The international journal of medical robotics + computer assisted surgery : MRCAS
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Case Reports
Robotic totally endoscopic coronary artery bypass grafting for spontaneous coronary artery dissection.
Patients with spontaneous coronary artery dissection may require surgical revascularization. Reports on the surgical management of this pathology are primarily limited to classic coronary artery bypass grafting via sternotomy on cardiopulmonary bypass, although a limited number of reports of alternatives also exist. ⋯ Selected patients with spontaneous coronary artery dissection may benefit from a totally endoscopic approach to surgical coronary revascularization.
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Review
Frameless stereotactic targeting devices: technical features, targeting errors and clinical results.
Brain biopsies (BB) and depth electrode placements (DEP) are increasingly performed using frameless stereotactic targeting devices. This paper is intended to provide a comprehensive review of the technical features, targeting errors and clinical results. ⋯ Frameless stereotactic targeting devices may reach targeting errors and clinical results comparable with standard frame-based stereotaxy. Advantages and disadvantages of different devices should be acknowledged to ensure optimal technical performance.
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Central venous catheterization is a procedure in which a doctor inserts a catheter into a patient's vein for transfusions. Risks of this procedure include bleeding from the puncture of blood vessels and pneumothorax caused by pleural puncture. To avoid these and other risks, physicians are required to ensure that the needle is inserted securely and that it stops within the vein. ⋯ The feasibility of this system was demonstrated in our experiments. Further studies, such as in vivo experiments, are required.
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Arthroscopy of the shoulder is a well-established diagnostic procedure which has widespread application. Advances in technology and the search for more minimal invasive surgery will always offer new techniques in any surgical field. Robotic technology is such an advance, offering technical advantages over standard laparoscopic approaches. The aim of the present study is to test whether robotic surgery can be used while performing shoulder arthroscopy or not. ⋯ Robotic shoulder arthroscopy seems feasible in a cadaveric model but has some significant limitations at this time. A clinical application could be performed as diagnostic arthroscopy and as simple arthroscopic surgery until more specific instrumentation is developed. It may also enable the surgeon to perform more complex and precise tasks in restricted spaces.
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Robotic-assisted laparoscopic prostatectomy (RALP) is usually performed in steep Trendelenburg position, which can be associated with cardiac impairment due to positioning and capnoperitoneum. This study investigated haemodynamic consequences and cardiac function in this type of surgery and evaluated the hypothesis that steep Trendelenburg position and capnoperitoneum results in haemodynamic and ventricular impairment. ⋯ The steep Trendelenburg position may improve haemodynamic function and does not deteriorate left or right ventricular function during RALP. However, mitral valve insufficiency may be aggravated by positioning and capnoperitoneum.