Performance Increase in Venous Drainage for Mini-Invasive Heart Surgery: Superiority of Self-Expanding Cannulas

Objective Originally, the Smartcanula principle (collapsed insertion and expansion in situ) was developed for venous drainage by gravity. However, in minimally invasive surgery, augmentation with either constrained force vortex pumps or vacuum is often used. The current study was set up to assess whether smaller diameters of self-expanding venous cannulas are sufficient in conjunction with venous drainage augmentation resulting in smaller access orifices. Methods To evaluate cannulas intended for cardiopulmonary bypass, an in vitro circuit was set up with silicone tubing between the test cannula encased in a lower reservoir, the centrifugal pump, and after an upper reservoir. Afterload was set arbitrarily at 60 mm Hg using a centrifugal pump. The pressure value was measured using Millar pressure transducers. Flow rate (Q) was measured using an ultrasonic flow meter calibrated with volume tank and timer. Revolutions per minute of the centrifugal pump were calibrated with a stroboscope. Data display and data recording were controlled using a Lab View application. Self-expanding (24F Smartcanula) and control (25F Biomedicus) cannulas were used. Results Sixty measurements were recorded. At pump speed of 1500, 1570, 2000, 2500, and 3000 rpm, the Q values were 3.6, 5.2, 6.6, 9.3, and 11.8 L/min for the 24F self-expanding cannula and 3, 4.3, 5.4, 7.5, and 9.3 L/min for the control cannula. The pressure values were 3.6, −5.4, −15.9, −45.3, and 80.6 mm Hg. Biomedicus 25F showed Q values from 16% to 19% less as compared with 24F Smartcanula. The pressure values were 6, 7, 4, 2, and 2 times more as compared with 24F Smartcanula. Conclusions Our experimental evaluation demonstrated the superior performance of the Smartcanula with its self-expanding design in comparison with the reference commercially available standard cannulas. The Smartcanula with its small diameter is particularly welcome for minimally invasive surgery.

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Robotic Laparoscopic Single-Site Surgery

10.5772/intechopen.96226 ◽

2021 ◽

Author(s):

Rene I. Luna

Keyword(s):

Minimally Invasive Surgery ◽

Robotic Surgery ◽

Minimally Invasive ◽

Invasive Surgery ◽

Minimally Invasive Surgical Procedures ◽

Single Site ◽

Proper Understanding ◽

Minimally Invasive Surgical ◽

Set Up ◽

Single Site Surgery

Minimally invasive surgery has changed the landscape of women’s surgical healthcare. Conventional and robotic laparoscopy are the preferred approach for many major minimally invasive gynecological procedures. However, the philosophy of minimally invasive surgery has been pushed to reduce the size and minimize the number of ports placed. Many conventional minimally invasive surgical procedures use 3–5 ports through multiple small incisions. Laparoscopic single site surgery tries to perform on that philosophy but has its limitations. Enters robotic surgery already a major force in minimally invasive surgery and now sets to remove the limitations of single site surgery. However it requires proper understanding of the instruments and the techniques for successful robotic single site surgery. It starts with patient selection. Knowing the instruments needed and the proper set up of those instruments. Then knowing how to use the instruments in operating and suturing and closing. And finish with special considerations.

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Minimally invasive surgery and transsulcal parafascicular approach in the evacuation of intracerebral haemorrhage

Stroke and Vascular Neurology ◽

10.1136/svn-2019-000264 ◽

2019 ◽

Vol 5 (1) ◽

pp. 40-49

Author(s):

Lina Marenco-Hillembrand ◽

Paola Suarez-Meade ◽

Henry Ruiz Garcia ◽

Ricardo Murguia-Fuentes ◽

Erik H Middlebrooks ◽

...

Keyword(s):

Patient Outcome ◽

Minimally Invasive Surgery ◽

Minimally Invasive ◽

Invasive Surgery ◽

Intracerebral Haemorrhage ◽

Small Diameter ◽

Substantial Improvement ◽

Brain Parenchyma ◽

Anatomical Dissection ◽

Surgical Manipulation

Intracerebral haemorrhage (ICH) describes haemorrhage into the brain parenchyma that may result in a decline of the patient’s neurological function. ICH is a common cause of morbidity and mortality worldwide. Aggressive surgical treatment for ICH has remained controversial as clinical trials have failed to demonstrate substantial improvement in patient outcome and mortality. Recently, promising mechanical and pharmacological minimally invasive surgery (MIS) techniques for the treatment of ICH have been described. MIS was designed with the objective of reducing morbidity due to complications of surgical manipulation. Mechanical MIS includes the use of tubular retractors and small diameter instruments for ICH removal. Pharmacological methods consist of catheter placement inside the haematoma cavity for the passive drainage of the haematoma over the course of several days. One of the most favourable approaches for MIS is the use of natural corridors for reaching the lesion, such as the transsulcal parafascicular approach. This approach provides an anatomical dissection of the subjacent white matter tracts, causing the least amount of damage while evacuating the haematoma. A detailed description of the currently known MIS techniques and devices is presented in this review. Special attention is given to the transsulcal parafascicular approach, which has particular benefits to provide a less traumatic MIS with promising overall patient outcome.

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Repulsive force control of minimally invasive surgery robot associated with three degrees of freedom electrorheological fluid-based haptic master

Proceedings of the Institution of Mechanical Engineers Part C Journal of Mechanical Engineering Science ◽

10.1177/0954406213508935 ◽

2013 ◽

Vol 228 (9) ◽

pp. 1606-1621 ◽

Cited By ~ 7

Author(s):

Sang-Rock Lee ◽

Chang-Ho Uhm ◽

Min-Sang Seong ◽

Jong-Seok Oh ◽

Seung-Bok Choi

Keyword(s):

Minimally Invasive Surgery ◽

Minimally Invasive ◽

Invasive Surgery ◽

Degrees Of Freedom ◽

Force Feedback ◽

Electrorheological Fluid ◽

Repulsive Force ◽

Superior Performance ◽

Robot Assisted ◽

Three Degrees Of Freedom

This paper presents a repulsive force feedback control in a haptic master–slave robot-assisted system for robot minimally invasive surgery. In general, the haptic master can provide position and force information for superior performance and reliability in master–slave robot-assisted interventions for a surgeon. In order to realize this potential, in this work three degrees of freedom electrorheological haptic master is adopted and associated with a four degrees of freedom slave robot. The haptic master featuring controllable electrorheological fluid is featured by a spherical joint mechanism and the slave robot is controlled by servomotors. After designing a user interface that is capable of providing force feedback in all the degrees of freedom available during robot minimally invasive surgery, the dynamic model of the haptic master is analyzed and the model parameters are identified to evaluate control performance of the haptic master on skin- and cancer-like tissues (palpation). Subsequently, the haptic architecture for robot minimally invasive surgery is established and experimentally implemented so that the reflection force for the object of the slave robot and the desired position for the master operator are transferred to each other. In order to demonstrate the effectiveness of the proposed system, repulsive force tracking control performances are evaluated and presented in time domain.

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