Renal Cooling Device for Use in Minimally Invasive Surgery

2012 ◽  
Vol 6 (2) ◽  
Author(s):  
Edward Summers ◽  
Thomas Cervantes ◽  
Rachel Batzer ◽  
Christie Simpson ◽  
Raymond Lewis ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
The Body ◽  
Surgical Removal ◽  
Ice Slurry ◽  
Cooling Device ◽  
Renal Surgery ◽  
Open Renal Surgery ◽  
The U.S

Over 58,000 patients suffer from renal cell carcinoma annually in the U.S. Treatment for this cancer often requires surgical removal of the cancerous tissue in a partial nephrectomy procedure. In open renal surgery, the kidney is placed on ice to increase allowable ischemia time; however, there is no widely accepted method for reducing kidney temperature during minimally invasive surgery. A device has been designed, prototyped, and evaluated to perform effective renal cooling during minimally invasive kidney surgery to reduce damage due to extended ischemia. The device is a fluid-containing bag with foldable cooling surfaces that wrap around the organ. It is deployed through a 15 mm trocar, wrapped around the kidney, and secured using bulldog clamps. The device then fills with an ice slurry and remains on the kidney for up to 20 min. The ice slurry is then removed from the device and the device is retracted from the body. Modeling results and tests of the prototype in a simulated lab environment show that the device successfully cools porcine kidneys from 37°C to 20°C in 6–20 min.

A Sensorized Instrument for Skills Assessment and Training in Minimally Invasive Surgery

2009 ◽  
Vol 3 (4) ◽  
Author(s):  
A. L. Trejos ◽  
R. V. Patel ◽  
M. D. Naish ◽  
A. C. Lyle ◽  
C. M. Schlachta
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Tracking System ◽  
The Body ◽  
Skills Assessment ◽  
Training Methods ◽  
Laparoscopic Instrument ◽  
Rms Error ◽  
And Training

Minimally invasive surgery (MIS) is carried out using long, narrow instruments and significantly reduces trauma to the body, postoperative pain, and recovery time. Unfortunately, the restricted access conditions, limited instrument motion, and degraded sense of touch inherent in MIS result in new perceptual-motor relationships, which are unfamiliar to the surgeon and require training to overcome. Current training methods do not adequately address the needs of surgeons interested in acquiring these skills. Although a significant amount of research has been focused on the development of sensorized systems for surgery, there is still a need for a system that can be used in any training scenario (laparoscopic trainer, animal laboratories, or real surgery) for the purpose of skills assessment and training. A sensorized laparoscopic instrument has been designed that is capable of noninvasively measuring its interaction with tissue in the form of forces or torques acting in all five degrees-of-freedom (DOFs) available during MIS. Strain gauges attached to concentric shafts within the instrument allow the forces acting in different directions to be isolated. An electromagnetic tracking system is used for position tracking. Two prototypes of the sensorized instrument were constructed. Position calibration shows a maximum root mean square (RMS) error of 1.3 mm. The results of the force calibration show a maximum RMS error of 0.35 N for the actuation force, 0.07 N in the x and y directions, and 1.5 N mm for the torque calibration with good repeatability and low hysteresis. Axial measurements were significantly affected by drift, noise, and coupling leading to high errors in the readings. Novel sensorized instruments for skills assessment and training have been developed and a patent has been filed for the design and operation. The instruments measure forces and torques acting at the tip of the instrument corresponding to all five DOFs available during MIS and provide position feedback in six DOFs. The instruments are similar in shape, size, and weight to traditional laparoscopic instruments allowing them to be used in any training environment. Furthermore, replaceable tips and handles allow the instruments to be used for a variety of different tasks.

scholarly journals Teach and Playback Training Device for Minimally Invasive Surgery

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Sriram Garudeswaran ◽  
Sohyung Cho ◽  
Ikechukwu Ohu ◽  
Ali K. Panahi
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Length Of Hospital Stay ◽  
The Body ◽  
Complex Nature ◽  
Training Device ◽  
Surgical Residents ◽  
Work Area ◽  
And Control

Recent technological progress offers the opportunity to significantly transform conventional open surgical procedures in ways that allow minimally invasive surgery (MIS) to be accomplished by specific operative instruments’ entry into the body through key-sized holes rather than large incisions. Although MIS offers an opportunity for less trauma and quicker recovery, thereby reducing length of hospital stay and attendant costs, the complex nature of this procedure makes it difficult to master, not least because of the limited work area and constricted degree of freedom. Accordingly, this research seeks to design a Teach and Playback device that can aid surgical training by key-framing and then reproducing surgical motions. The result is an inexpensive and portable Teach and Playback laparoscopic training device that can record a trainer’s surgical motions and then play them back for trainees. Indeed, such a device could provide a training platform for surgical residents generally and would also be susceptible of many other applications for other robot-assisted tasks that might require complex motion training and control.

scholarly journals Innovative Renal Cooling Device for Use in Minimally Invasive Surgery

2011 ◽  
Vol 5 (2) ◽  
Author(s):  
Ed Summers ◽  
Thomas Cervantes ◽  
Rachel Batzer ◽  
Julia Stark ◽  
Raymond Lewis
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Cooling Device

Port Placement Optimization for Robotically-Assisted Minimally Invasive Surgery

2018 ◽  
Author(s):  
Robert G. Stricko ◽  
Brett Page ◽  
Amy E. Kerdok ◽  
Brandon Itkowitz ◽  
Jason Pile
Keyword(s):  
Minimally Invasive Surgery ◽  
Laparoscopic Surgery ◽  
Minimally Invasive ◽  
Range Of Motion ◽  
Invasive Surgery ◽  
Body Wall ◽  
The Body ◽  
Spatial Awareness ◽  
Port Placement ◽  
Placement Optimization

Minimally invasive surgery (MIS) requires ports to be placed through the body wall in a manner such that instruments can reach a desired area. Limitations of laparoscopic surgery include maintaining triangulation and ergonomics for the surgeon while allowing access to the anatomy with non-wristed instruments [1]. In robotically-assisted MIS, the surgeon does not stand bedside, and they have wristed instruments that the robot manipulates. Limitations of robotically-assisted MIS include range of motion (ROM) limits and decreased spatial awareness, resulting in the potential for interfering robotic components. As a result, port placement varies between laparoscopic and robotically-assisted surgery.

scholarly journals A randomized 500-subject open-label phase 3 clinical trial of minimally invasive surgery plus alteplase in intracerebral hemorrhage evacuation (MISTIE III)

2019 ◽  
Vol 14 (5) ◽  
pp. 548-554 ◽  
Author(s):  
Wendy C Ziai ◽  
Nichol McBee ◽  
Karen Lane ◽  
Kennedy R Lees ◽  
Jesse Dawson ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Intracerebral Hemorrhage ◽  
Invasive Surgery ◽  
Tissue Injury ◽  
Surgical Removal ◽  
Open Label ◽  
Phase 3 ◽  
Patient Disposition ◽  
Open Label Phase

Rationale and hypothesisSurgical removal of spontaneous intracerebral hemorrhage may reduce secondary destruction of brain tissue. However, large surgical trials of craniotomy have not demonstrated definitive improvement in clinical outcomes. Minimally invasive surgery may limit surgical tissue injury, and recent evidence supports testing these approaches in large clinical trials.Methods and designMISTIE III is an investigator-initiated multicenter, randomized, open-label phase 3 study investigating whether minimally invasive clot evacuation with thrombolysis improves functional outcomes at 365 days compared to conservative management. Patients with supratentorial intracerebral hemorrhage clot volume ≥ 30 mL, confirmed by imaging within 24 h ofknown symptom onset,and intact brainstem reflexes were screened with a stability computed tomography scan at least 6 h after diagnostic scan. Patients who met clinical and imaging criteria (no ongoing coagulopathy; no suspicion of aneurysm, arteriovenous malformation, or any other vascular anomaly; and stable hematoma size on consecutive scans) were randomized to either minimally invasive surgery plus thrombolysis or medical therapy. The sample size of 500 was based on findings of a phase 2 study.Study outcomesThe primary outcome measure is dichotomized modified Rankin Scale 0–3 vs. 4–6 at 365 days adjusting for severity variables. Clinical secondary outcomes include dichotomized extended Glasgow Outcome Scale and all-cause mortality at 365 days; rate and extent of parenchymal blood clot removal; patient disposition at 365 days; efficacy at 180 days; type and intensity of ICU management; and quality of life measures. Safety was assessed at 30 days and throughout the study.

scholarly journals Robotic Surgery in Gynecologic Oncology

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
Robert DeBernardo ◽  
David Starks ◽  
Nichole Barker ◽  
Amy Armstrong ◽  
Charles A. Kunos
Keyword(s):  
Minimally Invasive Surgery ◽  
Robotic Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Gynecologic Oncology ◽  
Gynecologic Cancer ◽  
Morbidly Obese ◽  
Surgical Removal ◽  
Surgical Morbidity ◽  
Cancer Management

Robotic surgery for the management of gynecologic cancers allows for minimally invasive surgical removal of cancer-bearing organs and tissues using sophisticated surgeon-manipulated, robotic surgical instrumentation. Early on, gynecologic oncologists recognized that minimally invasive surgery was associated with less surgical morbidity and that it shortened postoperative recovery. Now, robotic surgery represents an effective alternative to conventional laparotomy. Since its widespread adoption, minimally invasive surgery has become an option not only for the morbidly obese but for women with gynecologic malignancy where conventional laparotomy has been associated with significant morbidity. As such, this paper considers indications for robotic surgery, reflects on outcomes from initial robotic surgical outcomes data, reviews cost efficacy and implications in surgical training, and discusses new roles for robotic surgery in gynecologic cancer management.

scholarly journals Monocular tissue reconstruction via remote center motion for robot-assisted minimally invasive surgery

2021 ◽  
Author(s):  
Peng Li ◽  
Ming Tang ◽  
Ke Ding ◽  
Xiaojun Wu ◽  
Yunhui Liu
Keyword(s):  
Minimally Invasive Surgery ◽  
Soft Tissue ◽  
Minimally Invasive ◽  
3D Reconstruction ◽  
Invasive Surgery ◽  
Soft Tissues ◽  
Texture Mapping ◽  
The Body ◽  
Depth Information ◽  
Target Area

AbstractIn minimally invasive surgery, the primary surgeon requires an assistant to hold an endoscope to obtain visual information from the body cavity. However, the two-dimensional images acquired by endoscopy lack depth information. Future automatic robotic surgeries need three-dimensional information of the target area. This paper presents a method to reconstruct a 3D model of soft tissues from image sequences acquired from a robotic camera holder. In this algorithm, a sparse reconstruction module based on the SIFT and SURF features is designed, and a multilevel feature matching strategy is proposed to improve the algorithm efficiency. To recover the realistic effect of the soft-tissue model, a complete 3D reconstruction algorithm is implemented, including densification, meshing of the point cloud and texture mapping reconstruction. During the texture reconstruction stage, a mathematical model is proposed to achieve the repair of texture seams. To verify the feasibility of the proposed method, we use a collaborative manipulator (AUBO i5) with a mounted camera to mimic an assistant surgeon holding an endoscope. To satisfy a pivotal constraint imposed by the remote center of motion (RCM), a kinematic algorithm of the manipulator is implemented, and the primary surgeon is provided with a voice control interface to control the directions of the camera with. We conducted an experiment to show a 3D reconstruction of soft tissue by the proposed method and the manipulator, which indicates that the manipulator works as a robotic assistant which can hold a camera to provide abundant information in the surgery.

Design of a Modular, Partially Disposable Robot for Minimally Invasive Surgery

2018 ◽  
Author(s):  
Nicholas Nelson ◽  
Carl A. Nelson
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Degrees Of Freedom ◽  
The Body ◽  
Rigid Instruments

Most robots for minimally invasive surgery (MIS) are large, bulky devices which mimic the paradigm of manual MIS by manipulating long, rigid instruments from outside the body [1]. Some of these incorporate “wristed” instruments to place some local dexterity at or near the tool tip [2]. In contrast, a small number of MIS robot designs place all of the degrees of freedom inside the patient’s body in order to increase the local dexterity [3].

scholarly journals Mechanical Follow-the-Leader motion of a hyper-redundant surgical instrument: Proof-of-concept prototype and first tests

2019 ◽  
Vol 233 (11) ◽  
pp. 1141-1150 ◽  
Author(s):  
Paul WJ Henselmans ◽  
Gerwin Smit ◽  
Paul Breedveld
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Surgical Procedures ◽  
Invasive Surgery ◽  
Degrees Of Freedom ◽  
Dimensional Space ◽  
Three Dimensional ◽  
The Body ◽  
Standard Size ◽  
Mechanical Approach

One of the most prominent drivers in the development of surgical procedures is the will to reduce their invasiveness, attested by minimally invasive surgery being the gold standards in many surgical procedures and natural orifices transluminal endoscopic surgery gaining acceptance. A logical next step in this pursuit is the introduction of hyper-redundant instruments that can insert themselves along multi-curved paths referred to as Follow-the-Leader motion. In the current state of the art, two different types of Follow-the-Leader instruments can be distinguished. One type of instrument is robotized; the movements of the shaft are controlled from outside the patient by actuators, for example, electric motors, and a controller storing a virtual track of the desired path. The other type of instrument is more mechanical; the movements of the shaft are controlled from inside the patient by a physical track that guides the shaft along the desired path. While in the robotized approach all degrees of freedom of the shaft require an individual actuator, the mechanical approach makes the number of degrees of freedom independent from the number of actuators. A desirable feature as an increasing number of actuators will inevitably drive up costs and increase the footprint of an instrument. Building the physical track inside the body does, however, impede miniaturization of the shaft’s diameter. This article introduces a new fully mechanical approach for Follow-the-Leader motion using a pre-determined physical track that is placed outside the body. This new approach was validated with a prototype called MemoFlex, which supports a Ø5 mm shaft (standard size in minimally invasive surgery) that contains 28-degrees-of-freedom and utilizes a simple steel rod as its physical track. Even though the performance of the MemoFlex leaves room for improvement, especially when following multiple curves, it does validate the proposed concept for Follow-the-Leader motion in three-dimensional space.

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