Port Placement Optimization for Robotically-Assisted Minimally Invasive Surgery

Author(s):  
Robert G. Stricko ◽  
Brett Page ◽  
Amy E. Kerdok ◽  
Brandon Itkowitz ◽  
Jason Pile

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.

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yunjin Wang ◽  
Liu Chen ◽  
Xu Cui ◽  
Chaoming Zhou ◽  
Qing Zhou ◽  
...  

Abstract Background The purpose of this study was to investigate the clinical effect of minimally invasive surgery for inguinal cryptorchidism. Methods The patients were divided into the minimally invasive surgery group (n = 100) and the traditional surgery group (n = 58). In the minimally invasive surgery group, patients with low inguinal cryptorchidism (n = 54) underwent surgery with a transscrotal incision, and patients with high inguinal cryptorchidism (n = 46) underwent laparoscopic surgery. Results There was no difference in the hospital stay duration or cost between the minimally invasive surgery group and the traditional surgery group (P > 0.05). As for the operative time, minimally invasive surgery of low inguinal cryptorchidism was shorter than traditional surgery (P = 0.033), while minimally invasive surgery of high inguinal cryptorchidism was comparable to traditional surgery (P = 0.658). Additionally, there were no cases of testicular atrophy, testicular retraction, inguinal hernia or hydrocele in either group. There was no significant difference in the incidence of poor wound healing between the two groups (P > 0.05). Although there was no significant difference in the incidence of scrotal hematoma between the two groups (P > 0.05), the incidence in the minimally invasive surgery group was higher than that in the traditional surgery group. Conclusions Minimally invasive surgery including a transscrotal incision for low inguinal cryptorchidism and laparoscopic surgery for high inguinal cryptorchidism is as safe and effective as traditional surgery, and could also provide a good cosmetic effect for children.


2020 ◽  
Vol 3 (68) ◽  
pp. 116
Author(s):  
Cătălin Bogdan Coroleucă ◽  
Manu Andrei ◽  
Alexandra Bauşic ◽  
Ana-Maria Rădulescu ◽  
Ciprian Andrei  Coroleucă ◽  
...  

2015 ◽  
Vol 23 (1) ◽  
pp. 81-85 ◽  
Author(s):  
Osa Emohare ◽  
Molly Stapleton ◽  
Alejandro Mendez

Resection of large presacral schwannomas can present a challenge. The posterior approach is commonly associated with coccygeal disarticulation, partial sacral resection, and muscular disarticulation, which can all result in significant morbidity. Minimally invasive surgery may obviate some of the morbidity traditionally associated with this approach. The authors present the case of a morbidly obese 49-year-old man with an enlarging presacral schwannoma. The patient refused laparoscopic resection because of the morbidity he had experienced with a previous laparoscopic surgery. The tumor was resected using a minimally invasive paracoccygeal approach, which affords improved access with minimal morbidity.


2012 ◽  
Vol 6 (2) ◽  
Author(s):  
Edward Summers ◽  
Thomas Cervantes ◽  
Rachel Batzer ◽  
Christie Simpson ◽  
Raymond Lewis ◽  
...  

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.


2020 ◽  
Author(s):  
Yunjin Wang ◽  
Liu Chen ◽  
Xu Cui ◽  
Chaoming Zhou ◽  
Qing Zhou ◽  
...  

Abstract Background: The purpose of this study was to investigate the clinical effect of minimally invasive surgery for inguinal cryptorchidism.Methods: The patients were divided into the minimally invasive surgery group (n=100) and the traditional surgery group (n=58). In the minimally invasive surgery group, patients with low inguinal cryptorchidism (n=54) underwent surgery with a transscrotal incision, and patients with high inguinal cryptorchidism (n=46) underwent laparoscopic surgery. Results: There was no difference in the hospital stay duration or cost between the minimally invasive surgery group and the traditional surgery group (P>0.05). As for the operative time, minimally invasive surgery of low inguinal cryptorchidism was shorter than traditional surgery (P=0.033), while minimally invasive surgery of high inguinal cryptorchidism was comparable to traditional surgery (P=0.658). Additionally, there were no cases of testicular atrophy, testicular retraction, inguinal hernia or hydrocele in either group. There was no significant difference in the incidence of poor wound healing between the two groups (P>0.05). Although there was no significant difference in the incidence of scrotal hematoma between the two groups (P>0.05), the incidence in the minimally invasive surgery group was higher than that in the traditional surgery group. Conclusions: Minimally invasive surgery including a transscrotal incision for low inguinal cryptorchidism and laparoscopic surgery for high inguinal cryptorchidism is as safe and effective as traditional surgery, and could also provide a good cosmetic effect for children.


2008 ◽  
Vol 90 (2) ◽  
pp. 48-49
Author(s):  
Mark Coleman

Over the last two decades, minimally invasive surgery (MIS) has become the mainstream method for the treatment of many abdominal diseases previously treated by open surgery. It has resulted in improvements in many outcomes during and after surgery. The Royal College of Surgeons of England has always played an active role in training both consultant surgeons and trainees in minimally invasive surgery with courses such as the Intercollegiate Basic Surgical Skills Courses (BSS) and laparoscopic cholecystectomy courses run in the College itself and in regional units. Laparoscopic surgery itself presents unique challenges that demand that courses be designed specifically with these in mind.


2006 ◽  
Vol 18 (3) ◽  
pp. 249-256 ◽  
Author(s):  
Makoto Jinno ◽  
◽  
Takamitsu Sunaoshi ◽  
Toyomi Miyagawa ◽  
Takehiro Hato ◽  
...  

Minimally invasive surgery accelerates postoperative recovery, but can only be applied by surgeons having advanced conduct skills. We developed a master-slave manipulator, i.e., robotic forceps for laparoscopic surgery that enhances surgical skill. Robotic forceps consists of a master-slave manipulator, a support component, a controller, an operating conditions display, and a foot switch for changing operating conditions. This paper details specifications and components of robotic forceps and evaluates conductance, such as measurement of the slave hand’s grip and suturing and ligaturing, conducted on a sponge stomach model. A comparison of support function in experiments demonstrates their effectiveness.


2009 ◽  
Vol 3 (4) ◽  
Author(s):  
A. L. Trejos ◽  
R. V. Patel ◽  
M. D. Naish ◽  
A. C. Lyle ◽  
C. M. Schlachta

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.


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