Finding the curved pathway of the large intestine for robot-aided colonoscopy

To assist the insertion of a robot-aided endoscope during colonoscopy, a measuring system is required so that the endoscope tip can align automatically and thus find the curved pathway of the large intestine. To achieve this, a selfexpanding nitinol wire basket is used to sense the contour of the intestine. As the wire basket touches the wall, it is deflected towards the center of the intestine. The relative position of the wire basket within the camera image is captured, which describes the desired direction to follow the organ. To identify the wire basket in the image, the original RGB image stream is converted into the HSV (hue, saturation, value) color space. Thus, a binary image can be created, in which only the neongreen color portion of the wire basket is visible as a cross. The Hough Transformation is used to search for straight lines in the binary image. Once two lines are found, the intersection point can be calculated and thus its position in the image. The evaluation of the execution time of the algorithm on a live stream was 45 ± 31 ms on average. The algorithm robustly recognizes the wire basket even if it was not visible to the human eye in the original RGB image due to deficient lighting.

Impacts of Wire Basket Retention and Removal on Whole Tree Stability and Long-term Growth1

When balled-and-burlapped trees are planted, a decision must be made regarding whether the wire basket, burlap, and other packing materials should be removed (completely or partially) or retained. While past research has failed to show a significant impact of either approach with regard to initial growth and establishment, many professionals still question whether a decision to leave the wire basket intact at planting will have longer-term impacts to tree health and stability. In this study, we revisit two nursery trials first initiated in 2011 and 2012 to assess the impact of burlap folding, and full wire basket removal, partial removal, or retention on tree growth and root anchorage five to six growing years after planting. We found that neither stem caliper (min P = 0.249) nor twig elongation (min P = 0.297) differed among removal treatments with the Norway maple (Acer platanoides L.) and ‘Skycole' honeylocust (Gleditsia triacanthos L. var. inermis) trees used in this study. Similarly, we were unable to detect any differences in rooting strength among the removal treatments tested (min P = 0.154). These results serve as further evidence that wire baskets are not a cause of early tree mortality or instability. Index words: Arboriculture, biomechanics, growth and longevity, nursery production, static-pull test, transplanting, transplant shock. Species used in this study: Norway maple (Acer platanoides L.); ‘Skycole' honeylocust (Gleditsia triacanthos L. var. inermis).

The Efficacy and Safety of Simultaneous Use of Wire Stone Basket and Pneumatic Lithotripter Probe in the Treatment of Ureteral Stones: Randomized Control Trial

Introduction: A routine treatment of ureteral stones is using ureteroscopic lithotripsy, a common problem of which is retropulsion of the stone to the renal pelvis and calyces that reduces the rate of lithotripsy’s success. In this study, we aim to investigate the safety and success of using wire basket to hold the stones along with pneumatic lithotripstic probe in endoscopic lithotripsy of ureteral stones. Methods: Patients with ureteral stone were randomly divided to groups A and B. Group A (control) undergone lithotripsy without basket and group B (case) with wire basket along with pneumatic lithotripsy. In addition to demographic and clinical data, rate of success, retropulsion and residual stone with a size of greater than 3 mm were collected, before, during and after lithotripsy. Additionally, the total duration of lithotripsy and ureteral traumatic side effects was also recorded in both groups. All the patients were followed up until their discharge. Data was analyzed using SPPSS ve. 20. Results: There was no significant difference between groups by the point of demographic data. When compared together, there was no significant difference between the location, side and size of the stone and duration of the lithotripsy in both groups. The rate of lithotripsy success was significantly higher in the case group. The incidence of retropulsion and need for a secondary intervention was significantly higher in the control group. We didn’t have any ureteral trauma in neither control nor case group. Conclusion: Based on the results of this study, using wire basked as an anti retropulsion device increases the stone free rate in addition to it’s easy applicability, So it can be useful in treatment of ureteral stone.

Impacts of Wire Basket Retention and Removal on Fraxinus americana ‘Autumn Purple’ Growth Nine Years After Transplanting

The topic of wire basket removal during planting remains an area of contention among nursery growers, landscapers, and arborists who work with balled-and-burlapped planting material. Those in favor of removal fear that the burlap and wire surrounding a tree’s root ball will impede root regrowth and eventually lead to the girdling of any roots that do penetrate into the surrounding soil. Those opposed to removal believe the advantages to tree and root system stability during transplanting and establishment outweigh any negatives to leaving the root ball intact. In 2008, 45 Fraxinus Americana ‘Autumn Purple’ were randomly assigned one of three transplanting treatments: 1) transplanted by tree spade without burlap/wire; 2) transplanted as balled-and-burlapped with only burlap and string removed; or 3) transplanted as balled-and-burlapped with all packaging materials (i.e., string, burlap, wire basket) removed. All trees survived regardless of treatment. In addition to survival, trunk diameter and tree height were measured annually for nine years. Marginal differences were noted for the two growth responses over the course of the trial (min P-value = 0.0599).

Too hot to handle: how quickly do surgical instruments cool sufficiently to use safely following sterilisation using the Medical Device Decontamination Capability (Forward)?

The Role 2 Basic medical treatment facility deploys with the Medical Device Decontamination Capability (MDDC) (Forward) to sterilise re-usable surgical instruments. After use, the instrument sets are placed in a wire basket, unwrapped and sterilised using MDDC (Forward). The instrument sets are taken out of the steriliser at 69°C but need to cool before reaching a safe handling temperature. If the instruments are needed immediately for surgery, current practice is to pour water over the instruments to speed the cooling process, although it is not known how long instruments take to reach a safe working temperature range. We compared the current standard practice of cooling against four other methods in order to establish the optimum technique.

Sialendoscopy, a minimally invasive diagnostic and interventional tool in the management of salivary gland diseases

Introduction. Sialendoscopy is a novel branch of minimally invasive surgery, which allows diagnostic and interventional procedures deep in the ductal systems of salivary glands. Clinical Department of Otorhinolaryngology and Cervicofacial Surgery Ljubljana is a joint otorhinolaryngological sialendoscopy center, representing in that field both Slovenian University Medical Centers.Patients and methods. Since 2011, from among more than 200 patients with unexplained swelling of the salivary glands, we have submitted 118 patients to sialendoscopy and sialendoscopy-assisted interventions and performed 131 operations (78.6% under local anesthesia), with an attempted examination of a total of 137 salivary glands. The patients had mainly submandibular problems (66%).Results. Our rate of failed sialendoscope introductions is 2.9% so far, which is comparable to the best results abroad. The most common interventional procedure was sialendoscopy-assisted combined approach salivary stone removal (36 cases). Adding 16 cases of wire basket stone retrievals, we reached a total of 52 successful stone extraction procedures. We found ductal strictures without sialolithiasis in 40 patients, mostly of parotid systems (24 patients), and in 19 of them, dilatation was performed, followed by a temporary stent insertion in 11 cases. In three patients with submandibular papillary stricture, we performed microsurgical ductostomy; our experience supports its recognition as a specific clinical entity. With no serious complications, the practice of sialendoscopy at our department reduced salivary gland resections because of obstructive disease by 90 %.Conclusions. We believe that sialendoscopy is a new minimally invasive approach paradigm that fundamentally changes the treatment of obstructive salivary gland diseases.

Sialendoscopy-assisted transfacial surgery for the removal of an iatrogenic foreign body in Stensen's duct: a stone and broken wire basket

Background:A foreign body is a rare cause of parotid gland obstructive sialadenitis; intra-oral penetration via Stensen's duct is unusual. The relatively recent introduction of interventional sialendoscopy to treat obstructive sialadenitis has allowed surgeons to adopt a gland-sparing approach by means of miniaturised endoscopes and instruments. However, unusual anatomy or pathological conditions can give rise to a risk of intraductal rupture that may lead to a subsequent iatrogenic foreign body.Case report:This paper describes the case of a patient with a 4 mm stone engaged by a broken wire basket stuck in a secondary branch of Stensen's duct.Results:The iatrogenic foreign body was successfully retrieved by means of sialendoscopy-assisted transfacial surgery.Conclusion:This is the first reported case of an intraductal rupture of a miniaturised device during interventional sialendoscopy successfully resolved by means of combined endoscopy and external surgery. This proved to be an effective method of rescuing a foreign body stuck in Stensen's duct.