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1.
Am J Occup Ther ; 75(1): 7501205020p1-7501205020p11, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33399050

RESUMO

IMPORTANCE: The effects of robot-assisted task-oriented training with tangible objects among patients with stroke remain unknown. OBJECTIVE: To investigate the effects of robot-assisted therapy (RT) with a Gloreha device on sensorimotor and hand function and ability to perform activities of daily living (ADLs) among patients with stroke. DESIGN: Randomized, crossover-controlled, assessor-blinded study. SETTING: Rehabilitation clinic. PARTICIPANTS: Patients (N = 24) with moderate motor and sensory deficits. INTERVENTION: Patients participated in 12 RT sessions and 12 conventional therapy (CT) sessions, with order counterbalanced, for 6 wk, with a 1-mo washout period. OUTCOMES AND MEASURES: Performance was assessed four times: before and after RT and before and after CT. Outcomes were measured using the Fugl-Meyer Assessment-Upper Extremity (FMA-UE), Box and Block Test, electromyography of the extensor digitorum communis (EDC) and brachioradialis, and a grip dynamometer for motor function; Semmes-Weinstein hand monofilament and the Revised Nottingham Sensory Assessment for sensory function; and the Modified Barthel Index (MBI) for ADL ability. RESULTS: RT resulted in significantly improved FMA-UE proximal (p = .038) and total (p = .046) and MBI (p = .030) scores. Participants' EDC muscles exhibited higher efficacy during the small-block grasping task of the Box and Block Test after RT than after CT (p = .050). CONCLUSIONS AND RELEVANCE: RT with the Gloreha device can facilitate whole-limb function, leading to beneficial effects on arm motor function, EDC muscle recruitment efficacy, and ADL ability for people with subacute and chronic stroke. WHAT THIS ARTICLE ADDS: The evidence suggests that a task-oriented approach combined with the Gloreha device can facilitate engagement in whole-limb active movement and efficiently promote functional recovery.


Assuntos
Robótica , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Atividades Cotidianas , Mãos , Humanos , Recuperação de Função Fisiológica , Extremidade Superior
2.
J Crit Care ; 61: 119-124, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33157307

RESUMO

The management of COVID-19 patients in the ICUs requires several and prolonged life-support systems (mechanical ventilation, continuous infusions of medications and nutrition, renal replacement therapy). Parameters have to be entered continuously into the device user interface by healthcare personnel according to the dynamic clinical condition. This leads to an increased risk of cross-contamination, use of personal protective equipment and the need for stringent and demanding protocols. Cables and tubing extensions have been utilized to make certain devices usable outside the patient's room but at the cost of introducing further hazards. Remote control of these devices decreases the frequency of unnecessary interventions and reduces the risk of exposure for both patients and healthcare personnel.


Assuntos
/prevenção & controle , Cuidados Críticos/métodos , Infecção Hospitalar/prevenção & controle , Controle de Infecções/instrumentação , Exposição Ocupacional/prevenção & controle , Equipamento de Proteção Individual , Pessoal de Saúde , Humanos , Unidades de Terapia Intensiva , Terapia de Substituição Renal , Respiração Artificial , Risco , Robótica
3.
Urol Clin North Am ; 48(1): 147-150, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33218589

RESUMO

"The new frontier of robotic surgery is well under way. Current research and development is rapidly progressing, allowing for the creation of many new robotic companies. Each company has its own identity and platform for what their vision for the future entails. The competition generated between these companies will shortly be forcing newer, cheaper, more accessible robotic systems worldwide."


Assuntos
Procedimentos Cirúrgicos Robóticos/instrumentação , Procedimentos Cirúrgicos Urológicos/instrumentação , Inteligência Artificial/tendências , Previsões , Humanos , Procedimentos Cirúrgicos Robóticos/métodos , Procedimentos Cirúrgicos Robóticos/tendências , Robótica/instrumentação , Robótica/tendências , Procedimentos Cirúrgicos Urológicos/métodos , Procedimentos Cirúrgicos Urológicos/tendências
4.
Hinyokika Kiyo ; 66(10): 331-335, 2020 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-33271645

RESUMO

Herein we present simple methods to prevent postoperative inguinal hernia (IH) after extraperitoneal and transperitoneal robot-assisted radical prostatectomy (RARP). Among 275 patients who underwent RARP between January 2014 and December 2016 at our institution, we evaluated 143 and 115 patients who underwent extraperitoneal-RARP (e-RARP) and transperitoneal-RARP (t-RARP), respectively, after excluding those with intraoperative detection of IH (17 patients). In the e-RARP group, all 143 patients (286 groins) underwent an IH prevention procedure. In the t-RARP group, the first 22 patients (44 groins) did not undergo an IH prevention procedure, whereas 29 patients (37 groins) with patent processus vaginalis (PPV) among the last 93 patients underwent the procedure. The IH prevention procedure during e-RARP included release of the vas deferens from the peritoneum and spermatic cord, and peritoneal dissection of the spermatic cord at the internal inguinal ring. The IH prevention procedure during t-RARP included release of the vas deferens from the peritoneum and spermatic cord, complete circumferential dissection of the peritoneum around the PPV at the level of the internal inguinal ring, and ligation of the PPV with a Hem-o- Loc○R clip. In the e-RARP group, postoperative IH occurred in 3 of the 143 patients (1.9%) during the follow-up period of 22.0±9.2 months. In the first subgroup of t-RARP, postoperative IH developed in 4 of the 22 patients (18%) during the follow-up period of 33.1±12.1 months, whereas in the last t-RARP group, postoperative IH developed in 3 of the 93 patients (3.3%) during the follow-up period of 20.1±8.6 months. Different IH prevention procedures performed in patients undergoing e-RARP and t-RARP were simple and effective in preventing postoperative IH.


Assuntos
Hérnia Inguinal , Neoplasias da Próstata , Robótica , Virilha , Humanos , Masculino , Complicações Pós-Operatórias , Prostatectomia , Neoplasias da Próstata/cirurgia , Estudos Retrospectivos
5.
Science ; 370(6521): 1165, 2020 12 04.
Artigo em Inglês | MEDLINE | ID: mdl-33273087
6.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 34(12): 1521-1525, 2020 Dec 15.
Artigo em Chinês | MEDLINE | ID: mdl-33319529

RESUMO

Objective: To compare the safety and accuracy of pedicle screw placement assisted by robot system with freehand pedicle screw placement in upper thoracic surgery. Methods: Between December 2017 and December 2019, 39 cases with upper thoracic pedicle screw internal fixation were included in the study, including 19 cases in robot group (group A, robot assisted pedicle screw placement) and 20 cases in freehand group (group B, freehand pedicle screw placement). There were 104 screws implanted in group A and 108 screws in group B. There was no significant difference in age, gender composition, body mass index, disease type, number of screws implanted, and segmental distribution between the two groups ( P>0.05). The operation time, intraoperative blood loss, and postoperative drainage were recorded and compared between the two groups. CT scan was performed in all patients at 2 days after operation to evaluate the screw accuracy based on the Gertzbein-Robbins grading standard. Results: The operation time of group A was significantly longer than that in group B ( t=2.759, P=0.009). There was no significant difference in intraoperative blood loss and postoperative drainage between the two groups ( t=-0.796, P=0.431; t=-0.814, P=0.421). At 2 days after operation, according to Gertzbein-Robbins grading standard, the accuracy of pedicle screw implantation in group A were grade A in 94 screws, grade B in 9 screws, and grade C in 1 screw; and in group B were grade A in 72 screws, grade B in 26 screws, grade C in 9 screws, and grade D in 1 screw; the difference between the two groups was significant ( Z=4.257, P=0.000). The accuracy rate of group A was 99.04%, and that of group B was 90.74%, showing significant difference ( χ 2=7.415, P=0.006). Conclusion: Compared with traditional freehand pedicle screw placement, robot-assisted pedicle screw placement significantly improves the accuracy and safety of screw placement without increasing the bleeding and postoperative drainage.


Assuntos
Parafusos Pediculares , Procedimentos Cirúrgicos Robóticos , Robótica , Cirurgia Torácica , Humanos , Estudos Retrospectivos
7.
Surg Technol Int ; 37: 395-403, 2020 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-33238025

RESUMO

Robotic-assisted surgery was introduced to make various mechanical aspects of a total hip arthroplasty more reproducible. When paired with sophisticated three-dimensional preoperative planning, robotic surgery offers the promise that a surgeon might select and reliably achieve targets for component position to optimize hip center-of-rotation, acetabular anteversion and inclination, femoral offset, as well as limb length. This paper describes a patient-specific step-by-step approach to performing these procedures including taking into account pelvic tilt. It is hoped that these described techniques will further optimize robotic-assisted hip arthroplasty procedures.


Assuntos
Artroplastia de Quadril , Prótese de Quadril , Procedimentos Cirúrgicos Robóticos , Robótica , Acetábulo/cirurgia , Humanos
8.
PLoS One ; 15(11): e0242078, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33211736

RESUMO

Telepresence robots allow users to be spatially and socially present in remote environments. Yet, it can be challenging to remotely operate telepresence robots, especially in dense environments such as academic conferences or workplaces. In this paper, we primarily focus on the effect that a speed control method, which automatically slows the telepresence robot down when getting closer to obstacles, has on user behaviors. In our first user study, participants drove the robot through a static obstacle course with narrow sections. Results indicate that the automatic speed control method significantly decreases the number of collisions. For the second study we designed a more naturalistic, conference-like experimental environment with tasks that require social interaction, and collected subjective responses from the participants when they were asked to navigate through the environment. While about half of the participants preferred automatic speed control because it allowed for smoother and safer navigation, others did not want to be influenced by an automatic mechanism. Overall, the results suggest that automatic speed control simplifies the user interface for telepresence robots in static dense environments, but should be considered as optionally available, especially in situations involving social interactions.


Assuntos
Robótica/instrumentação , Navegação Espacial , Algoritmos , Cibernética , Humanos , Interface Usuário-Computador
9.
Nature ; 587(7833): 219-224, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33177670

RESUMO

Soft machines are a promising design paradigm for human-centric devices1,2 and systems required to interact gently with their environment3,4. To enable soft machines to respond intelligently to their surroundings, compliant sensory feedback mechanisms are needed. Specifically, soft alternatives to strain gauges-with high resolution at low strain (less than 5 per cent)-could unlock promising new capabilities in soft systems. However, currently available sensing mechanisms typically possess either high strain sensitivity or high mechanical resilience, but not both. The scarcity of resilient and compliant ultra-sensitive sensing mechanisms has confined their operation to laboratory settings, inhibiting their widespread deployment. Here we present a versatile and compliant transduction mechanism for high-sensitivity strain detection with high mechanical resilience, based on strain-mediated contact in anisotropically resistive structures (SCARS). The mechanism relies upon changes in Ohmic contact between stiff, micro-structured, anisotropically conductive meanders encapsulated by stretchable films. The mechanism achieves high sensitivity, with gauge factors greater than 85,000, while being adaptable for use with high-strength conductors, thus producing sensors resilient to adverse loading conditions. The sensing mechanism also exhibits high linearity, as well as insensitivity to bending and twisting deformations-features that are important for soft device applications. To demonstrate the potential impact of our technology, we construct a sensor-integrated, lightweight, textile-based arm sleeve that can recognize gestures without encumbering the hand. We demonstrate predictive tracking and classification of discrete gestures and continuous hand motions via detection of small muscle movements in the arm. The sleeve demonstration shows the potential of the SCARS technology for the development of unobtrusive, wearable biomechanical feedback systems and human-computer interfaces.


Assuntos
Retroalimentação Sensorial , Maleabilidade , Robótica/instrumentação , Robótica/métodos , Interface Usuário-Computador , Dispositivos Eletrônicos Vestíveis , Mãos/fisiologia , Humanos , Movimento (Física) , Movimento , Têxteis
10.
Urologiia ; (5): 54-60, 2020 11.
Artigo em Russo | MEDLINE | ID: mdl-33185348

RESUMO

INTRODUCTION: Robot-assisted radical cystectomy (RARC) with intracorporeal neobladder formation is a complex surgical procedure. AIM: To describe the main stages of RARC and to analyze its short-term results. MATERIALS AND METHODS: RARC with ileocystoplasty was performed in 16 patients, most of whom were men (n=14). In 15 patients, the indication for surgery was bladder cancer (BCa), while one patient has radiation-induced sigmoid fistula with a formation of small, contracted bladder. During radical cystectomy (RC), the lower ureters were dissected, followed by posterior dissection of the bladder with mobilization from both sides to the pelvic fascia, clipping and transection of the vesical pedicles, and suturing of the dorsal venous complex with urethral dissection. After pelvic lymph node dissection, 40 cm of the ileum was resected, after that two distal segments of 15 cm were U-shaped, and a 1.5 cm incision was made in the lower part of the bowel, followed by a formation of the urethral anastomosis. Then bowel segments were detubularized, and continuous suture on the posterior and anterior walls of the neobladder was done. Ureters were implanted in the proximal tubular part of the resected colon according to the Nesbit technique. RESULTS: The mean operation time was 380 minutes. The blood loss ranged from 80 to 200 ml; however, blood transfusion was not performed. Complications during 30-days after RARC were observed in 7 (43.7%) patients, including 4 (25%) of class I-II according to Clavien - Dindo, and 3 (18.7%) of class III-IV. In patients with leakage at the uretero- intestinal anastomosis (n=2) and urethro-neobladder anastomosis (n=1), percutaneous drainage was performed, which allowed to resolve these complications. There were no cases of bowel obstruction. One patient with gastrointestinal bleeding required blood transfusion. The 90-day late complications occurred in 6 (37.5%) patients, including 2 cases of upper urinary tract infection. One patient died of acute myocardial infarction. CONCLUSION: RARC is a contemporary minimally invasive method for muscle-invasive BCa. Stepwise approach to RARC with intracorporeal neobladder formation may reduce the operation time and the rate of complications.


Assuntos
Procedimentos Cirúrgicos Robóticos , Robótica , Estruturas Criadas Cirurgicamente , Neoplasias da Bexiga Urinária , Derivação Urinária , Cistectomia/efeitos adversos , Humanos , Masculino , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Resultado do Tratamento , Neoplasias da Bexiga Urinária/cirurgia , Derivação Urinária/efeitos adversos
11.
PLoS One ; 15(11): e0242005, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33166328

RESUMO

Transhumeral percutaneous osseointegrated prostheses provide upper-extremity amputees with increased range of motion, more natural movement patterns, and enhanced proprioception. However, direct skeletal attachment of the endoprosthesis elevates the risk of bone fracture, which could necessitate revision surgery or result in loss of the residual limb. Bone fracture loads are direction dependent, strain rate dependent, and load rate dependent. Furthermore, in vivo, bone experiences multiaxial loading. Yet, mechanical characterization of the bone-implant interface is still performed with simple uni- or bi-axial loading scenarios that do not replicate the dynamic multiaxial loading environment inherent in human motion. The objective of this investigation was to reproduce the dynamic multiaxial loading conditions that the humerus experiences in vivo by robotically replicating humeral kinematics of advanced activities of daily living typical of an active amputee population. Specifically, 115 jumping jack, 105 jogging, 15 jug lift, and 15 internal rotation trials-previously recorded via skin-marker motion capture-were replicated on an industrial robot and the resulting humeral trajectories were verified using an optical tracking system. To achieve this goal, a computational pipeline that accepts a motion capture trajectory as input and outputs a motion program for an industrial robot was implemented, validated, and made accessible via public code repositories. The industrial manipulator utilized in this study was able to robotically replicate over 95% of the aforementioned trials to within the characteristic error present in skin-marker derived motion capture datasets. This investigation demonstrates the ability to robotically replicate human motion that recapitulates the inertial forces and moments of high-speed, multiaxial activities for biomechanical and orthopaedic investigations. It also establishes a library of robotically replicated motions that can be utilized in future studies to characterize the interaction of prosthetic devices with the skeletal system, and introduces a computational pipeline for expanding this motion library.


Assuntos
Membros Artificiais , Úmero/cirurgia , Robótica/instrumentação , Atividades Cotidianas , Amputados , Fenômenos Biomecânicos , Interface Osso-Implante/fisiologia , Humanos , Úmero/fisiologia , Cinética , Osseointegração , Desenho de Prótese , Amplitude de Movimento Articular
12.
PLoS One ; 15(11): e0242017, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33170883

RESUMO

Offshore oil and gas platforms have a finite life of production operations. Once production ceases, decommissioning options for the platform are assessed. The role that a platform's jacket plays as fish habitat can inform the decommissioning decision. In this study, conducted along the crossbeams of a California platform jacket and using an ROV, we compared estimates of fish diversity and densities determined from a targeted "biological" survey with those from a replicated "structural" survey. We found that the water column fish species assemblages characterized by the two methods were similar. By contrast, the two survey methods yielded different species assemblages inhabiting the crossbeam at the platform jacket base. This difference occurred because, at least off California, the platform jacket base species diversity tends to be highest where the bottom crossbeam is undercut, creating sheltering sites for many species. Because the structural method inadequately imaged the seafloor-crossbeam interface, particularly where a gap occurred between crossbeam and seafloor, substantial numbers of fishes were not visible. While we cannot extrapolate from this study to all platforms' worldwide, it is clear that routine platform structural integrity surveys may be a valuable source for opportunistic marine community surveys. Intentional planning of the structural survey to incorporate relatively minor variations (e.g., maintaining fixed ROV distance from the infrastructure and consistent 90° camera angle) coupled with a deliberate consideration of the platform ecology (e.g., positioning the ROV to capture the seafloor-crossbeam interface) can substantially improve the effects on fish assemblage assessments from routine structural surveys without compromising the integrity assessment. We suggest that these biases should be both acknowledged and, understood when using routine structural surveys to inform platform ecology assessment. Additional consideration may be given to structural surveys that incorporate incremental adjustments to provide better data applicability to biological assessments.


Assuntos
Monitoramento Ambiental/métodos , Robótica/métodos , Animais , Biodiversidade , California , Ecossistema , Peixes/classificação , Campos de Petróleo e Gás , Densidade Demográfica , Inquéritos e Questionários/estatística & dados numéricos , Água
13.
PLoS One ; 15(11): e0242613, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33253264

RESUMO

This paper aims to further increase the reliability of optimal results by setting the simulation conditions to be as close as possible to the real or actual operation to create a Cyber-Physical System (CPS) view for the installation of the Fractional-Order PID (FOPID) controller. For this purpose, we consider two different sources of variability in such a CPS control model. The first source refers to the changeability of a target of the control model (multiple setpoints) because of environmental noise factors and the second source refers to an anomaly in sensors that is raised in a feedback loop. We develop a new approach to optimize two objective functions under uncertainty including signal energy control and response error control while obtaining the robustness among the source of variability with the lowest computational cost. A new hybrid surrogate-metaheuristic approach is developed using Particle Swarm Optimization (PSO) to update the Gaussian Process (GP) surrogate for a sequential improvement of the robust optimal result. The application of efficient global optimization is extended to estimate surrogate prediction error with less computational cost using a jackknife leave-one-out estimator. This paper examines the challenges of such a robust multi-objective optimization for FOPID control of a five-bar linkage robot manipulator. The results show the applicability and effectiveness of our proposed method in obtaining robustness and reliability in a CPS control system by tackling required computational efforts.


Assuntos
Algoritmos , Modelos Teóricos , Robótica
14.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 34(11): 1376-1381, 2020 Nov 15.
Artigo em Chinês | MEDLINE | ID: mdl-33191693

RESUMO

Objective: To evaluate the performance, safety, and precision of the Yuanhua robotic-assisted total knee arthroplasty system (YUANHUA-TKA) through animal experiments, which will provide reference data for human clinical trials. Methods: Six 18-month-old goats, weighing 30-35 kg, were used in this study. The experimental study was divided into two parts: the preoperative planning and intraoperative bone resection. CT scans of the goats' lower extremities were firstly performed before the experiments. Then the CT scans were segmented to generate the femoral and tibial three-dimensional (3D) models in the YUANHUA-TKA system. The volumes and angles of each resection plane on the femur and tibia were planned. The bone resection was finally implemented under the assistance of the YUANHUA-TKA system. After completing all bone resections, the lower extremities of each goat were taken to have CT scans. By comparing the femoral and tibial 3D models before and after the experiments, the actual bone resection volumes and angles were calculated and compared with the preoperative values. Results: During the experiments, no abnormal bleeding was found; the YUANHUA-TKA system ran smoothly and stably and was able to stop moving and keep the osteotomy in the safe zone all the time. After the experiment, the resection planes were observed immediately and found to be quite flat. There was no significant difference between the planned and actual osteotomy thickness and osteotomy angle ( P>0.05); the error of the osteotomy thickness was less than 1 mm, and the error of the osteotomy angle was less than 2°. Conclusion: The YUANHUA-TKA system can assist the surgeons to perform osteotomy following the planned thickness and angle values. It is expected to assist surgeons to implement more accurate and efficient osteotomy in the future clinical applications.


Assuntos
Experimentação Animal , Artroplastia do Joelho , Osteoartrite do Joelho , Robótica , Cirurgia Assistida por Computador , Animais , Fêmur/diagnóstico por imagem , Fêmur/cirurgia , Humanos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/cirurgia , Osteoartrite do Joelho/cirurgia , Tíbia/diagnóstico por imagem , Tíbia/cirurgia
15.
Nat Commun ; 11(1): 5618, 2020 11 05.
Artigo em Inglês | MEDLINE | ID: mdl-33154372

RESUMO

Systemic chemotherapy remains the backbone of many cancer treatments. Due to its untargeted nature and the severe side effects it can cause, numerous nanomedicine approaches have been developed to overcome these issues. However, targeted delivery of therapeutics remains challenging. Engineering microrobots is increasingly receiving attention in this regard. Their functionalities, particularly their motility, allow microrobots to penetrate tissues and reach cancers more efficiently. Here, we highlight how different microrobots, ranging from tailor-made motile bacteria and tiny bubble-propelled microengines to hybrid spermbots, can be engineered to integrate sophisticated features optimised for precision-targeting of a wide range of cancers. Towards this, we highlight the importance of integrating clinicians, the public and cancer patients early on in the development of these novel technologies.


Assuntos
Sistemas de Liberação de Medicamentos , Neoplasias/tratamento farmacológico , Robótica , Portadores de Fármacos/administração & dosagem , Portadores de Fármacos/química , Portadores de Fármacos/farmacologia , Humanos , Comunicação Interdisciplinar , Nanomedicina , Robótica/classificação
16.
Science ; 370(6518): 768-769, 2020 11 13.
Artigo em Inglês | MEDLINE | ID: mdl-33184195
17.
Yonsei Med J ; 61(12): 1054-1059, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33251780

RESUMO

PURPOSE: Here, we compared the operative and perioperative outcomes between robot-assisted laparoscopic myomectomy (RALM) and abdominal myomectomy (AM) in patients with large (>10 cm) or heavy myomas (>250 g). MATERIALS AND METHODS: We included 278 patients who underwent multi-port RALM (n=126) or AM (n=151) for large or heavy myomas in a tertiary care hospital between April 2019 and June 2020. The t-test, chi-square, Bonferroni's test, and multiple linear regression were used. RESULTS: No differences were observed in age, body mass index, parity, or history of pelvic surgery between the two groups. Myoma diameters were not different (10.8±2.52 cm vs. 11.2±3.0 cm, p=0.233), but myomas were lighter in the RALM group than in the AM group (444.6±283.14 g vs. 604.68±368.35 g, respectively, p=0.001). The RALM group had a higher proportion of subserosal myomas, fewer myomas, fewer large myomas over >3 cm, lighter myomas, and longer total operating time. However, the RALM group also had shorter hospital stay and fewer short-term complications. Estimated blood loss (EBL) was not different between the two groups. The number of removed myomas was the most significant factor (coefficient=10.89, p<0.0001) affecting the EBL. CONCLUSION: RALM is a feasible myomectomy technique even for large or heavy myomas. RALM patients tend to have shorter hospital stays and fewer postoperative fevers within 48 hours. However, RALM has longer total operating time.


Assuntos
Laparoscopia/métodos , Leiomioma/cirurgia , Técnicas de Abdome Aberto/métodos , Procedimentos Cirúrgicos Robóticos/métodos , Miomectomia Uterina/métodos , Neoplasias Uterinas/cirurgia , Adulto , Feminino , Humanos , Leiomioma/patologia , Tempo de Internação , Pessoa de Meia-Idade , Duração da Cirurgia , Gravidez , Estudos Retrospectivos , Robótica , Resultado do Tratamento , Neoplasias Uterinas/patologia
20.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 55(10): 952-956, 2020 Oct 07.
Artigo em Chinês | MEDLINE | ID: mdl-33036510

RESUMO

Objective: To evaluate the safety and outcomes of robot-assisted electrode insertion in cochlear implantation. Methods: We first reported the case of robot-assisted electrode insertion of cochlear implantation in October 2019. A new slim electrode array of Nurotron cochlear implant (CS-10A TM) and RobOtol(®) robot system were used in this case. The robotic assistance procedures, surgical outcomes were analyzed. Results: Robot-assisted electrode insertion was successfully performed in this adult patient. The preparation of robot system cost six minutes, the electrode array was slowly and fully inserted into tympanic scala with robot assistance. No damage in the surgical field occurred by the robotic instrument. Intraoperative electrode impedances and neural response measurements were normal. No postoperative complications occurred. Up to three months of follow up after implantation, the cochlear implant functioned well and rehabilitated hearing was satisfactory. Conclusion: Otological robot system shows its advantage in the elimination of human involuntary tremors and the augmentation of accuracy during micromanipulation, it could safely assist cochlear implantation to realize minimally invasive and full tympanic scala insertion of the electrode array, and to ensure the good preservation of the intracochlear fine structure.


Assuntos
Implante Coclear , Implantes Cocleares , Robótica , Adulto , Cóclea/cirurgia , Eletrodos Implantados , Audição , Humanos
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