Publications (6)5.26 Total impact
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Chapter: Evolving Role of Simulators and Training in Robotic Urological Surgery
08/2012; , ISBN: 978-953-51-0811-5 -
Article: Blood loss comparison during transurethral resection of prostate and high power GreenLight(™) laser therapy using isotopic measure of red blood cells volume.
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ABSTRACT: Transurethral resection of the prostate (TURP) remains the gold standard in the operative management of symptomatic benign prostatic hyperplasia (BPH). The main morbidity of TURP is bleeding, which leads to clot retention and blood transfusion. Newer techniques have appeared, and photovaporization of the prostate (PVP) with the GreenLight™ laser has been developed to reduce the morbidity of bladder outflow surgery. Isotopic measurements of total red cell volume and total blood volume (BV) are a recommended reference technique to evaluate bleeding occurring during endoscopic ablation of the prostate. Here, we compare blood loss during PVP and TURP using an isotopic method. Eighteen patients underwent PVP, and 20 patients underwent a TURP for symptomatic BPH by one surgeon. The two groups were comparable in demographic data; however, prostate volume was significantly higher in the PVP group. BV was measured pre- and postoperatively using the isotope technique. The total BV was measured to have increased by 362 mL in PVP group compared with a loss of 315 mL in TURP group (p=0.001). The difference in total red cell volume increased by 148 mL in PVP group compared with a loss of 216 mL in TURP group (p=0.005). Using the isotope method, we have shown a significant difference in postoperative blood loss between TURP and PVP. Our study is the first to use an isotopic method to measure the blood loss during PVP. This technique needs further standardization before being introduced into routine clinical practice.Journal of endourology / Endourological Society 08/2011; 25(10):1655-9. · 1.75 Impact Factor -
Article: A comparative study between an improved novel air-cushion sensor and a wheeled probe for minimally invasive surgery.
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ABSTRACT: We describe a comparative study between an enhanced air-cushion tactile sensor and a wheeled indentation probe. These laparoscopic tools are designed to rapidly locate soft-tissue abnormalities during minimally invasive surgery (MIS). The air-cushion tactile sensor consists of an optically based sensor with a 7.8 mm sphere "floating" on a cushion of air at the tip of a shaft. The wheeled indentation probe is a 10 mm wide and 5 mm in diameter wheel mounted to a force/torque sensor. A continuous rolling indentation technique is used to pass the sensors over the soft-tissue surfaces. The variations in stiffness of the viscoelastic materials that are detected during the rolling indentations are illustrated by stiffness maps that can be used for tissue diagnosis. The probes were tested by having to detect four embedded nodules in a silicone phantom. Each probe was attached to a robotic manipulator and rolled over the silicone phantom in parallel paths. The readings of each probe collected during the process of rolling indentation were used to achieve the final results. The results show that both sensors reliably detected the areas of variable stiffness by accurately identifying the location of each nodule. These are illustrated in the form of two three-dimensional spatiomechanical maps. These probes have the potential to be used in MIS because they could provide surgeons with information on the mechanical properties of soft tissue, consequently enhancing the reduction in haptic feedback.Journal of endourology / Endourological Society 07/2010; 24(7):1155-9. · 1.75 Impact Factor -
Article: Air-cushion force-sensitive probe for soft tissue investigation during minimally invasive surgery.
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ABSTRACT: We propose a novel air-cushion force-sensitive indentation probe for rapidly locating abnormalities within soft tissues during minimally invasive surgery (MIS). This system comprises a spherical-tipped optical-based force-sensing device that employs an air-cushion technique to conduct continuous rolling indentation over the surface of soft tissues. The device combines rapid acquisition of tissue resistance forces with high manoeuvrability. To determine the stiffness variation, the interaction forces acquired during rolling indentation can be integrated to generate spatio-mechanical stiffness images that can be used for tissue diagnosis. Rolling indentation tests on the probe were carried out on excised porcine liver. The results demonstrate that the probe can be used to acquire force signals for constructing mechanical images, reliably indicating areas of variable stiffness. This probe could be used to characterize the force tissue deflection profile of soft tissues during minimally invasive surgery providing surgeons with enhanced haptic feedback.Journal of endourology / Endourological Society 09/2009; 23(9):1421-4. · 1.75 Impact Factor -
Article: Wheel/tissue force interaction: a new concept for soft tissue diagnosis during MIS.
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ABSTRACT: This paper describes a feasibility study of a novel force sensor that can be used to localise tissue abnormalities and provide tactile feedback to the surgeon during minimally invasive surgery. The proposed sensor makes use of an air-supported rigid ball mounted at the end of a tubular shaft to indent the tissue under investigation. Variations in tissue stiffness which cause changes in position of the ball are measured by using an optical sensing scheme. The sensor enables rapid acquisition of tactile information over large areas of soft tissue. Laboratory experiments were conducted to demonstrate the feasibility of the proposed sensor system. The outcome of the conducted experiments shows similarity to the results from a cylindrical wheel-based force sensor [1] which are shown here for comparative purposes.Conference proceedings: ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Conference 02/2008; 2008:5556-9. -
Article: Robotic telementoring/telesurgical system and randomized evaluation study.
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ABSTRACT: The paper presents a new telementoring system incorporating audio-video communication and remote robotic control. The system was developed around an off the shelf ISDN video conferencing system enhanced with video annotation and remote robot control features. The user can remotely control a robot of perform needle alignment and insertion in a Percutaneous access procedure. Particular attention was devoted to ensure the safety of the procedure. The data connection is continuously monitored and in the event of a failure the robot control is switched to the local operator. Two series of randomized trials were performed between Baltimore and London. The accuracy and procedure time were evaluated for manual needle placement, local robotic needle placement and remotely controlled robotic needle placement. The test showed that while the procedure time is not improved by the robotic approach there is an improvement in the accuracy of the procedure. The study showed also that there is no significant difference between the locally controlled robotic needled placement and the remotely controlled robotic needle placement. Thus, the proposed system can be safely used for remote robotic percutaneous access procedures.Conference proceedings: ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Conference 02/2005; 2:2167-70.
