surgical tool
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2022 ◽  
Vol 239 ◽  
pp. 107860
Yao Xue ◽  
Siming Liu ◽  
Yonghui Li ◽  
Ping Wang ◽  
Xueming Qian

G P Bijvoet ◽  
S M Chaldoupi ◽  
E Bidar ◽  
R J Holtackers ◽  
J G L M Luermans ◽  

Abstract Background Surgical epicardial AF ablation can be performed as a stand-alone (thoracoscopic) procedure or concomitant to other cardiac surgery. In hybrid AF ablation thoracoscopic surgical epicardial ablation is combined with a percutaneous endocardial ablation. The Medtronic Gemini-S clamp is a surgical tool that uses irrigated bipolar biparietal RF energy applied with two clamp lesions that overlap to create one epicardial box lesion including the posterior LA wall and the pulmonary veins. Case summary We describe three patients with therapy-refractory persistent AF and different stages of atrial remodelling in whom the Medtronic Cardioblate Gemini-S Irrigated RF Surgical Ablation System was used for hybrid AF ablation. Acute endocardial validation at the end of the hybrid ablation revealed a complete box lesion in all three cases. At 2-year follow-up, two out of three patients had recurrence of atrial arrhythmias. Invasive electro-anatomical mapping confirmed persistence of the box lesion, and the mechanism of arrhythmia recurrence in both patients was unrelated to posterior left atrium or the pulmonary veins. The third patient has been without arrhythmia symptoms since the ablation procedure. A 3D late gadolinium enhancement (LGE) magnetic resonance imaging (MRI) illustrates the ablation scar non-invasively in two cases. Discussion Thoracoscopic biparietal RF AF ablation with the Medtronic Cardioblate Gemini-S Irrigated RF Surgical Ablation System results in permanent transmural scar formation, irrespective of the stage of atrial remodelling, as shown in this small population by means of multimodality scar evaluation.

Robotics ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 129
Lamar O. Mair ◽  
Sagar Chowdhury ◽  
Xiaolong Liu ◽  
Onder Erin ◽  
Oleg Udalov ◽  

The application of force in surgical settings is typically accomplished via physical tethers to the surgical tool. While physical tethers are common and critical, some internal surgical procedures may benefit from a tetherless operation of needles, possibly reducing the number of ports in the patient or the amount of tissue damage caused by tools used to manipulate needles. Magnetic field gradients can dynamically apply kinetic forces to magnetizable objects free of such tethers, possibly enabling ultra-minimally invasive robotic surgical procedures. We demonstrate the untethered manipulation of a suture needle in vitro, exemplified by steering through narrow holes, as well as needle penetration through excised rat and human tissues. We present proof of principle manipulations for the fully untethered control of a minimally modified, standard stainless steel surgical suture needle.

Cureus ◽  
2021 ◽  
Baraa Mafrachi ◽  
Abdallah Al-Ani ◽  
Ashraf Al Debei ◽  
Mohamad Elfawair ◽  
Hussien Al-Somadi ◽  

2021 ◽  
Joonho Byun ◽  
Moinay Kim ◽  
Sang Woo Song ◽  
Young-Hoon Kim ◽  
Chang Ki Hong ◽  

Abstract Introduction : Surgery for cerebellar hemangioblastoma can be challenging because of the tumor’s location in the posterior fossa and its inherent nature of hypervascularity. Methods We reviewed a total of seven consecutive patients who received microsurgery adjunction with indocyanine green (ICG) videoangiography. Results Our study included four female and three male patients. All tumors were located in the cerebellum. We used ICG videoangiography for the purposes of identifying a small tumor inside the cyst in one case, for defining feeding arteries and draining veins in three cases, for confirming residual tumor in the resection cavity in two cases, and for assessment of tumor shunt flow in one case of extremely hypervascular hemangioblastoma. Median blood loss during surgery was 100 mL, and total resection was achieved in all cases with no complications. No adverse effects of ICG videoangiography were observed. Conclusions ICG videoangiography is a very useful adjunctive tool for cerebellar hemangioblastoma surgery.

Mohammad Fattahi Sani ◽  
Raimondo Ascione ◽  
Sanja Dogramadzi

Purpose: Recent developments in robotics and artificial intelligence (AI) have led to significant advances in healthcare technologies enhancing robot-assisted minimally invasive surgery (RAMIS) in some surgical specialties. However, current human–robot interfaces lack intuitive teleoperation and cannot mimic surgeon’s hand/finger sensing required for fine motion micro-surgeries. These limitations make teleoperated robotic surgery not less suitable for, e.g. cardiac surgery and it can be difficult to learn for established surgeons. We report a pilot study showing an intuitive way of recording and mapping surgeon’s gross hand motion and the fine synergic motion during cardiac micro-surgery as a way to enhance future intuitive teleoperation. Methods: We set to develop a prototype system able to train a Deep Neural Network (DNN) by mapping wrist, hand and surgical tool real-time data acquisition (RTDA) inputs during mock-up heart micro-surgery procedures. The trained network was used to estimate the tools poses from refined hand joint angles. Outputs of the network were surgical tool orientation and jaw angle acquired by an optical motion capture system. Results: Based on surgeon’s feedback during mock micro-surgery, the developed wearable system with light-weight sensors for motion tracking did not interfere with the surgery and instrument handling. The wearable motion tracking system used 12 finger/thumb/wrist joint angle sensors to generate meaningful datasets representing inputs of the DNN network with new hand joint angles added as necessary based on comparing the estimated tool poses against measured tool pose. The DNN architecture was optimized for the highest estimation accuracy and the ability to determine the tool pose with the least mean squared error. This novel approach showed that the surgical instrument’s pose, an essential requirement for teleoperation, can be accurately estimated from recorded surgeon’s hand/finger movements with a mean squared error (MSE) less than 0.3%. Conclusion: We have developed a system to capture fine movements of the surgeon’s hand during micro-surgery that could enhance future remote teleoperation of similar surgical tools during micro-surgery. More work is needed to refine this approach and confirm its potential role in teleoperation.

Alina Predescu

Serban Oliver Tataru and Alfred Guzzetti are filmmakers that investigate on camera the role of memory in the construction of family history. They interview family members, gather old home movies and family photographs, and dig for public archival footage, in an effort to assume their position within a personal historical continuum, and to affirm their agency within their familial community. In their creative affirmation of generational subjectivity, they push against accepted familial narratives, and use the camera as a surgical tool that troubles lingering wounds beyond the surface of old images. In Anatomy of a Departure (2012), Romanian-German filmmaker Serban Oliver Tataru interviews his parents about their decision to emigrate from Ceausescu’s Romania while he was a teenager, scrutinizing on camera the conditions and consequence of a life-changing decision. While the dynamic of filming one’s own family is reminiscent of home movie tropes, and the tension built around sharing delicate memories reveals an intimacy usually intended to remain private, the film proposes a multilayered performance of the authorial self. As the film reveals a self-portrait set against the familial portrait (Marianne Hirsch), an inherent performative element acts as the necessary mediator between private and public, between ethic, aesthetic and politic. Negotiating between a restorative and a reflective nostalgia (Svetlana Boym), Tataru proposes a live performance of homecoming.

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