Robotic Surgery: Rediscovering Human Anatomy

Since its advent, robotic surgery has redefined the operating room experience. It directly addressed and resolved many of the shortcomings of laparoscopic methods while maintaining a minimally invasive approach that brought benefits in cosmesis and healing for patients but also benefits in ergonomics and precision for surgeons. This new platform has brought with it changes in surgical training and education, principally through the utilization of virtual reality. Accurate depictions of human anatomy seen through augmented reality allow the surgeon-in-training to learn, practice and perfect their skills before they operate on their first patient. However, the anatomical knowledge required for minimally invasive surgery (MIS) is distinct from current methods of dissection and prosection that inherently cater towards open surgery with large cuts and unobstructed field. It is integral that robotic surgeons are also equipped with accurate anatomical information, heralding a new era in which anatomists can work alongside those developing virtual reality technology to create anatomical training curricula for MIS. As the field of surgery and medicine in general moves to include more and more technology, it is only fitting that the building blocks of medical education follow suit and rediscover human anatomy in a modern context.

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QUANTIFICATION OF THE INTERVENTIONAL APPROACHES INTO THE PTERYGOPALATINE FOSSA BY SOLID ANGLES USING VIRTUAL REALITY

Image Analysis & Stereology ◽

10.5566/ias.2581 ◽

2021 ◽

Author(s):

Anže Jerman ◽

Jiří Janáček ◽

Žiga Snoj ◽

Nejc Umek

Keyword(s):

Virtual Reality ◽

Minimally Invasive ◽

Solid Angle ◽

Preliminary Evidence ◽

Edge Length ◽

Pterygopalatine Fossa ◽

Target Point ◽

Transverse Diameter ◽

Invasive Approach ◽

Head Diameter

Virtual reality is increasingly used in medicine for diagnostics, for visualisation of complex structures and for preoperative planning. In interventional radiology, minimally invasive approach could be described with a target point representing the desired needle tip position and an array of all possible trajectories leading to it resembling irregular “cone” or “pyramid”. We present a pilot study of planning a minimally invasive posterior infrazygomatic and suprazygomatic approaches into the pterygopalatine fossa using a solid angle as a measure of size of the approach in five virtually reconstructed heads. The minimally invasive approaches were planned by manually drawing the edges of “pyramids” that described each approach in 3D using virtual reality program Tracer. For each head, a transverse diameter was measured and for each approach a solid angle size, average edge length and estimated area on the skin from where the target point could be reached were calculated. We found that, the solid angle of posterior infrazygomatic approach was significantly larger than suprazygomatic approach (p0.001). Furthermore, the transverse head diameter and solid angle in posterior infrazygomatic approach were negatively correlated (ρ=-0.55, p=0.0002), while transverse head diameter and the estimated area on the skin from where the target point could be reached in the suprazygomatic approach were positively correlated (ρ=0.37, p=0.0206). In conclusion, our findings provide important preliminary evidence on the feasibility of evaluating and comparing different minimally invasive approaches using virtual reality systems, and affirm the validity of solid angle as a measure of the size of the approach.

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Single Port 11 mm Laparoscopic Hysterectomy Performed on a 32-Year-Old Female with Adhesive Disease

Case Reports in Obstetrics and Gynecology ◽

10.1155/2020/3757391 ◽

2020 ◽

Vol 2020 ◽

pp. 1-4

Author(s):

Greg J. Marchand ◽

Ali Azadi ◽

Sienna Anderson ◽

Stacy Ruther ◽

Sophia Hopewell ◽

...

Keyword(s):

Minimally Invasive Surgery ◽

Robotic Surgery ◽

Minimally Invasive ◽

Single Port ◽

Laparoscopic Hysterectomy ◽

Minimally Invasive Procedures ◽

Invasive Procedures ◽

Invasive Approach ◽

Complicating Factors ◽

To Receive

In the field of minimally invasive surgery, there is constant drive to devise and execute the most minimally invasive surgeries possible. By the very nature of laparoscopy and robotic surgery, what one can accomplish with several ports of a given size will invariably be studied and attempted with fewer ports and with ports of smaller sizes. Although more complex pathology may require a more invasive approach, surgical cases without serious complicating factors may be amenable to extremely minimally invasive procedures. We report one such case where a 32-year-old female suffering from adenomyosis and endometriosis was able to receive a laparoscopic single-port hysterectomy and bilateral salpingo-oophorectomy through a single 11 mm port created with a blunt trochar.

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Minimally invasive approach for tumoral and non tumoral myasthenia gravis; from thoracoscopic to robotic surgery

Annals of Fundeni Hospital ◽

10.2478/v10206-011-0014-7 ◽

2011 ◽

Vol 16 (3-4) ◽

Author(s):

V. Tomulescu

Keyword(s):

Robotic Surgery ◽

Minimally Invasive ◽

Myasthenia Gravis ◽

Minimally Invasive Approach ◽

Invasive Approach

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Robotic Surgery Overview

Vietnam Journal of Endolaparoscopic Surgery ◽

10.51199/vjsel.2018.3.5 ◽

2018 ◽

Vol 8 (3) ◽

Author(s):

Quang Nghĩa Lê ◽

Vĩnh Hững Trần

Keyword(s):

Minimally Invasive Surgery ◽

Robotic Surgery ◽

Minimally Invasive ◽

Invasive Surgery ◽

Postoperative Outcomes ◽

New Era ◽

The Past

Tóm tắt Trong thập niên vừa qua, Robotic Surgery mở ra kỷ nguyên mới trong mọi chuyên ngành ngoại khoa giúp giảm tai biến, biến chứng trên người bệnh và tăng chất lượng kết quả sau mổ. Bài này trình bày lịch sử, sự phát triển và công dụng của Robotic surgery. Abstract Over the past decade, Robotic Surgery has opened a new era in all surgical specialties in helping reduceaccident, complications in caring the patientsand to improve the quality of postoperative outcomes. This article reviews the history, development,current and future applications of Robotic surgery. Keyword: Minimally Invasive Surgery (MIS); Laparoscopic Technologies; Robotic Surgery

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Mini Fronto-Orbital Approach: “Window Opening” Towards the Superomedial Orbit – A Virtual Reality-Planned Anatomic Study

Operative Neurosurgery ◽

10.1093/ons/opz420 ◽

2020 ◽

Vol 19 (3) ◽

pp. 330-340 ◽

Cited By ~ 2

Author(s):

Carmine Antonio Donofrio ◽

Jody Filippo Capitanio ◽

Lucia Riccio ◽

Aalap Herur-Raman ◽

Anthony J Caputy ◽

...

Keyword(s):

Virtual Reality ◽

Minimally Invasive ◽

Three Dimensional ◽

Skin Incision ◽

Surgical Approaches ◽

Target Area ◽

Minimally Invasive Approach ◽

Invasive Approach ◽

Window Opening ◽

Dissection Technique

Abstract BACKGROUND Surgical approaches to the orbit are challenging and require combined multispecialist skills. Considering its increasing relevance in neurosurgical practice, keyhole surgery could be also applied to this field. However, mastering a minimally invasive approach necessitates an extended learning curve. For this reason, virtual reality (VR) can be effectively used for planning and training in this demanding surgical technique. OBJECTIVE To validate the mini fronto-orbital (mFO) approach to the superomedial orbit, using VR planning and specimen dissections, conjugating the principles of skull base and keyhole neurosurgery. METHODS Three-dimensional measurements were performed thanks to Surgical Theater (Surgical Theater© LLC), and then, simulated craniotomies were implemented on cadaver specimens. RESULTS The mFO approach affords optimal exposure and operability in the target area and reduced risks of surrounding normal tissue injuries. The eyebrow skin incision, the minimal soft-tissue retraction, the limited temporalis muscle dissection and the single-piece craniotomy, as planned with VR, are the key elements of this minimally invasive approach. Furthermore, the “window-opening” cotton-tip intraorbital dissection technique, based on widening surgical corridors between neuromuscular bundles, provides a safe orientation and a deep access inside the orbit, thereby significantly limiting the risk of jeopardizing neurovascular structures. CONCLUSION The mFO approach associated to the window-opening dissection technique can be considered safe, effective, suitable, and convenient for treating lesions located in the superomedial orbital aspect, up to the orbital apex.

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