scholarly journals Augmented Reality and Image-Guided Robotic Liver Surgery

Cancers ◽  
2021 ◽  
Vol 13 (24) ◽  
pp. 6268
Author(s):  
Fabio Giannone ◽  
Emanuele Felli ◽  
Zineb Cherkaoui ◽  
Pietro Mascagni ◽  
Patrick Pessaux
Keyword(s):  
Artificial Intelligence ◽  
Augmented Reality ◽  
Liver Surgery ◽  
Tactile Feedback ◽  
Parenchymal Transection ◽  
Practical Applications ◽  
Indocyanine Green Fluorescence ◽  
Oncological Results ◽  
Vascular Structures ◽  
Robotic Liver Surgery

Artificial intelligence makes surgical resection easier and safer, and, at the same time, can improve oncological results. The robotic system fits perfectly with these more or less diffused technologies, and it seems that this benefit is mutual. In liver surgery, robotic systems help surgeons to localize tumors and improve surgical results with well-defined preoperative planning or increased intraoperative detection. Furthermore, they can balance the absence of tactile feedback and help recognize intrahepatic biliary or vascular structures during parenchymal transection. Some of these systems are well known and are already widely diffused in open and laparoscopic hepatectomies, such as indocyanine green fluorescence or ultrasound-guided resections, whereas other tools, such as Augmented Reality, are far from being standardized because of the high complexity and elevated costs. In this paper, we review all the experiences in the literature on the use of artificial intelligence systems in robotic liver resections, describing all their practical applications and their weaknesses.

scholarly journals Three-Device (3D) Technique for Liver Parenchyma Dissection in Robotic Liver Surgery

2021 ◽  
Vol 10 (22) ◽  
pp. 5265
Author(s):  
Aristotelis Perrakis ◽  
Mirhasan Rahimli ◽  
Andrew A. Gumbs ◽  
Victor Negrini ◽  
Mihailo Andric ◽  
...  
Keyword(s):  
Liver Surgery ◽  
Liver Parenchyma ◽  
R0 Resection ◽  
Parenchymal Transection ◽  
Minimally Invasive Liver Surgery ◽  
Robotic Hepatectomy ◽  
Liver Resections ◽  
New Strategy ◽  
Laparoscopic Techniques ◽  
Robotic Liver Surgery

Background: The implementation of robotics in liver surgery offers several advantages compared to conventional open and laparoscopic techniques. One major advantage is the enhanced degree of freedom at the tip of the robotic tools compared to laparoscopic instruments. This enables excellent vessel control during inflow and outflow dissection of the liver. Parenchymal transection remains the most challenging part during robotic liver resection because currently available robotic instruments for parenchymal transection have several limitations and there is no standardized technique as of yet. We established a new strategy and share our experience. Methods: We present a novel technique for the transection of liver parenchyma during robotic surgery, using three devices (3D) simultaneously: monopolar scissors and bipolar Maryland forceps of the robot and laparoscopic-guided waterjet. We collected the perioperative data of twenty-eight patients who underwent this procedure for minor and major liver resections between February 2019 and December 2020 from the Magdeburg Registry of minimally invasive liver surgery (MD-MILS). Results: Twenty-eight patients underwent robotic-assisted 3D parenchyma dissection within the investigation period. Twelve cases of major and sixteen cases of minor hepatectomy for malignant and non-malignant cases were performed. Operative time for major liver resections (≥ 3 liver segments) was 381.7 (SD 80.6) min vs. 252.0 (70.4) min for minor resections (p < 0.01). Intraoperative measured blood loss was 495.8 (SD 508.8) ml for major and 256.3 (170.2) ml for minor liver resections (p = 0.090). The mean postoperative stay was 13.3 (SD 11.1) days for all cases. Liver surgery-related morbidity was 10.7%, no mortalities occurred. We achieved an R0 resection in all malignant cases. Conclusions: The 3D technique for parenchyma dissection in robotic liver surgery is a safe and feasible procedure. This novel method offers an advanced locally controlled preparation of intrahepatic vessels and bile ducts. The combination of precise extrahepatic vessel handling with the 3D technique of parenchyma dissection is a fundamental step forward to the standardization of robotic liver surgery for teaching purposing and the wider adoption of robotic hepatectomy into routine patient care.

Robotic Liver Surgery – Current Standards and Future Perspectives

2021 ◽  
Vol 59 (01) ◽  
pp. 56-62
Author(s):  
Felix Becker ◽  
Haluk Morgül ◽  
Shadi Katou ◽  
Mazen Juratli ◽  
Jens Peter Hölzen ◽  
...  
Keyword(s):  
Liver Surgery ◽  
German Literature ◽  
Minimal Invasive ◽  
Parenchymal Transection ◽  
Future Directions ◽  
Intracorporeal Suturing ◽  
Physiologic Tremor ◽  
Major Hepatectomies ◽  
Robotic Liver Surgery ◽  
Current Standards

Abstract Background Robotic liver surgery is emerging as the future of minimal invasive surgery. The robotic surgical system offers a stable camera platform, elimination of physiologic tremor, augmented surgical dexterity as well as improved ergonomics because of a seated operating position. Due to the theoretical advantages of the robotic assisted system, complex liver surgery might be an especially interesting indication for a robotic approach since it demands delicate tissue dissection, precise intracorporeal suturing as well as difficult parenchymal transection with subsequent need for meticulous hemostasis and biliostasis. Material and methods An analysis of English and German literature on open, laparoscopic and robotic liver surgery was performed and this review provides a general overview of the existing literature along with current standards and aims to specifically point out future directions of robotic liver surgery. Results Robotic liver surgery is safe and feasible compared to open and laparoscopic surgery, with improved short-term postoperative outcomes and at least non-inferior oncological outcomes. Conclusion In complex cases including major hepatectomies, extended hepatectomies with biliary reconstruction and difficult segmentectomies of the posterior-superior segments, robotic surgery appears to emerge as a reasonable alternative to open surgery rather than being an alternative to laparoscopic procedures.

scholarly journals Clinical use of augmented reality, mixed reality, three-dimensional-navigation and artificial intelligence in liver surgery

2021 ◽  
Vol 2 (4) ◽  
pp. 94-104
Author(s):  
Roger Wahba ◽  
Michael N Thomas ◽  
Alexander C Bunck ◽  
Christiane J Bruns ◽  
Dirk L Stippel
Keyword(s):  
Artificial Intelligence ◽  
Augmented Reality ◽  
Liver Surgery ◽  
Mixed Reality ◽  
Three Dimensional ◽  
Clinical Use

A touch screen interface design with tactile feedback for practical applications

2013 ◽  
Vol 3 (1) ◽  
pp. 8 ◽  
Author(s):  
Hiroaki Nishino ◽  
Ryotaro Goto ◽  
Yuki Fukakusa ◽  
Jiaqing Lin ◽  
Tsuneo Kagawa ◽  
...  
Keyword(s):  
Interface Design ◽  
Touch Screen ◽  
Tactile Feedback ◽  
Practical Applications

scholarly journals Augmented Reality, Virtual Reality and Artificial Intelligence in Orthopedic Surgery: A Systematic Review

2021 ◽  
Vol 11 (7) ◽  
pp. 3253
Author(s):  
Umile Giuseppe Longo ◽  
Sergio De Salvatore ◽  
Vincenzo Candela ◽  
Giuliano Zollo ◽  
Giovanni Calabrese ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Systematic Review ◽  
Virtual Reality ◽  
Augmented Reality ◽  
Orthopaedic Surgery ◽  
Resident Training ◽  
Comprehensive Search ◽  
Virtual And Augmented Reality ◽  
Orthopaedic Training ◽  
Meta Analyses

Background: The application of virtual and augmented reality technologies to orthopaedic surgery training and practice aims to increase the safety and accuracy of procedures and reducing complications and costs. The purpose of this systematic review is to summarise the present literature on this topic while providing a detailed analysis of current flaws and benefits. Methods: A comprehensive search on the PubMed, Cochrane, CINAHL, and Embase database was conducted from inception to February 2021. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were used to improve the reporting of the review. The Cochrane Risk of Bias Tool and the Methodological Index for Non-Randomized Studies (MINORS) was used to assess the quality and potential bias of the included randomized and non-randomized control trials, respectively. Results: Virtual reality has been proven revolutionary for both resident training and preoperative planning. Thanks to augmented reality, orthopaedic surgeons could carry out procedures faster and more accurately, improving overall safety. Artificial intelligence (AI) is a promising technology with limitless potential, but, nowadays, its use in orthopaedic surgery is limited to preoperative diagnosis. Conclusions: Extended reality technologies have the potential to reform orthopaedic training and practice, providing an opportunity for unidirectional growth towards a patient-centred approach.

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