The international journal of medical robotics + computer assisted surgery : MRCAS
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Femoroacetabular impingement (FAI) is increasingly recognized as a potential cause of hip osteoarthritis. A system capable of pre-operatively simulating hip range of motion (ROM) by given surface models from either healthy or FAI diseased bone is desirable. ⋯ The present study demonstrates a pre-operative approach to virtually simulate and predict the functional hip ROM based on the given bone models. The impingement detection and ROM simulation systems developed may also be used for other orthopedic applications.
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Review Case Reports
Totally robotic right colectomy: a preliminary case series and an overview of the literature.
Since the introduction of robotics, relatively few series have been published evaluating its role for right colectomy. The aim of this study was to report our preliminary experience with totally robotic right colectomy (TRRC). ⋯ TRRC is not only safe and feasible but also oncologically effective. Although preliminary and small, this experience confirmed the results from previous series using a hand-sewn intracorporeal anastomosis. Larger series are required to draw firm conclusions concerning the possible indications for TRRC.
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Percutaneous pedicle screws are commonly used in minimally invasive spinal procedures. Traditional techniques of percutaneous pedicle screw placement have employed the use of multiplanar fluoroscopy and Kirschner wires (K-wires). The use of multiplanar fluoroscopy for the placement of percutaneous pedicle screws likely increases radiation exposure to the surgeon when compared to open techniques. K-wires can break or become bent during the procedure, making it difficult to insert and remove instrumentation over them. Additionally, there is also a risk of visceral or vascular injury with the use of K-wires. The authors present a novel method of percutaneous pedicle screw placement utilizing three-dimensional (3D) fluoroscopy-based image guidance in which K-wires are not used and there is minimal to no radiation exposure to the surgeon and operating room staff. ⋯ Percutaneous pedicle screws can be placed accurately and safely using 3D image guidance without the use of K-wires. Little to no radiation exposure to the surgeon or OR staff occurs with this technique. No complications occurred in this study as a result of screw placement or image guidance.
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During surgical procedures, various medical systems, e.g. microscope or C-arm, are used. Their precise and repeatable manual positioning can be very cumbersome and interrupts the surgeon's work flow. Robotized systems can assist the surgeon but they require suitable kinematics and control. However, positioning must be fast, flexible and intuitive. ⋯ The robotic system assists the surgeon, so that he can position the microscope precisely and repeatedly without interrupting the clinical workflow. The combination of manual und automatic control guarantees fast and flexible positioning during surgical procedures.
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Robotically assisted laparoscopic surgery has a different learning curve to straight stick laparoscopic surgery. The learning curve for novices is likely to be different to that for experienced surgeons. We assessed the early learning curve for trainees with 18 months or less of surgical experience. ⋯ For surgical novices tested on an in vitro dexterity exercise, a robotically assisted laparoscopic system offers a shorter learning curve and improved accuracy compared to straight stick surgery.