Cooperative Robotic System to Support Surgical Interventions

How can robot-assisted surgery provide value for money?

BMJ Surgery, Interventions, & Health Technologies ◽

10.1136/bmjsit-2020-000042 ◽

2021 ◽

Vol 3 (1) ◽

pp. e000042

Author(s):

Sejal Patel ◽

Maroeska M Rovers ◽

Michiel J P Sedelaar ◽

Petra L M Zusterzeel ◽

Ad F T M Verhagen ◽

...

Keyword(s):

Current System ◽

Health Effect ◽

Cost Effective ◽

Robotic System ◽

Utilization Rate ◽

Value For Money ◽

Robot Assisted ◽

Surgical Interventions ◽

Interactive Tool ◽

Robot Assisted Surgery

ObjectivesTo develop an interactive tool that estimates what potential benefits are needed for the robot to provide value for money when compared with endoscopic or open surgical interventions.DesignA generic online interactive tool was developed to analyze the (health) effects needed to compensate for the additional costs of using a surgical robotic system from a healthcare perspective. The application of the tool is illustrated with a hypothetical new surgical robotic platform. A synthesis of evidence from different sources was used combined with interviews with surgeons.SettingFlexible tool that can be adapted to flexible settings.ParticipantsAny hospital patient group for which robotic, endoscopic or open surgical procedures may be considered as appropriate treatment alternatives (eg, urology, gynecology, and so on).InterventionRobotically assisted surgical interventions.ComparatorEndoscopic or open surgical interventions.Main outcome measuresThresholds of how much (health) effect is needed for robot-assisted surgery to provide value for money and to become cost-effective.ResultsThe utilization rate of the surgical robotic system and a reduction in complications appeared to be important aspects in determining the value for money. To become cost-effective, it was deemed important for new surgical robotic systems to have added clinical benefit and become less costly than the current system.ConclusionsThis paper and its assisting interactive tool can be used by clinicians, researchers, and policymakers to gain insight in the benefit needed to provide value for money when using a (new) surgical robotic system or, when the effects are known or can be estimated, to assess the value for money for a specific indication. For robotic surgery to provide most value for money, we recommend assessing for each indication whether the necessary effects seem achievable.

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Virtual fixtures with autonomous error compensation for human–robot cooperative tasks

Robotica ◽

10.1017/s0263574709990415 ◽

2009 ◽

Vol 28 (2) ◽

pp. 267-277 ◽

Cited By ~ 11

Author(s):

Raúl A. Castillo-Cruces ◽

Jürgen Wahrburg

Keyword(s):

Control Strategy ◽

Error Compensation ◽

Robotic System ◽

Cooperative System ◽

Complete Control ◽

End Effector ◽

Surgical Interventions ◽

Virtual Fixtures ◽

Cooperative Tasks

SUMMARYThis paper presents a control strategy for surgical interventions, applied on a human–robot cooperative system, which facilitates the sharing of responsibilities between surgeon and robot. The controller utilizes virtual fixtures to constrain the movements of the end-effector into a predefined path or region. Possible deviation error can be compensated in two different ways: (a) manual compensation and (b) autonomous compensation. With manual compensation, the system defines both virtual fixtures and error compensation directions, but the surgeon must apply manual forces himself/herself in order to generate end-effector motion. With autonomous compensation, a clear distribution of responsibilities between surgeon and robotic system is present, meaning the surgeon has complete control of the end-effector along the preferred directions, while the robot autonomously compensates for any deviation along the non-preferred directions.

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A Fully Sensorized Cooperative Robotic System for Surgical Interventions

Sensors ◽

10.3390/s120709423 ◽

2012 ◽

Vol 12 (7) ◽

pp. 9423-9447 ◽

Cited By ~ 8

Author(s):

Saúl Tovar-Arriaga ◽

José Emilio Vargas ◽

Juan M. Ramos ◽

Marco A. Aceves ◽

Efren Gorrostieta ◽

...

Keyword(s):

Robotic System ◽

Surgical Interventions

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1272: Do Younger Physicians Acquire Laparoscopic Skills Faster than their Senior Colleagues? Influence of the Davinci Robotic System

The Journal of Urology ◽

10.1016/s0022-5347(18)38497-0 ◽

2004 ◽

Vol 171 (4S) ◽

pp. 335-335

Author(s):

David A. Anderson ◽

David S. Wang

Keyword(s):

Robotic System ◽

Laparoscopic Skills

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The association of gynaecological malignancies with hemorheological parameters during the surgical interventions

Geburtshilfe und Frauenheilkunde ◽

10.1055/s-0036-1593008 ◽

2016 ◽

Vol 76 (10) ◽

Author(s):

P Pinidis ◽

A Liberis ◽

Z Koukouli ◽

P Naoumis ◽

C Bouschanetsis ◽

...

Keyword(s):

Surgical Interventions ◽

Gynaecological Malignancies

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Antiplasmin Deficiency in Polycythaemia: a Form of Thrombopathy

Thrombosis and Haemostasis ◽

10.1055/s-0038-1654576 ◽

1961 ◽

Vol 06 (03) ◽

pp. 445-461 ◽

Cited By ~ 3

Author(s):

S. I de Vries ◽

M. A. J Braat-van Straaten ◽

E Müller ◽

M Wettermark

Keyword(s):

Fibrinolytic Activity ◽

Alcoholic Extract ◽

Surgical Interventions ◽

Fallot's Tetralogy ◽

Naturally Occurring ◽

Fallot’S Tetralogy

SummaryA marked fibrinolytic activity could be demonstrated in the blood of 10 patients with polycythaemia. In these cases fibrinolysis was considered the result of a deficiency an antiplasmin. It could be demonstrated that this naturally occurring inhibitor of fibrinolysis is present in normal platelets but is lacking in the patient’s own thrombocytes. This factor is probably attached to the surface of the thrombocytes. It could be removed by repeatedly washing. Lack of antiplasmin is a dysfunction of platelets and a form of thrombopathy. It does not respond on treatment with ACA or prednisone. In primary polycythaemia busulfan (Myleran) was considered to be the treatment of choice, whereas in 1 case of secundary erythrocytosis (Fallot’s tetralogy) the reaction on unroasted peanuts was unmistakable. In 4 more patients an alcoholic extract of peanuts was given, and promising results were obtained in 3 of them. The importance of this “thrombopathic type’ of fibrinolysis has been pointed out especially in view of surgical interventions.

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