Multi-Functional Surgical Robot for Laparo-Endoscopic Single-Site Colectomies

2011 ◽  
Author(s):  
T. D. Wortman ◽  
R. L. McCormick ◽  
E. J. Markvicka ◽  
T. P. Frederick ◽  
S. M. Farritor ◽  
...  
Keyword(s):  
User Interface ◽  
Operating Room ◽  
Surgical Procedure ◽  
Abdominal Cavity ◽  
Colon Resection ◽  
Surgical Robot ◽  
Single Site ◽  
Robotic Platform ◽  
Robot Platform

This paper presents work to develop a miniature in vivo robot for Laparo-Endoscopic Single-Site (LESS) colectomy. Colon resections are generally not done laparoscopically and would benefit from a robotic platform that reduces the limitations that are currently encountered. This paper looks at the workspace, forces, and speeds of a recently developed miniature in vivo surgical robot platform and analyzes the ability to perform a colon resection based on these criteria. The robotic platform used in this study consists of a two armed robotic prototype and a remote surgeon interface. For the surgical procedure, each arm of the robot is inserted individually into a single five centimeter incision and then assembled within the abdominal cavity. A surgeon then utilizes a user interface that is remotely located within the operating room. The current robotic platform has recently been demonstrated successfully in an in vivo procedure.

Workspace and Force Capabilities of a Miniature Multi-Functional Surgical Robot

2010 ◽  
Author(s):  
Kyle W. Strabala ◽  
Ryan M. McCormick ◽  
Tyler D. Wortman ◽  
Amy C. Lehman ◽  
Shane M. Farritor ◽  
...  
Keyword(s):  
Surgical Robot ◽  
Single Site ◽  
Design Criteria ◽  
Medical Applications ◽  
Laparoendoscopic Single Site ◽  
Animal Surgery ◽  
Laparoendoscopic Single Site Surgery ◽  
Single Site Surgery

This paper describes the capabilities of a miniature multi-functional in vivo robot designed and developed for Laparoendoscopic Single-Site Surgery (LESS). The paper outlines several competing design criteria including robot size, workspace volume, endpoint speeds, and endpoint forces. In this paper, the robot is evaluated according to these criteria. The workspace is described and the maximum no-load endpoint speeds and maximum attainable endpoint forces are presented. Finally, the robot capabilities are discussed, related to medical applications, and demonstrated in an animal surgery.

scholarly journals Single-Site Colectomy With Miniature In Vivo Robotic Platform

2013 ◽  
Vol 60 (4) ◽  
pp. 926-929 ◽  
Author(s):  
T. D. Wortman ◽  
J. M. Mondry ◽  
S. M. Farritor ◽  
D. Oleynikov
Keyword(s):  
Single Site ◽  
Robotic Platform

Multi-Quadrant Surgical Robot for Single Incision Laparoscopic Colectomy

2013 ◽  
Author(s):  
E. J. Markvicka ◽  
R. L. McCormick ◽  
T. P. Frederick ◽  
J. R. Bartels ◽  
S. M. Farritor ◽  
...  
Keyword(s):  
Visual Feedback ◽  
Degrees Of Freedom ◽  
Financial Burden ◽  
Abdominal Cavity ◽  
Surgical Robot ◽  
Surgical Instruments ◽  
Robotic Device ◽  
Incision Site ◽  
Active Research

Colorectal surgery is an area of active research within general surgery. However, over 80% of these procedures currently require an open surgery based on the size and location of the tumor. The current state-of-the-art surgical instruments are unintuitive, restricted by the incision site, and often require timely repositioning tasks during complex surgical procedures. A multi-quadrant miniature in vivo surgical robot has been developed to mitigate these limitations as well as the invasiveness of colorectal procedures. By reducing invasiveness, the patient benefits from improved cosmetics, decreased postoperative pain, faster recovery time, and reduced financial burden. A paradigm shift in invasiveness is often inversely proportional to surgeon benefits. Yet, through the use of a robotic device, the surgeon benefits from improved ergonomics, intuitive control, and fewer required repositioning tasks. This paper presents a two armed robotic device that can be controlled from a remote surgical interface. Each arm has six internally actuated degrees of freedom, decoupling the system from the incision site. Each arm is also equipped with a specialized interchangeable end effector. For the surgical procedure, visual feedback is provided through the use of a standard laparoscope with incorporated light source. The robotic device is introduced into the abdominal cavity through a hand-assisted laparoscopic surgery (HALS) port that is placed within the navel. The device is then grossly positioned to the site of interest within the abdominal cavity through the use of a protruding rod that is rigidly attached to each arm. The surgeon can then begin to manipulate tissue through the use of the surgical interface that is remotely located within the operating room. This interface is comprised of a monitor to provide visual feedback, foot pedals to control the operational state of the device, and two haptic devices to control the end point location of each arm and state of the end effectors.

Biomedical applications: Pitfalls in the practice

1994 ◽  
Vol 52 ◽  
pp. 378-379
Author(s):  
J. D. Shelburne ◽  
Peter Ingram ◽  
Victor L. Roggli ◽  
Ann LeFurgey
Keyword(s):  
Operating Room ◽  
Liquid Nitrogen ◽  
Lung Tissue ◽  
Biomedical Applications ◽  
Microprobe Analysis ◽  
Tissue Sample ◽  
Cellular Level ◽  
Tissue Samples ◽  
Asbestos Fibers

At present most medical microprobe analysis is conducted on insoluble particulates such as asbestos fibers in lung tissue. Cryotechniques are not necessary for this type of specimen. Insoluble particulates can be processed conventionally. Nevertheless, it is important to emphasize that conventional processing is unacceptable for specimens in which electrolyte distributions in tissues are sought. It is necessary to flash-freeze in order to preserve the integrity of electrolyte distributions at the subcellular and cellular level. Ideally, biopsies should be flash-frozen in the operating room rather than being frozen several minutes later in a histology laboratory. Electrolytes will move during such a long delay. While flammable cryogens such as propane obviously cannot be used in an operating room, liquid nitrogen-cooled slam-freezing devices or guns may be permitted, and are the best way to achieve an artifact-free, accurate tissue sample which truly reflects the in vivo state. Unfortunately, the importance of cryofixation is often not understood. Investigators bring tissue samples fixed in glutaraldehyde to a microprobe laboratory with a request for microprobe analysis for electrolytes.

scholarly journals A Dynamic Culture Method to Produce Ovarian Cancer Spheroids under Physiologically-Relevant Shear Stress

Cells ◽  
2018 ◽  
Vol 7 (12) ◽  
pp. 277 ◽  
Author(s):  
Timothy Masiello ◽  
Atul Dhall ◽  
L. Hemachandra ◽  
Natalya Tokranova ◽  
J. Melendez ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Shear Stress ◽  
Fluid Shear Stress ◽  
Abdominal Cavity ◽  
Culture Method ◽  
Experimental Conditions ◽  
Dynamic Cell ◽  
Screening Platform ◽  
Cancer Spheroids

The transcoelomic metastasis pathway is an alternative to traditional lymphatic/hematogenic metastasis. It is most frequently observed in ovarian cancer, though it has been documented in colon and gastric cancers as well. In transcoelomic metastasis, primary tumor cells are released into the abdominal cavity and form cell aggregates known as spheroids. These spheroids travel through the peritoneal fluid and implant at secondary sites, leading to the formation of new tumor lesions in the peritoneal lining and the organs in the cavity. Models of this process that incorporate the fluid shear stress (FSS) experienced by these spheroids are few, and most have not been fully characterized. Proposed herein is the adaption of a known dynamic cell culture system, the orbital shaker, to create an environment with physiologically-relevant FSS for spheroid formation. Experimental conditions (rotation speed, well size and cell density) were optimized to achieve physiologically-relevant FSS while facilitating the formation of spheroids that are also of a physiologically-relevant size. The FSS improves the roundness and size consistency of spheroids versus equivalent static methods and are even comparable to established high-throughput arrays, while maintaining nearly equivalent viability. This effect was seen in both highly metastatic and modestly metastatic cell lines. The spheroids generated using this technique were fully amenable to functional assays and will allow for better characterization of FSS’s effects on metastatic behavior and serve as a drug screening platform. This model can also be built upon in the future by adding more aspects of the peritoneal microenvironment, further enhancing its in vivo relevance.

scholarly journals CAN VIRTUAL REALITY BE AS GOOD AS OPERATING ROOM TRAINING? EXPERIENCE FROM A RESIDENCY PROGRAM IN GENERAL SURGERY

2018 ◽  
Vol 31 (4) ◽  
Author(s):  
Bruno Della Mea GASPERIN ◽  
Thamyres ZANIRATI ◽  
Leandro Totti Cavazzola
Keyword(s):  
Virtual Reality ◽  
Operating Room ◽  
General Surgery ◽  
Training Experience ◽  
Total Procedure Time ◽  
Significant Difference ◽  
Hands On ◽  
Second Year ◽  
Practice Time

ABSTRACT Background: The increasingly intense usage of technology applied to videosurgery and the advent of robotic platforms accelerated the use of virtual models in training surgical skills. Aim: To evaluate the performance of a general surgery department’s residents in a video-simulated laparoscopic cholecystectomy in order to understand whether training with virtual reality is sufficient to provide the skills that are normally acquired in hands-on experience at the operating room. Methods: An observational study with twenty-five first- and second-year general surgery residents. Each subject performed three video-laparoscopic cholecystectomies under supervision in a simulator. Only the best performance was evaluated in the study. Total number of complications and total procedure time were evaluated independently. The groups were defined according to total practice time (G1 and G2) and the year of residency (R1 and R2), each being analysed separately. Results: Twenty-one residents finished the three practices, with four follow-up losses. Mean practice time was 33.5 hours. Lowering of the rate of lesions in important structures could be identified after a level of proficiency of 60%, which all participants obtained regardless of previous in vivo experience. No significant difference between the R1 and R2 groups was observed. Conclusion: Learning in groups R1 and R2 was equal, regardless of whether previous practice was predominantly in vivo (R2) or with virtual reality (R1). Therefore, it is possible to consider that skills obtained in virtual reality training are capable of equalising the proficiency of first- and second-year residents, being invaluable to increase patient safety and homogenise learning of basic surgical procedures.

scholarly journals Kinetics of the cercaria-schistosomul um transformation in vivo: 2. The effect of oxamniquine

1985 ◽  
Vol 18 (4) ◽  
pp. 251-255 ◽  
Author(s):  
A. L. Melo ◽  
L.H. Pereira
Keyword(s):  
Peritoneal Cavity ◽  
Abdominal Cavity ◽  
Long Time ◽  
Peritoneal Washings ◽  
High Doses ◽  
Kinetics Of

To study the cercaria-schistosomulum transformation in vivo, underthe influence of an antischistosomal compound (oxamniquine), a model using cercarial infections into the abdominal cavity of mice was chosen. This procedure provided easy and reproducible recoveries of larvae from peritoneal washings with appropriate solutions for a long time (30 to 180 min) after inoculation. The results show that high doses of oxamniquine (given intramuscularly one hour before the infection) produce a marked delay in the kinetics of the cercaria-schistosomulum transformation. Cercariae, tail-less cercarial bodies and schistosomula were recovered from the peritoneal cavity ofdrug treated mice in numbers significantly different from those recovered from untreated mice.

scholarly journals Concentrations of ceftriaxone (1,000 milligrams intravenously) in abdominal tissues during open prostatectomy.

1996 ◽  
Vol 40 (5) ◽  
pp. 1311-1313 ◽  
Author(s):  
C Martin ◽  
X Viviand ◽  
A Cottin ◽  
V Savelli ◽  
C Brousse ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Single Dose ◽  
Klebsiella Pneumoniae ◽  
Proteus Mirabilis ◽  
Surgical Procedure ◽  
Postoperative Infection ◽  
Abdominal Cavity ◽  
Open Prostatectomy ◽  
Three Stages

Ceftriaxone concentrations in abdominal tissues were evaluated at different stages of open prostatectomy. Ceftriaxone was administered as antibiotic prophylaxis, and 15 consecutive patients were given a single dose of ceftriaxone (1,000 mg intravenously in 1 min) 30 min before surgery. Ceftriaxone concentrations in tissue were determined at three stages of the surgical procedure; upon the opening of the abdominal cavity, during the prostatectomy, and upon the closure of the abdominal cavity. Samples of the following tissues or sample were assayed: epiploic and abdominal-wall fat; Retzius' space, bladder, and prostate tissue; and urine. During the different stages of the surgical procedure, for all patients, and in the different tested tissues, ceftriaxone concentrations greater than or equal to the cutoff point (4 micrograms/g of tissue) were measured. The highest concentrations were obtained in the bladder (43 +/- 18 micrograms/g) and in the prostate (35 +/- 18 micrograms/g). In fatty tissues, concentrations were between 13 +/- 5 and 22 +/- 8 micrograms/g. All patients (15 of 15) had ceftriaxone levels in tissue greater than the MICs for the potential pathogens (Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis). In conclusion, during open prostatectomy and after the use of a single dose of ceftriaxone (1,000 mg), high antibiotic levels were obtained throughout the surgical procedure in the tissues potentially involved in postoperative infection.

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