scholarly journals Above and Beyond Robotic Surgery and 3D Modelling in Paediatric Cancer Surgery

2021 ◽  
Vol 9 ◽  
Author(s):  
Laura Privitera ◽  
Irene Paraboschi ◽  
Kate Cross ◽  
Stefano Giuliani
Keyword(s):  
Robotic Surgery ◽  
Augmented Reality ◽  
New Technologies ◽  
Survival Rates ◽  
Surgical Oncology ◽  
Cancer Surgery ◽  
High Definition ◽  
Novel Technologies ◽  
Early Adoption ◽  
Surgical Field

Although the survival rates for children's cancers have more than doubled in the last few decades, the surgical practise has not significantly changed. Among the most recent innovations introduced in the clinic, robotic surgery and augmented reality are two of the most promising, even if they are not widespread. The increased flexibility of the motion, the magnification of the surgical field and the tremor reduction provided by robotic surgery have been beneficial to perform complex oncological procedures in children. Besides, augmented reality has been proven helpful in planning for tumour removal, facilitating early discrimination between cancer and healthy organs. Nowadays, research in the field of surgical oncology is moving fast, and new technologies and innovations wich will help to shape a new way to perform cancer surgery. Paediatric surgeons need to be ready to adopt these novel devices and intraoperative techniques to allow more radical tumour resections with fewer complications. This review aims to present the mechanism of action and indications of several novel technologies such as optical imaging surgery, high definition cameras, and intraoperative loco-regional treatments. We hope this will enhance early adoption and more research on how to employ technology for the benefit of children.

scholarly journals Evolving robotic surgery training and improving patient safety, with the integration of novel technologies

2020 ◽  
Author(s):  
I-Hsuan Alan Chen ◽  
Ahmed Ghazi ◽  
Ashwin Sridhar ◽  
Danail Stoyanov ◽  
Mark Slack ◽  
...  
Keyword(s):  
Machine Learning ◽  
Robotic Surgery ◽  
Performance Feedback ◽  
New Technologies ◽  
Current Evidence ◽  
Robotic Training ◽  
Novel Technologies ◽  
Surgery Training ◽  
Consensus Statements ◽  
Robotic Surgery Training

Abstract Introduction Robot-assisted surgery is becoming increasingly adopted by multiple surgical specialties. There is evidence of inherent risks of utilising new technologies that are unfamiliar early in the learning curve. The development of standardised and validated training programmes is crucial to deliver safe introduction. In this review, we aim to evaluate the current evidence and opportunities to integrate novel technologies into modern digitalised robotic training curricula. Methods A systematic literature review of the current evidence for novel technologies in surgical training was conducted online and relevant publications and information were identified. Evaluation was made on how these technologies could further enable digitalisation of training. Results Overall, the quality of available studies was found to be low with current available evidence consisting largely of expert opinion, consensus statements and small qualitative studies. The review identified that there are several novel technologies already being utilised in robotic surgery training. There is also a trend towards standardised validated robotic training curricula. Currently, the majority of the validated curricula do not incorporate novel technologies and training is delivered with more traditional methods that includes centralisation of training services with wet laboratories that have access to cadavers and dedicated training robots. Conclusions Improvements to training standards and understanding performance data have good potential to significantly lower complications in patients. Digitalisation automates data collection and brings data together for analysis. Machine learning has potential to develop automated performance feedback for trainees. Digitalised training aims to build on the current gold standards and to further improve the ‘continuum of training’ by integrating PBP training, 3D-printed models, telementoring, telemetry and machine learning.

Augmented reality–assisted pedicle screw insertion: a cadaveric proof-of-concept study

2019 ◽  
Vol 31 (1) ◽  
pp. 139-146 ◽  
Author(s):  
Camilo A. Molina ◽  
Nicholas Theodore ◽  
A. Karim Ahmed ◽  
Erick M. Westbroek ◽  
Yigal Mirovsky ◽  
...  
Keyword(s):  
Augmented Reality ◽  
Pedicle Screw ◽  
User Experience ◽  
Pedicle Screws ◽  
Screw Insertion ◽  
Pedicle Screw Insertion ◽  
Insertion Method ◽  
Comparative Accuracy ◽  
Placement Accuracy ◽  
Surgical Field

OBJECTIVEAugmented reality (AR) is a novel technology that has the potential to increase the technical feasibility, accuracy, and safety of conventional manual and robotic computer-navigated pedicle insertion methods. Visual data are directly projected to the operator’s retina and overlaid onto the surgical field, thereby removing the requirement to shift attention to a remote display. The objective of this study was to assess the comparative accuracy of AR-assisted pedicle screw insertion in comparison to conventional pedicle screw insertion methods.METHODSFive cadaveric male torsos were instrumented bilaterally from T6 to L5 for a total of 120 inserted pedicle screws. Postprocedural CT scans were obtained, and screw insertion accuracy was graded by 2 independent neuroradiologists using both the Gertzbein scale (GS) and a combination of that scale and the Heary classification, referred to in this paper as the Heary-Gertzbein scale (HGS). Non-inferiority analysis was performed, comparing the accuracy to freehand, manual computer-navigated, and robotics-assisted computer-navigated insertion accuracy rates reported in the literature. User experience analysis was conducted via a user experience questionnaire filled out by operators after the procedures.RESULTSThe overall screw placement accuracy achieved with the AR system was 96.7% based on the HGS and 94.6% based on the GS. Insertion accuracy was non-inferior to accuracy reported for manual computer-navigated pedicle insertion based on both the GS and the HGS scores. When compared to accuracy reported for robotics-assisted computer-navigated insertion, accuracy achieved with the AR system was found to be non-inferior when assessed with the GS, but superior when assessed with the HGS. Last, accuracy results achieved with the AR system were found to be superior to results obtained with freehand insertion based on both the HGS and the GS scores. Accuracy results were not found to be inferior in any comparison. User experience analysis yielded “excellent” usability classification.CONCLUSIONSAR-assisted pedicle screw insertion is a technically feasible and accurate insertion method.

scholarly journals Augmented Reality with HoloLens® in Parotid Tumor Surgery: A Prospective Feasibility Study

ORL ◽  
2021 ◽  
pp. 1-10
Author(s):  
Claudia Scherl ◽  
Johanna Stratemeier ◽  
Nicole Rotter ◽  
Jürgen Hesser ◽  
Stefan O. Schönberg ◽  
...  
Keyword(s):  
Augmented Reality ◽  
Tumor Surgery ◽  
Parotid Tumor ◽  
Hand Gestures ◽  
Surgical Performance ◽  
3D Images ◽  
Additional Information ◽  
Parotid Surgery ◽  
Surgical Field ◽  
Improve Planning

<b><i>Introduction:</i></b> Augmented reality can improve planning and execution of surgical procedures. Head-mounted devices such as the HoloLens® (Microsoft, Redmond, WA, USA) are particularly suitable to achieve these aims because they are controlled by hand gestures and enable contactless handling in a sterile environment. <b><i>Objectives:</i></b> So far, these systems have not yet found their way into the operating room for surgery of the parotid gland. This study explored the feasibility and accuracy of augmented reality-assisted parotid surgery. <b><i>Methods:</i></b> 2D MRI holographic images were created, and 3D holograms were reconstructed from MRI DICOM files and made visible via the HoloLens. 2D MRI slices were scrolled through, 3D images were rotated, and 3D structures were shown and hidden only using hand gestures. The 3D model and the patient were aligned manually. <b><i>Results:</i></b> The use of augmented reality with the HoloLens in parotic surgery was feasible. Gestures were recognized correctly. Mean accuracy of superimposition of the holographic model and patient’s anatomy was 1.3 cm. Highly significant differences were seen in position error of registration between central and peripheral structures (<i>p</i> = 0.0059), with a least deviation of 10.9 mm (centrally) and highest deviation for the peripheral parts (19.6-mm deviation). <b><i>Conclusion:</i></b> This pilot study offers a first proof of concept of the clinical feasibility of the HoloLens for parotid tumor surgery. Workflow is not affected, but additional information is provided. The surgical performance could become safer through the navigation-like application of reality-fused 3D holograms, and it improves ergonomics without compromising sterility. Superimposition of the 3D holograms with the surgical field was possible, but further invention is necessary to improve the accuracy.

scholarly journals Modern Diagnosis of Early Esophageal Cancer: From Blood Biomarkers to Advanced Endoscopy and Artificial Intelligence

Cancers ◽  
2021 ◽  
Vol 13 (13) ◽  
pp. 3162
Author(s):  
Pierfrancesco Visaggi ◽  
Brigida Barberio ◽  
Matteo Ghisa ◽  
Mentore Ribolsi ◽  
Vincenzo Savarino ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Esophageal Cancer ◽  
Clinical Symptoms ◽  
Survival Rates ◽  
Screening Strategy ◽  
Cancer Surveillance ◽  
Blood Biomarkers ◽  
Early Esophageal Cancer ◽  
Novel Technologies ◽  
Bolus Impaction

Esophageal cancer (EC) is the seventh most common cancer and the sixth cause of cancer death worldwide. Histologically, esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC) account for up to 90% and 20% of all ECs, respectively. Clinical symptoms such as dysphagia, odynophagia, and bolus impaction occur late in the natural history of the disease, and the diagnosis is often delayed. The prognosis of ESCC and EAC is poor in advanced stages, being survival rates less than 20% at five years. However, when the diagnosis is achieved early, curative treatment is possible, and survival exceeds 80%. For these reasons, mass screening strategies for EC are highly desirable, and several options are currently under investigation. Blood biomarkers offer an inexpensive, non-invasive screening strategy for cancers, and novel technologies have allowed the identification of candidate markers for EC. The esophagus is easily accessible via endoscopy, and endoscopic imaging represents the gold standard for cancer surveillance. However, lesion recognition during endoscopic procedures is hampered by interobserver variability. To fill this gap, artificial intelligence (AI) has recently been explored and provided encouraging results. In this review, we provide a summary of currently available options to achieve early diagnosis of EC, focusing on blood biomarkers, advanced endoscopy, and AI.

Short- and Long-Term Outcomes of Robotic Surgery for Rectal Neuroendocrine Tumor

2021 ◽  
pp. 155335062110304
Author(s):  
Kentaro Saito ◽  
Yusuke Yamaoka ◽  
Akio Shiomi ◽  
Hiroyasu Kagawa ◽  
Hitoshi Hino ◽  
...  
Keyword(s):  
Robotic Surgery ◽  
Neuroendocrine Tumor ◽  
Surgical Approach ◽  
Anal Verge ◽  
Survival Rates ◽  
Long Term Outcomes ◽  
Conversion To Open Surgery ◽  
Short And Long Term ◽  
Rectal Neuroendocrine Tumor

Background. The optimal radical surgical approach for rectal neuroendocrine tumor (NET) is unknown. Methods. This study evaluated the short- and long-term outcomes of 27 patients who underwent robotic radical surgery for rectal NET between 2011 and 2019. Results. The median distance from the lower border of the tumor to the anal verge was 5.0 cm. The median tumor size was 9.5 mm. Six patients (22%) had lymph node metastasis. The incidences of postoperative complications of grade II and grade III or more according to the Clavien–Dindo classification were 11% and 0%, respectively. All patients underwent sphincter-preserving surgery, and no patients required conversion to open surgery. The median follow-up time was 48.9 months, and both the 3-year overall survival and relapse-free survival rates were 100%. Conclusions. Short- and long-term outcomes of robotic surgery for rectal NET tumor were favorable. Robotic surgery may be a useful surgical approach for rectal NET.

Improving Global Surgical Oncology Benchmarks: Defining the Unmet Need for Cancer Surgery in Ghana

2021 ◽  
Author(s):  
Cameron E. Gaskill ◽  
Adam Gyedu ◽  
Barclay Stewart ◽  
Robert Quansah ◽  
Peter Donkor ◽  
...  
Keyword(s):  
Unmet Need ◽  
Surgical Oncology ◽  
Cancer Surgery

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.

The different shades of innovation emergence in smart service systems: the case of Italian cluster for aerospace technology

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Orlando Troisi ◽  
Anna Visvizi ◽  
Mara Grimaldi
Keyword(s):  
New Technologies ◽  
Service Systems ◽  
Constructivist Grounded Theory ◽  
Structured Interviews ◽  
Social Rules ◽  
Content Type ◽  
Novel Technologies ◽  
Aerospace Technology ◽  
Smart Service ◽  
Relational Strategies

Purpose The purpose of this paper is to explore the emergence of innovation in smart service systems to conceptualize how actor’s relationships through technology-enabled interactions can give birth to novel technologies, processes, strategies and value. The objectives of the study are: to detect the different enablers that activate innovation in smart service systems; and to explore how these can lead dynamically to the emergence of different innovation patterns. Design/methodology/approach The empirical research adopts an approach based on constructivist grounded theory, performed through observation and semi-structured interviews to investigate the development of innovation in the Italian CTNA (Italian acronym of National Cluster for Aerospace Technology). Findings The identification and re-elaboration of the novelties that emerged from the analysis of the Cluster allow the elaboration of a diagram that classifies five different shades of innovation, introduced through some related theoretical propositions: technological; process; business model and data-driven; social and eco-sustainable; and practice-based. Originality/value The paper embraces a synthesis view that detects the enabling structural and systems dimensions for innovation (the “what”) and the way in which these can be combined to create new technologies, resources, values and social rules (the “how” dimension). The classification of five different kinds of innovation can contribute to enrich extant research on value co-creation and innovation and can shed light on how given technologies and relational strategies can produce varied innovation outcomes according to the diverse stakeholders engaged.

scholarly journals UX in AR-Supported Industrial Human–Robot Collaborative Tasks: A Systematic Review

2021 ◽  
Vol 11 (21) ◽  
pp. 10448
Author(s):  
Riccardo Karim Khamaisi ◽  
Elisa Prati ◽  
Margherita Peruzzini ◽  
Roberto Raffaeli ◽  
Marcello Pellicciari
Keyword(s):  
Augmented Reality ◽  
Industrial Revolution ◽  
New Technologies ◽  
Recent Literature ◽  
Modern Human ◽  
Assessment Procedure ◽  
Functional Requirements ◽  
Collaborative Robotics ◽  
Fourth Industrial Revolution ◽  
Standardization Process

The fourth industrial revolution is promoting the Operator 4.0 paradigm, originating from a renovated attention towards human factors, growingly involved in the design of modern, human-centered processes. New technologies, such as augmented reality or collaborative robotics are thus increasingly studied and progressively applied to solve the modern operators’ needs. Human-centered design approaches can help to identify user’s needs and functional requirements, solving usability issues, or reducing cognitive or physical stress. The paper reviews the recent literature on augmented reality-supported collaborative robotics from a human-centered perspective. To this end, the study analyzed 21 papers selected after a quality assessment procedure and remarks the poor adoption of user-centered approaches and methodologies to drive the development of human-centered augmented reality applications to promote an efficient collaboration between humans and robots. To remedy this deficiency, the paper ultimately proposes a structured framework driven by User eXperience approaches to design augmented reality interfaces by encompassing previous research works. Future developments are discussed, stimulating fruitful reflections and a decisive standardization process.

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