The Centre for Minimal Access Surgery—teaching for tomorrow

2000 ◽  
Vol 6 (2_suppl) ◽  
pp. 14-15 ◽  
Author(s):  
Lianne Durst
Keyword(s):  
Skill Acquisition ◽  
Surgical Procedures ◽  
Surgical Techniques ◽  
The Body ◽  
Minimal Access Surgery ◽  
Research Centre ◽  
Minimal Access ◽  
Technological Education ◽  
Human Form ◽  
Access Surgery

The Centre for Minimal Access Surgery (CMAS) was established as a state-of-the-art multidisciplinary technological education and research centre for minimal access surgical techniques. Up-to-date training models were obtained to facilitate skill acquisition. Among these were the Minimal Access Therapy trainer and the Body Form Simulator, which provide simulations of the human form on which students can practise operative procedures. The CMAS also acquired the MIST Virtual Reality system, a computer program that facilitates the acquisition of laparoscopy skills. Finally, the CMAS compiled a multimedia library of resources. While many skills can be gained in these synthetic and didactic environments, they cannot provide all the preparation necessary to practise competently. To facilitate the realtime observation of surgical procedures and the telementoring process, the CMAS has commissioned the development of an integrated videoconferencing system that permits the high-quality, rapid transfer of multi-feed video and audio data of surgical procedures from an operating room to the classroom.

scholarly journals Interim safety analysis of the first-in-human clinical trial of the Versius surgical system, a new robot-assisted device for use in minimal access surgery

2020 ◽  
Author(s):  
Dhananjay Kelkar ◽  
Mahindra A. Borse ◽  
Girish P. Godbole ◽  
Utkrant Kurlekar ◽  
Mark Slack
Keyword(s):  
Clinical Trial ◽  
Surgical Procedures ◽  
Open Surgery ◽  
Safety Analysis ◽  
Minimal Access Surgery ◽  
Minimal Access ◽  
Robot Assisted ◽  
Post Surgery ◽  
Access Surgery ◽  
Surgical System

Abstract Objective The aim of this study was to provide an interim safety analysis of the first 30 surgical procedures performed using the Versius Surgical System. Background Robot-assisted laparoscopy has been developed to overcome some of the important limitations of conventional laparoscopy. The new system is currently undergoing a first-in-human prospective clinical trial to confirm the safety and effectiveness of the device when performing minimal access surgery (MAS). Methods Procedures were performed using Versius by a lead surgeon supported by an operating room (OR) team. Male or female patients aged between 18 and 65 years old and requiring elective minor or intermediate gynaecological or general surgical procedures were enrolled. The primary endpoint was the rate of unplanned conversion of procedures to other MAS or open surgery. Results The procedures included nine cholecystectomies, six robot-assisted total laparoscopic hysterectomies, four appendectomies, five diagnostic laparoscopy cases, two oophorectomies, two fallopian tube recanalisation procedures, an ovarian cystectomy and a salpingo-oophorectomy procedure. All procedures were completed successfully without the need for conversion to MAS or open surgery. No patient returned to the OR within 24 h of surgery and readmittance rate at 30 and 90 days post-surgery was 1/30 (3.3%) and 2/30 (6.7%), respectively. Conclusions This first-in-human interim safety analysis demonstrates that the Versius Surgical System is safe and can be used to successfully perform minor or intermediate gynaecological and general surgery procedures. The cases presented here provide evidence that the Versius clinical trial can continue to extend recruitment and begin to include major procedures, in alignment with the IDEAL-D Framework Stage 2b: Exploration.

Diagnosis and treatment of pudendal nerve entrapment syndrome subtypes: imaging, injections, and minimal access surgery

2009 ◽  
Vol 26 (2) ◽  
pp. E9 ◽  
Author(s):  
Aaron G. Filler
Keyword(s):  
Pudendal Nerve ◽  
Surgical Techniques ◽  
Muscle Spasm ◽  
Nerve Entrapment ◽  
Minimal Access Surgery ◽  
Functional Score ◽  
Minimal Access ◽  
Sciatic Notch ◽  
Pudendal Nerve Entrapment ◽  
Access Surgery

Object To improve diagnostic accuracy and achieve high levels of treatment success in patients with pudendal nerve entrapment (PNE) syndromes, the author of this study applied advanced technology diagnostics in distinguishing the various syndrome types according to the different entrapment locations and evaluated new minimal access surgical techniques to treat each subtype. Methods Two hundred cases were prospectively evaluated using a standardized set of patient-completed functional and symptom assessments, a collection of new physical examination maneuvers, MR neurography, open MR image–guided injections, intraoperative neurophysiology, minimal access surgery, and formal outcome assessment with the Oswestry Disability Index, pain diagrams, and analog pain scales. Results Four primary types of PNE syndromes were identified based on the different locations of entrapment: Type I, entrapment at the exit of the greater sciatic notch in concert with piriformis muscle spasm; Type II, entrapment at the level of the ischial spine, sacrotuberous ligament, and lesser sciatic notch entrance; Type III, entrapment in association with obturator internus muscle spasm at the entrance of the Alcock canal; and Type IV, distal entrapment of terminal branches. The application of new, targeted minimal access surgical techniques led to sustained good to excellent outcomes (50–100% improvement in the pain score or functional score) in 87% of patients. Most of these patients obtained most of their improvement within 4 weeks of surgery, although some continued to experience progressive improvements up to 12 months after surgery. Conclusions The application of advanced diagnostics to categorize PNE syndrome origins into 4 major subtypes and the subsequent treatment of each subtype with a tailored strategy greatly improved therapeutic outcomes as compared with those reported when only a single treatment paradigm was applied to all patients.

New Tools for a New Job-Single Port Laparoscopic Surgery Equipment

2009 ◽  
Vol 2 ◽  
pp. MEI.S3144 ◽  
Author(s):  
Euan R. MacDonald ◽  
Ewan Brownlee ◽  
Irfan Ahmed
Keyword(s):  
Laparoscopic Surgery ◽  
Surgical Procedures ◽  
Single Port ◽  
Minimal Access Surgery ◽  
Minimal Access ◽  
Scarless Surgery ◽  
Single Port Surgery ◽  
Instrument Technology ◽  
Access Surgery

Single port transumbilical laparoscopic surgery (LESS, SILS, ENOTES) is a technique which has recently emerged with a view to improving the cosmesis following minimal access surgery, aiming to achieve ‘scarless’ surgery. This rapidly progressing technique is facilitated by developments in port and instrument technology, allowing surgeons to perform a wider range of surgical procedures with increasing ease. This paper aims to summarise the equipment available at present for single port surgery.

scholarly journals Five thousand years of minimal access surgery: 1850 to 1990: Technological developments

2020 ◽  
pp. 014107682096791
Author(s):  
Rachel Hargest
Keyword(s):  
Surgical Care ◽  
The Body ◽  
Minimal Access Surgery ◽  
Minimal Access ◽  
Medical Practitioners ◽  
Wide Range ◽  
Therapeutic Procedures ◽  
Technological Developments ◽  
History Of ◽  
Access Surgery

Summary This is the second of a three-part series that charts the history of minimal access surgery from antiquity to current times. Although rapid developments in laparoscopic and robotic surgery have transformed surgical care over the last 30 years, our predecessors made significant advances in their time which set the principles for modern practice. Part I of this series described how ancient medical practitioners developed simple instruments, from metal or wood, for viewing body cavities. Improvements in the use of metal, glass and lighting allowed for inspection of deeper parts of the body. This second part of the series will show how advances in electrical technology allowed the development of improved lighting for endoscopy and laparoscopy along with the use of electrocautery for a wide range of therapeutic procedures.

scholarly journals Using end-user feedback to optimize the design of the Versius Surgical System, a new robot-assisted device for use in minimal access surgery

2019 ◽  
Vol 1 (1) ◽  
pp. e000019 ◽  
Author(s):  
Luke Hares ◽  
Paul Roberts ◽  
Keith Marshall ◽  
Mark Slack
Keyword(s):  
Surgical Procedures ◽  
Surgical Robot ◽  
Minimal Access Surgery ◽  
Minimal Access ◽  
Robot Assisted ◽  
Robot System ◽  
Long Term Study ◽  
Surgical Teams ◽  
Access Surgery ◽  
Surgical System

BackgroundRobot-assisted minimal access surgery (MAS) reduces blood loss, recovery time, intraoperative and postoperative complications and pain. However, uptake of robotic MAS remains low, suggesting there are barriers to its use. To overcome these barriers, a new surgical robot system, Versius, was developed based on the needs and feedback of surgeons and surgical teams.MethodsThe surgical robot prototype was designed based on observations in the operating room (OR) and previous interviews with surgeons. Formative studies with surgeons and surgical teams were used to refine the prototype design, resulting in modifications to all components, including the arms, instruments, handgrips and surgeon console. Proof-of-concept cadaver studies were used to further optimize its design by assessing its usability during surgical procedures.ResultsFeedback led to the development of a novel, mobile design with independent arm carts and surgical console, linked by supported serial or parallel connections, providing maximum flexibility in the OR. Instrument tips were developed based on surgeons’ preferred designs and wristed at the tip providing seven degrees of freedom within the patient. Multiple handgrip designs were assessed by surgeons; of these, a ‘game controller’ design was rated most popular and usable. An open surgical console design allowing multiple working positions was rated highest by surgeons and the surgical teams.ConclusionsThis surgical robot system has been developed using feedback from end users throughout the design process and aims to minimize barriers to robotic MAS uptake. Additionally, these studies demonstrate system success in the surgical procedures it was designed for. The studies reported here, and further studies of the Versius Surgical System, are intended to align with IDEAL (Idea, Development, Exploration, Assessment, Long-term study) Framework guidance.

Minimal access surgery?which path to competence?

1994 ◽  
Vol 8 (9) ◽  
pp. 1047-1048 ◽  
Author(s):  
Kenneth A. Forde
Keyword(s):  
Minimal Access Surgery ◽  
Minimal Access ◽  
Access Surgery
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