deployment, were performed with assistance from the CorPath<sup>©</sup> GRX Robotic System (Corindus, a Siemens Healthineers Company, Waltham, MA, USA). This represents a major milestone in the treatment of neurovascular disease and opens the doors for the development of remote robotic neuroendovascular procedures.

scholarly journals Does robotic assisted technology improve the accuracy of acetabular component positioning in patients with DDH?

2021 ◽  
Vol 29 (2) ◽  
pp. 230949902110253
Author(s):  
Yixin Zhou ◽  
Hongyi Shao ◽  
Yong Huang ◽  
Wang Deng ◽  
Dejin Yang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Acetabular Component ◽  
Statistical Significance ◽  
Conventional Group ◽  
Robotic Technology ◽  
Robotic Group ◽  
Surgical Time ◽  
Robotic Assisted ◽  
Perioperative Bleeding ◽  
Safe Zones

Background: Accurate positioning of the acetabular component is key in performing total hip arthroplasty (THA). However, reconstruction of the acetabulum in the setting of developmental dysplasia of the hip (DDH) is a challenge. Robotic assisted THA has the potential to improve the accuracy of implantation of the acetabular cup in cases with DDH. The purpose of this study was to assess whether robotic technology improves the accuracy of acetabular component positioning in patients with DDH. Material and methods: We included 59 THAs using robotic assisted technology from June 2019 to January 2020 as the study group. These were compared to conventional THAs without robotic technology after control for age, gender, body mass index (BMI), Crowe type and operation date. Radiographic measurements were taken by 2 blinded orthopaedic residents. The percentage of hips within the Lewinnek and Collanan safe zones were calculated, along with acetabular rotation centers for the “target zone.” Surgical time and perioperative bleeding were also compared between both groups. Results: One patient suffered dislocation in conventional group while no dislocation occurred in robotic group. The acetabular components of the robotic assisted group had more cases located within the Lewinnek ( p = 0.013) and Collanan ( p = 0.008) safe zones than conventional group (94.9% vs 79.7% and 74.6% vs 50.8%). There were 7 cases in conventional group and 4 cases in robotic group that had more lateral or more superior rotational centers of THA, but did not reach statistical significance ( p = 0.342). No statistical difference was detected between groups with regards to blood loss ( p = 0.098) and surgical time ( p = 0.602). Conclusion: Robot assisted technology can assist surgeons with implanting acetabular cups more in Lewinnek and Callanan safe zone than conventional techniques without additional blood loss and surgical time. Level of Evidence: Therapeutic Level Ⅲ.

scholarly journals The Role of Robotic Surgery in Benign Otolaryngology Head and Neck Surgery: A Systematic Review of the Literature.

2021 ◽  
Vol 9 (2) ◽  
Author(s):  
Sarah Gillanders ◽  
Akshaya Ravi ◽  
Shawkat Abdulrahman
Keyword(s):  
Systematic Review ◽  
Head And Neck ◽  
Neck Surgery ◽  
Review Of The Literature ◽  
Inclusion Criteria ◽  
Robot Assisted ◽  
Robotic Assisted ◽  
Robotic Assisted Surgery ◽  
Near Future

The role of robotic-assisted surgery has increased exponentially in many surgical specialities over recent years. However, common usage within otolaryngology still appears limited. We aim to explore the alternative uses for robot-assisted surgery in benign otolaryngology, head and neck pathologies. A systematic review of the literature was performed by searching electronic databases and references libraries. 2485 papers were identified through our search. 96 studies met our inclusion criteria. Our results are categorized and displayed in table format. There are multiple novel adaptations of robotic-assisted surgery being performed across the world in benign otolaryngology, head and neck pathologies. Exciting advances in technology and availability will expand this scope even further in the near future.

EP.TU.4973 year oncological outcomes of robotic-assisted versus laparoscopic rectal cancer resections – a single centre experience

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Lauren O'Connell ◽  
Sinead Ramjit ◽  
Tim Nugent ◽  
Paul Neary ◽  
Adnan Hafeez ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Neoadjuvant Chemoradiotherapy ◽  
Disease Free Survival ◽  
Final Analysis ◽  
Inclusion Criteria ◽  
Recurrence Rates ◽  
Robotic Assisted ◽  
Oncological Outcomes ◽  
Lymph Node Retrieval ◽  
Significant Difference

Abstract Background Robotic-assisted minimally invasive surgery (MIS) for rectal cancer is a relatively new technique. Studies to date suggest that short term outcomes including TME quality, margin status, lymph node retrieval and 30-day morbidity and mortality are equivalent in robotic-assisted and laparoscopic MIS for rectal cancer. By contrast, there is a paucity of data on the medium and long-term oncologic safety of robotic-assisted comparative to laparoscopic surgery for rectal cancer. Methods A retrospective review was conducted of all robotic-assisted (n = 31) and laparoscopic (n = 23) rectal cancer cases performed at our institution between January 2016 to December 2018. Inclusion criteria were patients scheduled electively for a laparoscopic or robotic-assisted resection of rectal cancer (anterior resection or abdomino-perineal resection). Patients with distant metastases at presentation, those who proceeded to surgery as an emergency and those with a non-colorectal primary were excluded from analysis. Results A total of 54 (n = 54) cases met the inclusion criteria and were included in the final analysis. The median follow-up was 34 months. Of the 54, 21 patients received neoadjuvant chemoradiotherapy prior to definitive surgery. No significant difference was detected in local recurrence rates (p = 0.5), overall survival (p = 0.7) or disease-free survival (p = 0.8) between the robotic-assisted and laparoscopic cohorts. Conclusion In this series, robotic-assisted rectal cancer resections were associated with equivalent medium term oncological outcomes as laparoscopic procedures. However, given the small numbers in this cohort, outcomes from larger scale datasets will be required to confirm these results.

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