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Robust Control of a Bevel-Tip Needle for Medical Interventional Procedures

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IEEE/CAA Journal of Automatica Sinica 2020年第1期7卷 244-256页

作者： Surender Hans Felix Orlando Maria Joseph Department of Electrical Engineering Indian Institute of Technology RoorkeeRoorkeeUttarakhand 247667India

In minimally invasive surgery, one of the main objectives is to ensure safety and target reaching accuracy during needle steering inside the target organ. In this research work, the needle steering approach is determined using a robust control algorithm namely the integral sliding mode control(ISMC) strategy to eliminate the chattering problem associated with the general clinical scenario. In general, the discontinuity component of feedback control input is not appropriate for the needle steering methodology due to the practical limitations of the driving actuators. Thus in ISMC, we have incorporated the replacement of the discontinuous component using a super twisting control(STC)input due to its unique features of chattering elimination and disturbance observation characteristics. In our study, the kinematic model of an asymmetric flexible bevel-tip needle in a soft-tissue phantom is used to evaluate stability analysis. A comparative study based on the analysis of chattering elimination is executed to determine the performance of the proposed control strategy in real-time needle steering with conventional sliding mode control using vision feedback through simulation and experimental results. This validates the efficacy of the proposed control strategy for clinical needle steering.

关键词： minimal invasive surgery needle steering nonholonomic system robust control sliding mode control

Role of robotic-assisted pancreatic surgery:lessons learned from our initial experience

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Hepatobiliary & Pancreatic Diseases International 2017年第6期16卷 652-658页

作者： Emilio Vicente Yolanda Quijano Benedetto Ielpo Hipolito Duran Eduardo Diaz Isabel Fabra Luis Malave Riccardo Caruso General surgery Department Sanchinarro University Hospital San Pablo University CEU Madrid Spain

BACKGROUND:minimally invasive surgery has achieved worldwide acceptance in various fields, however, pancreatic surgery remains one of the most challenging abdominal procedures. In fact, the indication for robotic surgery in pancreatic disease has been controversial. The present study aimed to assess the safety and feasibility of robotic pancreatic ***:We retrospectively reviewed our experience of robotic pancreatic resection done in Sanchinarro University Hospital. Clinicopathologic characteristics, and perioperative and postoperative outcomes were recorded and ***:From October 2010 to April 2016, 50 patients underwent robotic-assisted surgery for different pancreatic pathologies. All procedures were performed using the da Vinci robotic system. Of the 50 patients, 26 were male and 24 female. The average age of all patients was 62 years. Operative time was 370 minutes. Among the procedures performed were 16 pancreaticoduodenectomies(PD), 23 distal pancreatectomies(DP), 11 tumor enucleations(TE). The mean hospital stay was 17.6 days in PD group, 9.0 days in DP group and 8.4 days in TE group. Pancreatic fistula occurred in 10 cases(20%), 2 after PD, 3 after DP, and 5 after TE. Four patients had postoperative transfusion in PD group and one in DP group. Conversion to open laparotomy occurred in four patients(8%). No serious intraoperative complications were observed. CONCLUSIONS:From our early experience, robotic pancreatic surgery is a safe and feasible procedure. Further experience and follow-up are required to confirm the role of robotic approach in pancreatic surgery.

关键词： robotic surgery pancreatic cancer minimal invasive surgery

Single port laparoscopy in gastroenterology and hepatology: A fine step forward

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World Journal of Gastroenterology 2014年第42期20卷 15599-15607页

作者： Christof Mittermair Jan Schirnhofer Eberhard Brunner Katharina Pimpl Christian Obrist Michael Weiss Helmut G Weiss General surgery Department Saint John of God Hospital

Single incision laparoscopy(SIL) has become an emerging technology aiming at a further reduction of abdominal wall trauma in minimally invasive surgery. Available data is encouraging for the safe application of standardized SIL in a wide range of procedures in gastroenterology and hepatology. Compared to technically simple SIL procedures, the merit of SIL in advanced surgeries, such as liver or colorectal interventions, compared to conventional laparsocopy is self-evident without any doubt. SIL has already passed the learning curve and is routinely utilized in expert centers. This minimized approach has allowed to enter a new era of surgical management that can not be acceded without a fruitful combination of prudent training, consistent day-to-day work and enthusiastic motivation for technical innovations. Both, basic and novel technical specifics as well as particular procedures are described herein. The focus is on the most important surgical interventions in gastroenterology and aims at reviewingthe current literature and shares our experience in a high volume center.

关键词： minimal invasive surgery Single port surgery Single incision laparoscopy Gastroenterology Hepatology

Laparoscopic revolution in bariatric surgery

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World Journal of Gastroenterology 2014年第41期20卷 15135-15143页

作者： Magnus Sundbom Department of Surgical Sciences Uppsala University

The history of bariatric surgery is investigational. Dedicated surgeons have continuously sought for an ideal procedure to relieve morbidly obese patients from their burden of comorbid conditions, reduced life expectancy and low quality of life. The ideal procedure must have low complication risk, both in short- and long term, as well as minimal impact on daily life. The revolution of laparoscopic techniques in bariatric surgery is described in this summary. Advances in minimal invasive techniques have contributed to reduced operative time, length of stay, and complications. The development in bariatric surgery has been exceptional, resulting in a dramatic increase of the number of procedures performed world wide during the last decades. Although, a complex bariatric procedure can be performed with operative mortality no greater than cholecystectomy, specific procedure-related complications and other drawbacks must be taken into account. The evolution of laparoscopy will be the legacy of the 21st century and at present, day-care surgery and further reduction of the operative trauma is in focus. The impressive effects on comorbid conditions have prompted the adoption of minimal invasive bariatric procedures into the field of metabolic surgery.

关键词： Laparoscopy Bariatric surgery minimal invasive surgery Gastric bypass Duodenal switch Gastric banding Metabolic surgery

Laparoscopic approach to Meckel's diverticulum

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World Journal of Gastroenterology 2014年第25期20卷 8173-8178页

作者： Alfonso Papparella Fabiano Nino Carmine Noviello Antonio Marte Pio Parmeggiani Ascanio Martino Giovanni Cobellis Departments of Paediatrics Paediatric Surgery Faculty of Medicine Paediatric Surgery-Second University of Naples80138 NaplesItaly Paediatric surgery Unit-Salesi Children Hospital 60121 AnconaItaly

AIM: To retrospective review the laparoscopic management of Meckel Diverticulum(MD) in two Italian Pediatric surgery ***: Between January 2002 and December 2012, 19 trans-umbilical laparoscopic-assisted(TULA) procedures were performed for suspected MD. The children were hospitalized for gastrointestinal bleeding and/or recurrent abdominal pain. Median age at diagnosis was 5.4 years(range 6 mo-15 years). The study included 15 boys and 4 girls. All patients underwent clinical examination, routine laboratory tests, abdominal ultrasound and technetium-99m pertechnetate scan, and patients with bleeding underwent gastrointestinal endoscopy. The abdominal exploration was performed with a 10 mm operative laparoscope. Pneumoperitoneum was establishedbased on the body weight. Systematic overview of the peritoneal cavity allowed the ileum to be grasped with an atraumatic instrument. The complete exploration and surgical treatment of MD were performed extracorporeally, after intestinal exteriorization through the umbilicus. All patients' demographics, main clinical features, diagnostic investigations, operative time, histopathology reports, conversion rate, hospital stay and complications were registered and ***: MD was identified in 17 patients, while 1 had an ileal duplication and 1 a jejunal hemangioma. Fifteen patients had painless intestinal bleeding, while 4 had recurrent abdominal pain and exhibited cyst like structures in an ultrasound study. Eleven patients had a positive technetium-99m pertechnetate scan. In the patients with bleeding, gastrointestinal endoscopy did not name the source of hemorrhage. All patients were subjected to a TULA surgical procedure. An intestinal resection/anastomosis was performed in 14 patients, while 4 had a wedge resection of the diverticulum and 1 underwent stapling diverticulectomy. All surgical procedures were performed without conversion to open laparotomy. Mean operative time was 75 min(range 40-115 min). No m

关键词： Meckel's diverticulum Laparoscopy One trocar surgery Gastrointestinal bleeding minimal invasive surgery Ileal duplication Jejunal hemangioma

Clinical Application of Percutaneous Nephrostomy in Some Urologic Diseases

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2008年第4期28卷 439-442页

作者：罗洪波刘修恒吴天鹏张孝斌 Department of Urology Renmin Hospital Wuhan University

Percutaneous nephrostomy was applied in some other urologic diseases and the efficacy was evaluated. Percutaneous nephrostomy for percutaneous nephrolithotomy （PNL） was performed in patients with various renal, perinephric and bladder diseases （n=79）. The tract establishment, operation duration and complications were observed and the efficacy was assessed. The results showed that the tracts were successfully established in 79 cases. The operation lasted 4–20 min. 12F–16F single tract was established in nephrohydrop patients and 16F–20F single or multiple tracts were established in patients with pyonephrosis, renal cortical abscess, renal cyst and perinephric abscess. During dilation, no leakage of liquor puris was noted. Establishment of 18F single tract was achieved in one urinoma patient. In two patients with foreign body in kidney, the foreign bodies were removed via established 14F single tract. 18F tracts were established in 2 patients with bladder contracture, which was followed by the placement of 16F balloon urethral catheter for drainage. No complications, such as massive bleeding, intestinal injury and spreading of infection took place in our series. All the patients were followed up for 2–12 months. No long-term complications such as dropping of drainage tube occurred. It is concluded that as a minimally invasive technique, percutaneous nephrostomy has the advantages of convenience, simplicity and causing less complications and can be used for various urologic diseases.

关键词： urologic disease percutaneous nephrostomy minimal invasive surgery

Robotic donor hepatectomy:Are we there yet?

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World Journal of Gastrointestinal surgery 2021年第7期13卷 668-677页

作者： Ashwin Rammohan Mohamed Rela Institute of Liver Disease&Transplantation Dr.Rela Institute&Medical CentreBharath Institute of Higher Education&ResearchChennai 600044India

In living donor liver transplantation(LDLT)the safety of the live donor(LD)is of paramount *** all efforts,the morbidity rates approach 25%-40%with conventional open donor hepatectomy(DH)***,most of these complications are related to the operative wound and despite increased selfesteem and satisfaction in various quality of life analyses on LD,the most common grievance is that of the *** safe and precise DH through a conventional laparoscopic approach is a formidable task with a precipitous learning curve for the whole *** to the ramifications the donor operation carries for the donor,the recipient,the transplant team and for the LDLT program in general,the development and acceptance of minimally invasive DH(MIDH)has been *** robotic surgical system overcomes the reduced visualization,restricted range of motion and physiological tremor associated with laparoscopic surgery and allows for a comparatively easier transition from technical feasibility to ***,many questions especially with regards to standardization of surgical technique,comparison of outcomes,understanding of the learning curve,*** *** aim of this review is to provide insights into the evolution of MIDH and highlight the current status of robotic DH,appreciating the existing challenges and its future role.

关键词： Liver transplantation Donor hepatectomy minimal invasive surgery Robotic surgery Outcomes

Primary repair of esophageal atresia gross type C via thoracoscopic magnetic compression anastomosis:A case report

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World Journal of Gastrointestinal surgery 2023年第12期15卷 2919-2925页

作者： Hong-Ke Zhang Xiao-Quan Li Hong-Xia Song Shi-Qi Liu Fang-Hui Wang Jian Wen Mi Xiao A-Ping Yang Xu-Feng Duan Zhen-Zhen Gao Kai-Lun Hu Wei Zhang Yi Lv Xi-Hui Zhou Zhen-Jie Cao Department of Pediatric surgery The First Affiliated Hospital of Xi’an Jiaotong UniversityXi’an 710061Shannxi ProvinceChina Department of Neonatology The First Affiliated Hospital of Xi’an Jiaotong UniversityXi’an 710061Shannxi ProvinceChina Department of Neonatal surgery Xi’an Children’s HospitalXi’an 710003Shannxi ProvinceChina Department of Anesthesiology The First Affiliated Hospital of Xi’an Jiaotong UniversityXi’an 710061Shannxi ProvinceChina Department of Hepatobiliary surgery The First Affiliated Hospital of Xi’an Jiaotong UniversityXi’an 710061Shannxi ProvinceChina

BACKGROUND Esophageal atresia(EA)is a life-threatening congenital malformation in newborns,and the traditional repair approaches pose technical challenges and are extremely ***,surgeons have been actively investigating new minimally invasive techniques to address this *** compression anastomosis has been reported in several studies for its potential in repairing *** this paper,the primary repair of EA with magnetic compression anastomosis under thoracoscopy was *** SUMMARY A full-term male weighing 3500 g was diagnosed with EA gross type *** magnetic devices used in this procedure consisted of two magnetic rings and several *** fistula ligation and two purse strings were *** magnetic compression anastomosis was then completed *** the primary repair,no additional operation was conducted.A patent anastomosis was observed on the 15th day postoperatively,and the magnets were removed on the 23rd *** leakage existed when the transoral feeding *** Thoracoscopic magnetic compression anastomosis may be a promising minimally invasive approach for repairing EA.

关键词： Congenital esophageal atresia minimal invasive surgery Thoracoscopic repair Magnetic compression anastomosis Primary repair Case report

Simultaneous lateral and subxiphoid access methods for safe and accurate resection of a superior vena cava aneurysm:A case report

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World Journal of Clinical Cases 2023年第31期11卷 7635-7639页

作者： Sang Pil Kim Joohyung Son Department of Thoracic and Cardiovascular surgery Kyunghee University HospitalSeoul 02447South Korea Department of Thoracic and Cardiovascular surgery Pusan National University Yangsan HospitalYangsan-si 50612South Korea

BACKGROUND Superior vena cava(SVC)aneurysms are a relatively uncommon disease that has not been widely *** conventional surgical approach for treating SVC aneurysms includes open thoracotomy and ***,in this case,the aneurysm could be safely resected by thoracoscopic simultaneous lateral and subxiphoid access *** SUMMARY A 58-year-old male presented with intermittent chest pain and persistent discomfort in the chest area.A chest computed tomography scan revealed a 6.2 cm aneurysm in the left innominate vein and SVC *** surgical resection,simultaneous lateral and subxiphoid access were planned to achieve optimal proximal and distal aneurysm *** approach site was 1 cm below the xiphoid process,the fifth mid-axillary line and the seventh anterior axillary line on the right *** aneurysm was resected using a *** patient was discharged on the third day after chest tube removal on the second postoperative day with no particular *** Aneurysms located within the mediastinum can be accessed through thoracoscopic approach without open surgery and safely resected using vascular staples.

关键词： Aneurysm Cardiopulmonary bypass Superior vena cava minimal invasive surgery Video assisted thoracic surgery Case report