scholarly journals Robotic Surgery and Successful Set-Up: A Stepwise Approach

2020 ◽  
Author(s):  
Christopher J. Anderson ◽  
Hiten R.H. Patel
Keyword(s):  
Robotic Surgery ◽  
Stepwise Approach ◽  
Set Up

Teaching robotic surgery: a stepwise approach

2006 ◽  
Vol 21 (6) ◽  
pp. 912-915 ◽  
Author(s):  
Mohamed R. Ali ◽  
Jason Rasmussen ◽  
Bobby BhaskerRao
Keyword(s):  
Robotic Surgery ◽  
Stepwise Approach

scholarly journals Robotic Laparoscopic Single-Site Surgery

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.

The Determination of Relevant Contextual Factors for the Interpretation of Intervention Studies: a Stepwise Approach with Online Information (Preprint)

2020 ◽  
Author(s):  
Michael Van der Elst ◽  
Birgitte Schoenmakers ◽  
Eva Dierckx ◽  
Liesbeth De Donder ◽  
Ellen De Roeck ◽  
...  
Keyword(s):  
Intervention Studies ◽  
Contextual Factors ◽  
Local Context ◽  
Future Research ◽  
Online Information ◽  
Web Based ◽  
Stepwise Approach ◽  
Scope Project ◽  
Set Up ◽  
Public Datasets

BACKGROUND The role of the context within intervention studies is often ignored. To consider the context in future research, one needs to know whether enough information is available, and a uniform methodology to study the local context in a standardized way is desirable. Through the World Wide Web, a lot of information is nowadays available. OBJECTIVE The present study aims to test the feasibility of studying the local context with online information and to provide a stepwise approach how to detect these relevant contextual factors which might moderate the effect of an intervention. METHODS The present study is framed within the D-SCOPE project, where a complex intervention by means of home visits was set up to improve the access to tailored care in 3 municipalities (Ghent, Knokke-Heist and Tienen). A case study of these three municipalities was performed to determine which contextual factors could influence the D-SCOPE intervention, a five-step approach was designed and tested: (1) a theoretical/conceptual discussion of relevant contextual factor domains was held; (2) a search was done to find appropriate web-based public datasets which covered these topics with standardized information (e.g., official statistics); (3) a list of all identified contextual factors was made (inventory); (4) a concise list with the assumedly most relevant contextual factors was made by two independent reviewers to reduce the long list of contextual factors+; and (5) a Nominal Grouping Technique was applied. RESULTS Based on the aims of the D-SCOPE intervention, the research team decided that the datasets should cover sociodemographic contextual factors, socioeconomic contextual factors, contextual factors related to care supply/availability or care use and contextual factors related to the local government. The team also decided to use only standardized data. Three public web-based datasets were found resulting in an inventory of 157 contextual factors. After the selection by two independent reviewers, 41 contextual factors were left over and presented in the Nominal Grouping Technique. According to the Nominal Grouping Technique, contextual factors such as: dependency ratio (65+/20-64y), availability of a community center, percentage of people aged 65 or more living alone, and the total resources of the community social security system were considered as most decisive. CONCLUSIONS The present study shows that the five-step approach is feasible to determine relevant contextual factors that might affect the results of an intervention study. Such information may be used to correct for in the statistical analyses and for interpretation of the outcomes of intervention studies. CLINICALTRIAL none

scholarly journals Stepwise approach for implementation of antimicrobial resistance surveillance in Africa

2016 ◽  
Vol 5 (3) ◽  
Author(s):  
Olga Perovic ◽  
Constance Schultsz
Keyword(s):  
Antimicrobial Resistance ◽  
Capacity Building ◽  
Gap Analysis ◽  
Treatment Guidelines ◽  
African Countries ◽  
Stepwise Approach ◽  
Laboratory Capacity ◽  
New Antibiotics ◽  
Key Issues ◽  
Set Up

Background: Antimicrobial resistance (AMR) has reached an end point, prompting a worldwide scare as no new antibiotics are in the pipeline, particularly for treatment of Gram-negative bacteria. To prevent further development and spread of AMR and to inform empirical treatment guidelines, surveillance of AMR is necessary.Objective: We aim to provide a framework for a stepwise approach toward implementation of laboratory-based surveillance for AMR in African countries.Methods and Results: Building up a surveillance system is a robust process that begins with a gap analysis in each participating country. This framework provides practical guidance on how to set up surveillance, identify responsibilities and set timelines in sustainable manner for African countries. It addresses sampling strategies, human resources, procurement and maintenance issues for AMR testing at routine clinical and national reference and public health laboratories involved in AMR surveillance. Key issues such as laboratory capacity building, training and continuous education, quality and diagnostic stewardship are discussed in detail.Discussion: There are several priorities for AMR surveillance that need to be addressed in a comprehensive manner at regional and national levels, whilst keeping in line with current and proposed initiatives for laboratory capacity building, in order for African countries to achieve goals for combatting the real and current threat of AMR.

282 Set up of a xenogenic, orthotopic and bioluminescent model of localized lung cancer in mice: a stepwise approach

2010 ◽  
Vol 8 (7) ◽  
pp. 91-92
Author(s):  
P. Mordant ◽  
B. Lahon ◽  
Y. Loriot ◽  
Y. Castier ◽  
J.C. Soria ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Stepwise Approach ◽  
Set Up

A prospective study of the components of operating room utilisation time for robotic urological surgery in a public teaching hospital setting

2020 ◽  
pp. 205141582094271
Author(s):  
Mark P Broe ◽  
Jarlath M Bolger ◽  
Sarah Norton ◽  
Silviu David ◽  
John C Coffey ◽  
...  
Keyword(s):  
Robotic Surgery ◽  
Operating Room ◽  
Outcome Measures ◽  
Operative Time ◽  
Significant Proportion ◽  
Learning Curves ◽  
Secondary Outcome ◽  
Port Placement ◽  
Depth Analysis ◽  
Set Up

Introduction and aim: Although there are several publications on learning curves and patient outcomes in robotic surgery, the literature is lacking in depth analysis of operating room (OR) utilisation time which is an expansive healthcare resource for robotic surgery, especially in urology. Thus, we aimed to study individual operating theatre component times in order to improve performance and efficacy. Method: A cross-specialty robotic-surgery programme was established at our institution in mid-June 2016 using the daVinci Xi dual console robot. A detailed database was established before initiation of the project. The times taken for each element of the preparation and completion of robotic urological procedure were collected by an independent nurse for all the procedures. Primary outcome measures were total OR time, operative time and console time. Secondary outcome measures were port placement time, set-up time and non-operative time. The statistical significance was calculated by using the Student’s t-test, Fisher’s exact test or Wilcoxon matched pairs test where appropriate. Result: Thirty consecutive urological cases were analysed. Mean total OR time, operative time and console time were 320.86 (range 172–485), 235.7 (124–295) and 152.3 min (66–219) respectively. Console time accounted for about less than half of OR time. A significant proportion of OR time was non-operative time (almost one third). After an initial learning curve, set-up time was consistently maintained for most robotic procedures. Conclusions: The findings of this study have three implications for clinical practice. Firstly, console time contributed about half of the OR time. This can be optimised with experience. Secondly robot set-up time is likely to reduce with the experience of the whole team. Finally, non-operative OR time constitute a significant one third of the OR time during robotic surgery. Efforts to reduce non-surgical aspect of OR time will have potential to reduce cost and improve efficiency. Level of Evidence: 4

PS02.010: ESTABLISHMENT OF THE UPPER GI INTERNATIONAL ROBOTIC ASSOCIATION (UGIRA)

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 123-123
Author(s):  
Berend Kingma ◽  
M Chaudry ◽  
Philip Chiu ◽  
Peter Grimminger ◽  
James Luketich ◽  
...  
Keyword(s):  
Robotic Surgery ◽  
Conflicts Of Interest ◽  
Gastric Surgery ◽  
Web Based ◽  
Global Consensus ◽  
Effective Implementation ◽  
Upper Gi ◽  
International Registry ◽  
Effective Training ◽  
Set Up

Abstract Background Robot-assisted surgery is increasingly performed for both benign and malignant upper gastro-intestinal disease. However, no global consensus exists regarding exact techniques and implementation methods of robotic esophageal and gastric surgery. To facilitate the effective implementation and advancement of these procedures, evidence based guidelines should be generated. In this context, the ‘Upper GI International Robotic Association’ (UGIRA) was established in 2017. Until now, 20 experienced robotic surgeons from 10 different countries in Europe (The Netherlands, Germany, United Kingdom, Denmark), Asia (Japan, Hong Kong, North-Korea, Taiwan), North-America (United States of America), and South-America (Brazil) have confirmed to become a member of the UGIRA. By means of an oral presentation, we would like to announce the establishment of the UGIRA and to introduce its primary aims, which are: To set up a web-based registry for international data collection.An international registry is created to enable international collaboration on research. Data collection should especially focus on the robotic elements of upper gastro-intestinal surgery, such as trocar positions, anastomotic technique, conduit stapling technique, and conduit diameter in esophagectomy.To establish guidelines for robotic upper gastro-intestinal surgical procedures.The approach to robotic upper gastro-intestinal surgical procedures should be standardized by formulating step-by-step guidelines. These guidelines will encompass robotic surgery for both benign (i.e. hiatal hernia, fundoplication) and malignant disease (i.e. esophageal and gastric cancer), with the exception of bariatric procedures.To form effective training programs that involve proctoring by experienced surgeons.In order to safely implement robotic surgery, training pathways that involve proctoring should be followed. The UGIRA will serve as the core platform to establish these training pathways and to appoint proctors in all continents. Completion of the training pathway will result in UGIRA credentialing. Methods Not applicable. Results Not applicable. Conclusion The UGIRA was recently established to facilitate the effective implementation and advancement of robotic esophageal and gastric surgery worldwide. To this end, the primary aims include setting up a web-based international registry, establishing guidelines for robotic upper gastro-intestinal procedures, and forming effective training pathways that involve proctoring. Disclosure All authors have declared no conflicts of interest.

The Effects of Drying Techniques on Clay-Rich Soil Texture

1974 ◽  
Vol 32 ◽  
pp. 466-467
Author(s):  
T. G. Naymik
Keyword(s):  
Critical Point ◽  
Liquid Nitrogen ◽  
Liquid Nitrogen Temperature ◽  
Drying Methods ◽  
Air Drying ◽  
Freeze Dried ◽  
Critical Point Drying ◽  
Set Up ◽  
The Relationship ◽  
Quartz Grains

Three techniques were incorporated for drying clay-rich specimens: air-drying, freeze-drying and critical point drying. In air-drying, the specimens were set out for several days to dry or were placed in an oven (80°F) for several hours. The freeze-dried specimens were frozen by immersion in liquid nitrogen or in isopentane at near liquid nitrogen temperature and then were immediately placed in the freeze-dry vacuum chamber. The critical point specimens were molded in agar immediately after sampling. When the agar had set up the dehydration series, water-alcohol-amyl acetate-CO2 was carried out. The objectives were to compare the fabric plasmas (clays and precipitates), fabricskeletons (quartz grains) and the relationship between them for each drying technique. The three drying methods are not only applicable to the study of treated soils, but can be incorporated into all SEM clay soil studies.

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