FUNCTIONAL SALVAGE OF A HAND AFTER UNSUCCESSFULL ATTEMPT OF REPLANTATION

Amputation by crush injuries generally represents a contraindication for replantation, and especially when the lesion is caused by the summation of multiple concomitant traumatic mechanisms.We present the case of a 22 year- old female who arrived in our service with a crush/torsion amputation of all long fingers at the metacarpo-phalangeal level of the right hand. After the unsuccessful attempt of replantation, the functional reconstruction of the hand was achieved by using a double free flap transfer: anterolateral thigh perforator flap (ALT) and digital block transfer of second and third toes.

Autonomous Operation in Surgical Robotics

The article focuses on developing an algorithm for automation based on stereo computer vision and dynamic registration in a surgical robotic context. The performance of the algorithm was further tested experimentally utilizing the block transfer task which corresponds to tissue manipulation as designed by Fundamentals of Laparoscopic Surgery (FLS). The surgical robotics field as a whole progresses towards the reduction of invasiveness limiting the trauma at the periphery of the surgical site and increase of semi-autonomous operation while positioning the surgeon as a decision maker rather than as an operator. The autonomous FLS task is implemented successfully and tested experimentally with the Raven II surgical robot system. The data indicate that the autonomous operational mode has better overall performance and limited tool-environment interaction compared with the human teleoperation mode. Surgeon’s intention may also be extracted from a database that may lead to seamless switching between the human operator and the autonomous system and in that sense, it may allow the autonomous algorithm to cope with more complex surgical environments.