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ABSTRACT: This paper presents the clinical motivation, design specifications, kinematics, statics, and actuation compensation for a newly constructed telerobotic system for Minimally Invasive Surgery (MIS) of the throat. A hybrid dual-arm telesurgical slave, with twenty joint-space Degrees of Freedom (DoF), is used in this telerobotic system to provide the necessary dexterity in deep surgical fields such as the throat. The telerobotic slave uses novel continuum robots that use multiple super-elastic backbones for actuation and structural integrity. The paper presents the kinematics of the telesurgical slave and methods for actuation compensation to cancel the effects of backlash, friction, and flexibility of the actuation lines. A method for actuation compensation is presented in order to overcome uncertainties of modeling, friction, and backlash. This method uses a tiered hierarchy of two novel approaches of actuation compensation for remotely actuated snake-like robots. The tiered approach for actuation compensation uses compensation in both joint space and configuration space of the continuum robots. These actuation hybrid compensation schemes use intrinsic model information and external data through a recursive linear estimation algorithm and involve compensation using configuration space and joint space variables. Experimental results validate the ability of our integrated telemanipulation system through experiments of suturing and knot tying in confined spaces.
The International Journal of Robotics Research 09/2009; 28(9):1134-1153. · 3.11 Impact Factor
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I. J. Robotic Res. 01/2009; 28:1134-1153.
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ABSTRACT: The authors present the clinical application of robotics to laryngeal surgery in terms of enhancement of surgical precision and performance of other minimally invasive procedures not feasible with current instrumentation. Presented in this article are comparisons of human arm with robotic arm in terms of degrees of freedom and discussion of surgeries and outcomes with use of the robotic arm. Robotic equipment for laryngeal surgery has the potential to overcome many of the limitations of endolaryngeal procedures by improving optics, increasing instrument degrees of freedom, and modulating tremor. Outside of laryngology, a multi-armed robotic system would have utility in microvascular surgery, procedures at the base of the skull, sinus surgery, and single-port gastrointestinal and thoracic access surgery.
Otolaryngologic Clinics of North America 09/2008; 41(4):781-91, vii. · 1.65 Impact Factor
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Head & Neck 06/2007; 29(6):609-14. · 2.40 Impact Factor
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ABSTRACT: To evaluate the clinical, radiological presentation and surgical management of fibrovascular polyps of the hypopharynx.
Retrospective medical analysis of a case report. We report the case of a 66-year-old man, who presented with an incarcerated left inguinal hernia, vomiting and regurgitation of a large mass into the oral cavity resulting in syncope. MRI and cine-esophagram demonstrated a large mass in the cervical esophagus. At the time of herniorrhaphy, endoscopy revealed an 11.8-cm hypopharyngeal mass that completely obstructed the oropharynx.
The airway was secured by tracheostomy and the lesion was subsequently removed via open pharyngotomy. Postoperatively, a second polyp was found ball-valving into the airway, and an endoscopic resection was performed prior to decannulation. Histopathology of both lesions confirmed the diagnosis of a fibrovascular polyp.
Fibrovascular polyps are rare benign intraluminal esophageal lesions resulting in mild symptoms of dysphagia that may also cause significant morbidity such as syncope and asphyxia. This is the first report of synchronous fibrovascular polyps of the hypopharynx.
ORL 02/2004; 66(6):341-4. · 0.91 Impact Factor
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Proceedings of the 2004 IEEE International Conference on Robotics and Automation, ICRA 2004, April 26 - May 1, 2004, New Orleans, LA, USA; 01/2004
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Medical Image Computing and Computer-Assisted Intervention -- MICCAI 2004, 7th International Conference Saint-Malo, France, September 26-29, 2004, Proceedings, Part II; 01/2004
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ABSTRACT: In this study, we describe a novel in vitro reconstitution system for tracheal epithelium that could be useful for investigating the cellular and molecular interaction of epithelial and mesenchymal cells. In this system, a Transwell insert was used as a basement membrane on which adult bone marrow mesenchymal stem cells (MSCs) were cultured on the lower side whereas normal human bronchial epithelial (NHBE) cells were cultured on the opposite upper side. Under air-liquid interface conditions, the epithelial cells maintained their capacity to progressively differentiate and form a functional epithelium, leading to the differentiation of mucin-producing cells between days 14 and 21. Analysis of apical secretions showed that mucin production increased over time, with peak secretion on day 21 for NHBE cells alone, whereas mucin secretion by NHBE cells cocultured with MSCs remained constant between days 18 and day 25. This in vitro model of respiratory epithelium, which exhibited morphologic, histologic, and functional features of a tracheal mucosa, could help to understand interactions between mesenchymal and epithelial cells and mechanisms involved in mucus production, inflammation, and airway repair. It might also play an important role in the design of an composite prosthesis for tracheal replacement.
Tissue Engineering 10(9-10):1426-35. · 4.02 Impact Factor
