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Robotic Surgery - Science topic

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Potential problems in robotic surgery in laparoscopy What is the role of the biomedical engineer in solving them?
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Cost and Accessibility Problem: Robotic surgery systems are expensive, limiting their availability and increasing the cost of procedures.
Role of Biomedical Engineers: Engineers focus on cost-reduction strategies by refining designs and materials, optimizing the manufacturing process, and working on modular systems that can be used across multiple procedures. They also collaborate on open-source projects that aim to make robotic surgery more accessible.
I believe that when accessibility is universal, the other issues will be optimized, which for me are secondary.
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I would like to perform a literature review at this time on augmented learning and learning augmented algorithms to enhance performance-guided surgery
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1. **Define the Scope and Objectives**:
- Clearly define the objectives of your literature review. For example, you may want to focus on understanding the current state of research in using augmented learning and learning-augmented algorithms to enhance surgical performance and guidance.
- Determine the key aspects you want to cover, such as the specific applications of these techniques in the context of performance-guided surgery, the methodologies employed, the reported outcomes and benefits, as well as any challenges or limitations.
2. **Search and Gather Relevant Literature**:
- Identify relevant databases and search engines, such as PubMed, IEEE Xplore, ACM Digital Library, and Google Scholar, to search for peer-reviewed journal articles, conference proceedings, and other relevant publications.
- Use a combination of keywords, such as "augmented learning", "learning-augmented algorithms", "performance-guided surgery", "surgical guidance", "surgical decision support", etc., to conduct your searches.
- Ensure you include both recent and seminal publications in your search to capture the latest advancements as well as the foundations of the field.
3. **Review and Critically Analyze the Literature**:
- Carefully read and analyze the selected publications, focusing on the key aspects identified in the scope and objectives.
- Identify the main themes, methodologies, findings, and contributions reported in the literature.
- Assess the quality, validity, and reliability of the studies, and identify any gaps, inconsistencies, or areas that require further investigation.
4. **Synthesize the Findings**:
- Organize the literature review in a logical and coherent manner, potentially using a thematic or chronological approach.
- Synthesize the key insights, trends, and conclusions drawn from the literature, highlighting the potential applications, benefits, and limitations of using augmented learning and learning-augmented algorithms in performance-guided surgery.
5. **Identify Future Research Directions**:
- Based on your analysis of the literature, identify areas that require further research, such as specific surgical procedures or applications that could benefit from these techniques, methodological improvements, or the integration of these approaches with other emerging technologies.
- Provide recommendations for future research that could contribute to the advancement of this field and address the identified gaps.
6. **Structure and Write the Literature Review**:
- Organize your literature review into a well-structured document, including an introduction, background, review of the literature, synthesis of findings, and a conclusion.
- Use appropriate headings, subheadings, and transitions to ensure the flow and readability of your review.
- Properly cite the references using a consistent citation style, such as APA or IEEE.
Good luck; partial credit AI
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Robotic surgery is the future - any opinion or thoughts? Would like to hear everyone’s thoughts
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Amritpal Singh Many thanks , Yes in a respect but still only few pockets and the larger part of the world still is untouched by it.
Do you see it becoming the bedrock like laparotomy / laparoscopy ? Or do you see it phasing out and declining eventually . With AI , tele surgery and VR super imposed , what vistas could it lead to , the possibilities seem far reaching .
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In the case of a fit patient (ECOG 0/1), having a distal ureteric tumor, with a proven TCC high grade pT1- of the bladder, what would be the most apt management strategy?
Would the choice of management vary, depending on-
A) Age of the patient
B) Status of the Opposite kidney
C) Role of reimplantation of the ureter in a diseased bladder.
D) Need for surveillance of the upper tract.
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Yes, the management of UTUC and bladder Ca depends on many patient-related factors, including age, grade, stage, multifocality, bilaterality or status of contralateral kidney function….
For high grade, high stage, AND unilateral UTUC, radical Nephroureterectomy is recommended.
For low grade, superficial and single tumor, solitary kidney or bilateral involvement,…nephron sparing approach including ureteric resection and reimplantation is preferable.
But in this index case, we know the status bladder Ca (high grade pT1) and that of ureteric tumor was not mentioned.
If high grade or stage tumor, Radical cystectomy with Nephroureterectomy can be an option. But we need to consider the mentioned factors to decide.
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In which branches, industry, the development of robotics, work automation and the implementation of artificial intelligence into production processes, logistics, etc. is currently the most dynamic?
Please reply
I invite you to the discussion
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During the SARS-CoV-2 (Covid-19) coronavirus pandemic, robotics developed effectively in the field of automation of procurement and delivery logistics processes in logistics centers. In addition, during a pandemic, robots are used in infectious disease departments of hospitals to help care for people suffering from Covid-19 disease. Robots are also used in shopping malls, city parks and other public places to check, for example, whether citizens wear protective masks and whether they maintain an appropriate social distance.
Best regards,
Dariusz Prokopowicz
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With advanced technology there is shift towards conservative management. Advent of transoral robotic surgery there are centres suggesting a selective nodal dissection leg me II to V. Is dissective level 1 b necessary or it can be avoided completely with similar oncological safety.?
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Thanks..
The best evidence for nexk management is a minimum of level II to IV neck dissection.
If nose positive neck and/Or oropharyngeal disease extending anteriorly to oral cavity then neck dissection (I to V).
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i have treated the both and didn't really noticed any big difference. its just the size of the incision which will make the pt feel more pain. unfortunately, i couldn't find any articles regarding pt management for such case and i do believe sooner or later this case should undergo for research.
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Yes i also agree that there is gap in research to find out the post surgery pulmonary complication which i think might have a difference in outcomes.
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I read about urethral stricture because there is often relapse after surgery, the stricture comes back.
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With the available Holmium Laser, it takes about 20 to 30 minutes to vaporize with no down time and no bleeding. Can be repeated easily with almost return of normal urethra. Please see several of my publications...google.
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We know that laparoscopic systems with haptic feedback have more advantage than something else. so, Do they have mass production? In which countries?
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The New European Surgical Academy is working in this type of robotic device.
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Urology,  Robotic Surgery,  Prostate cancer. Prostatectomy 
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In experienced hands these techniques yield the same result (trifecta). More important than the approach is the surgeon performing the intervention.
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I would like to obtain a realistic model for the human hand while it is in interaction with a surgery tool and soft or hard tissues. I would like to know more about the methods that I can use for getting the appropriate DOF for hand and the way to get the data to do so.
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Do you mean the model of the hand the enables a surgeon to interact with the tools remotely? or to sense the tool interaction within its environment while guided by the surgeon?
Haptic interface is the main approach ti reflect such feelings to the hand during interaction. There are different available modeling techniques within this approach
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Let’s imagine that there is only one available option regarding hands-on training in laparoscopic and/or robotic surgery for residents, besides assisting at surgical operations. The choices are as follows:
  1. surgery simulation using high-end virtual reality software or
  2. animal models as part of licensed live-tissue research protocols.
Which one would you choose and why?
It would be interesting to explore the perspective of professionals from different scientific fields (i.e. residents, board certified surgeons, professors, computer engineers, animal specialists or even financial analysts etc).
*Evidence-based answers with literature references will be appreciated.
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Efficacy of virtual reality versus wet-lab training is indeed a topic of interest in medical education. As a learner, I feel that wetlab using animal model has the advantage of increased realism and use of the actual surgical instruments, whereas virtual reality simulator provide automated feedback which helps identifying potential weak points/ area for improvement.
From my recent Simulation based learning workshop, I came to aware that on top of modality and/ or fidelity of the simulator, effective simulation exercise should be integrated into curriculum (not as standalone) with well planned briefing, instructional design, debriefing and feedback. I find this a good read- Simulation in Medical Education by Ker et al- http://onlinelibrary.wiley.com/doi/10.1002/9781444320282.ch12/summary
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Someone might be confused about the difference between the robot assisted surgery and the navigation system, which is helping a surgeon to direct the target. To answer this question, several experts' points of view is required.
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Robotic surgery, computer-assisted surgery, are terms for technological developments that use robotic systems to aid in surgical procedures. In computer-assisted surgery, the actual intervention is defined as surgical navigation. Using the surgical navigation system the surgeon will use special instruments, which are connected to the navigation system to touch an anatomical position on the patient. This position is simultaneously shown in the images taken from this patient. The surgeon can thus use the instrument to 'navigate' the images of the patient by moving the instrument.
"Wikipedia"
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Robotic-assisted laparoscopic surgery—most rapidly in urology but also in gynaecology, cardiothoracics, head and neck, and general surgery has fascinated surgeons. But has this innovation in surgery translated to benefits for patients? The Da Vinci surgical system is the only robot approved by the FDA for soft tissue surgery. The device provides a magnified 3D view of the operative field from a console, from which the surgeon controls the robot which holds a camera and tremor-free instruments with a greater range of movement than laparoscopic instruments.The benefits to the surgeon are fantastic. There is improved vision and precision. Robotic surgery is more expensive than open surgery due to the cost of the robot (an initial outlay of some £1•5 million) and disposable equipment but this may be offset by other savings, such as reduced length of stay or reduction in complications. Start-up costs are high. Which procedure in your opinion has better outcomes: robotic or open or laparoscopic surgery?
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First of all we should remeber how the research of evidence is very hard in surgery and few operations (open, laparoscopic or robotic) had reached a sufficient level of evidence according to the Oxford Standards. On the other hands, the reasearch and surgical innovations still continue to try improving the quality of life of patients, despite some methodological concerns. Recent publications reported excellent outcomes of robotics, but they are confined to single centers with high financial availability. I am strongly convinced that robotic surgery could overhelm many of the technical drawbacks of laparoscopy when dealing with pancreatic surgery, includind node dissection and anastomosis. In the future, the robotic surgery add reproducibility to many complex operations.
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Reduce the hand tremors in assistant medical robot
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First, excuse me for my bad english. I suppose you want to reproduce with a robot the trajectory that a human surgeon do by hand. Eliminate the hand tremor is relatively easy by filtering the trajectory during the acquisition, but the filter will introduce a dead time. Depending the bandwidth of the tremor this dead time can be any 1/10 of seconds. Technically, realize the filter is not a big problem. There are a lot of possibilities for designing an efficient filter. We have developed and applyed this kind of filters in our project "Policapture" (video : https://www.youtube.com/watch?v=mH4XxW_1IRY Description in french : http://www.hevs.ch/fr/rad-instituts/institut-systemes-industriels/projets/politrack--systeme-de-programmation-rapide-de-robots-de-polissage-policapture-1797 ).
It's not exactly the same application as yours, but the problem is similar. We have the technology to solve your problem. If you are interested, we are able to develop special algorithms for your application.
Prof. J-D Marcuard, HES-SO Valais, mad@hevs.ch 
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The gastrectomy with D2 limphadenectomy is the gold standard for treatment of advanced gastric cancer. A minimally invasive treatment is possible, but a long learning curve is necessary.....
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I agree with you that comparing well with laparoscopic gastrectomy, robot-assisted gastrectomy is a feasible and safe surgical procedure with clear operation field, precise dissection, better lymphadenectomy, minimal trauma, reduced intraoperative blood loss and fast recovery . However, actually there aren't randomized controlled trials for to evaluate the safety and efficacy of procedure. . The results of two recent meta-analysis suggest that robotic gastrectomy is a better alternative technique to open and laparoscopic gastrectomy for gastric cancer.
I ask you how long after the use of procedures of gastrectomy (B I, BII, Roux, ), the first Randomized comparative studies have come out in the literature ? But how much earlier the publication of the randomized controlled trials, the Roux en Y was considered by surgeons, the technique of choice , if compared with BI and BII?
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LESS is still technically difficult and in urology we have already our own limitations. Therefore, do you think that LESS will survive?
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Dear Aly,
if in fact the surgical quality is identical and the scar invisible there is no doubt that LESS will be the future: However, my personal experience teaches me - at least valid for myself - there are complex procedures I can do better by multiarm robotics compared to classical laparoscopy and particularly single site surgery. A lot of procedures in fact can be done by all of the thechniques in same quality. However there are also surgeons who do it best open - either due to their training or capability.
So, we agree that the quality of surgery is most important and not how to come there. So, there is no best access generally, but only individually: each surgeon has to decide how to access (with minimized injury) to guarantuee best surgical qualitiy and minimized morbiditiy of access, but with clear priority. Although surgical qualitiy is extremely difficult to measure we shold not confuse it with feasability.
Happy and Healthy New Year Aly
Yours Rainer
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Do you think that the future of surgery will be ruled by robotic devices, or will it be limited due to the high costs of this technology?
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Dear Giorgio,
very good question!
I think that robotic surgery will have and can have a future only when we will show advantages in terms of results and costs compared to the traditional open surgery. For example today the advantages of robotic prostatectomies are demonstrated and for this operation the robot can improve the results.
I think our role in the future development of robotic surgery, will be to show when and how this technology should be used in order to improve our surgical results and, consequentially, reduce the costs.