Intelligent Surgery最新文献

{"title":"The reflection of the development of orthopaedic robotics in Beijing Jishuitan Hospital","authors":"Yajun Liu","doi":"10.1016/j.isurg.2023.10.002","DOIUrl":"https://doi.org/10.1016/j.isurg.2023.10.002","url":null,"abstract":"<div><p>Beijing Jishuitan Hospital Affiliated to Capital Medical University, known for its leading role in Chinese orthopedics, is the birthplace of orthopedic robotic surgery in China. Over the last two decades, through continuous exploration, Beijing Jishuitan Hospital has gradually matured the robotic and navigation-assisted orthopedic surgery technology, enhancing the precision, intelligence, and safety of orthopedic procedures. This article reviews the development history of orthopedic robots in Beijing Jishuitan Hospital, introduces the application scenarios of orthopedic robots, demonstrates its advantages in clinical work, and looks forward to the future of orthopedic robots.</p></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"6 ","pages":"Pages 75-77"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666676623000169/pdfft?md5=e504c3493ff2fcd344f5807b14880d55&pid=1-s2.0-S2666676623000169-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92139624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic-assisted laparoscopic hepatic hilar cholangiocarcinoma (Bismuth-Corlette Ⅲb) radical resection","authors":"Zhongyu Li,&nbsp;Zhanzhi Meng,&nbsp;Guangchao Yang,&nbsp;Yong Ma","doi":"10.1016/j.isurg.2023.07.001","DOIUrl":"https://doi.org/10.1016/j.isurg.2023.07.001","url":null,"abstract":"<div><h3>Study objective</h3><p>To demonstrate a case for the successful use of the robotic-assisted laparoscopic hepatic hilar cholangiocarcinoma (Bismuth-Corlette Ⅲb) radical resection.</p></div><div><h3>Design</h3><p>Stepwise demonstration with narrated video footage, including left hemi hepatectomy, total caudate lobectomy, extrahepatic biliary tract resection and reconstruction, hepaticojejunostomy, cholecystectomy, and hepatic hilar lymph node dissection.</p></div><div><h3>Setting</h3><p>The First Affiliated Hospital of Harbin Medical University.</p></div><div><h3>Case presentation</h3><p>A 34-year-old female patient developed icteric skin and sclera without obvious triggers, accompanied by dark urine, and light-colored loose stools. She had a dull pain in the upper abdomen and lost 2.5 ​kg weight in this period. Before admission, she had accepted percutaneous transhepatic cholangial drainage (PTCD) in other hospital, with two drainage tubes collecting 500 ml of bile per day in total. Due to the liver-enhanced CT scan suggesting proximal bile duct obstruction, space-occupying lesions of the hilar bile duct are considered, with no exclusion of cholangiocarcinoma. Routine preoperative laboratory examinations were performed after admission. The total bilirubin level was 75.5 μmol/L (normal range, 3.4–21 μmol/L) and the direct bilirubin level was 40.8 μmol/L (normal range, 0.01–3.4 μmol/L); alanine aminotransferase level was 282.6 U/L (normal range, 5–40 U/L); aspartate aminotransferase level was 124.2 U/L (normal range, 8–40 U/L); γ-glutamyl transpeptidase level was 79.8 U/L (normal range, 10–60 U/L); CA19-9 level was 62.68 U/mL (normal range, 0–37 U/mL).</p></div><div><h3>Intervention</h3><p>Since the first robot-assisted hepatectomy was reported in 2002, the use of robot-assisted surgery in the hepatobiliary department has grown rapidly.<span>¹</span>^,<span>²</span> However, robot-assisted surgery for hepatic hilar cholangiocarcinoma radical resection is rarely reported. Although the tumor volume is not large, hepatic hilar cholangiocarcinoma radical resection is regarded as one of the most challenging operations because it includes major hepatectomy, hepatic hilar lymph node dissection, and bile duct reconstruction.<span>³</span>^,<span>⁴</span>. The operative area is located at the core of the first porta hepatis, possessing a close anatomic relationship with the hepatic artery and portal vein, which greatly increases the difficulty and risk of the operation. In addition, for such tumors located at such a unique place, operating space for surgeons is objectively limited, and the radical resection of tumors can only be achieved by ensuring the absolute negative margin of the bile duct and the precise dissection of the hepatic hilar lymph node. The emergence of the robotic-assisted system has solved this problem<span>⁵</span>. With the three core technologies: naked ","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"6 ","pages":"Pages 40-41"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49891133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic single-site secondary abdominal cerclage replacement following initial repair of cervical isthmus injury arising from a history of open abdominal cerclage and subsequent PPROM at 14 weeks gestation","authors":"Nurul Farhanah Binte Abdul Latif ,&nbsp;Zhenkun Guan ,&nbsp;Brooke Thigpen ,&nbsp;Sowmya Sunkara ,&nbsp;Xiaoming Guan","doi":"10.1016/j.isurg.2023.09.003","DOIUrl":"https://doi.org/10.1016/j.isurg.2023.09.003","url":null,"abstract":"<div><h3>Study objective</h3><p>To demonstrate the surgical techniques for removal and replacement of a prior cerclage, repair of a cervical injury caused by the prior abdominal cerclage placement resulting in PPROM during surgery, and methods to mitigate the risk.</p></div><div><h3>Design</h3><p>Stepwise demonstration with narrated video footage.</p></div><div><h3>Setting</h3><p>An academic tertiary care hospital. Our patient is a 32-year-old G4P1 with a complex obstetric history. Her first pregnancy ended with a miscarriage at 7 weeks. A transvaginal cerclage was performed during her second pregnancy at 12 weeks, and she subsequently suffered from PPROM at 24 weeks. The baby was delivered via cesarean section and was 18 months old at the time of the last follow-up. Another transvaginal cerclage was performed at 14 weeks for her third pregnancy, which ended with an IUFD at 16 weeks. She subsequently underwent the removal of the vaginal cerclage and a D&amp;C. In her fourth pregnancy, an open abdominal cerclage was attempted at 14 weeks of pregnancy. The latter caused PPROM during the surgery due to blind needle placement, which resulted in the loss of the fetus. Perioperative notes regarding that particular surgery were not accessible to us at the time of submission. She presented to us as a non-gravid patient seeking the replacement of her abdominal cerclage. Given a complex obstetric history of multiple second-trimester losses with two vaginal cerclages and one open abdominal cerclage, an abdominal cerclage was indicated at the level of the internal cervical os, regardless of cervical length, in a non-pregnant patient.</p></div><div><h3>Interventions</h3><p>Cervical insufficiency is a condition that results in painless, recurrent pregnancy loss before the second trimester in the absence of biochemical triggers. Epidemiologically, cervical incompetence occurs in 0.1–1% of the obstetric population.<span>¹</span> Though rare, this condition has devastating consequences for both the expectant parents and the healthcare system, with preterm births responsible for 70% of all neonatal morbidity and mortality.<span>²</span> The two most common surgical interventions aimed at resolving this condition are the transvaginal and abdominal cerclages. An abdominal cerclage has a reported success rate of 79–100% when done via laparoscopic means.<span>³</span> This is the primary intervention indicated in patients with a history of failed transvaginal cerclages, a shortened or absent cervix due to cervical surgery, or uterine anomalies. Though the intervention has minimal risks and complications for the experienced surgeon in a non-gravid uterus, the difficulty exponentially increases post-conception and even more with increasing gestational age. Owing to the engorged uterine vessels during pregnancy and the amniotic sac that flanks the sides of the internal cervical os, the clearance for safe needle passage during cerclage pla","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"6 ","pages":"Pages 68-69"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49891134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A single-center experience performing robotic liver caudate lobectomy","authors":"Yubin Sheng ,&nbsp;Jiaqi Gao ,&nbsp;Junhao Zheng ,&nbsp;Liye Tao ,&nbsp;Zefeng Shen ,&nbsp;Jingwei Cai ,&nbsp;Xiao Liang","doi":"10.1016/j.isurg.2022.08.005","DOIUrl":"10.1016/j.isurg.2022.08.005","url":null,"abstract":"<div><h3>Background</h3><p>Robotic liver resection is a hot topic in the field of liver surgery in recent years. We report our initial experience with robotic liver caudate lobectomy and discuss its safety.</p></div><div><h3>Methods</h3><p>We retrospectively analyzed the clinical data of 13 patients who underwent the robotic liver caudate lobectomy between May 2018 and May 2021 in a single institution. The details of the surgical strategy were described.</p></div><div><h3>Results</h3><p>All operations were performed robotically, and six operations were combined with other sites resection. The average operation time was 207.69 ​± ​104.81 ​min (single caudate lobectomy: 155.71 ​± ​45.41 ​min); intraoperative bleeding volume was 102.31 ​± ​158.84 ​ml (single: 42.14 ​± ​30.26 ​ml); and the average postoperative hospital stay was 5.08 ​± ​3.04 days (single: 3 ​± ​0.82 days). No deaths or serious surgical complications occurred perioperatively.</p></div><div><h3>Conclusion</h3><p>This study suggests that robotic surgery is safe, effective, and feasible for liver caudate lobectomy.</p></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"5 ","pages":"Pages 1-5"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666676622000801/pdfft?md5=8c67f329ea5d33dc370f9c4115f998c0&pid=1-s2.0-S2666676622000801-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82592632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical experience of minimally invasive duodenum preserving pancreatic head resection","authors":"Hang Xu ,&nbsp;Jialin Li ,&nbsp;Jiang Liu ,&nbsp;Bo Zhang ,&nbsp;Wei Wang","doi":"10.1016/j.isurg.2022.10.001","DOIUrl":"10.1016/j.isurg.2022.10.001","url":null,"abstract":"<div><h3>Background</h3><p>In recent years, an increasing number of pancreatic surgeons has begun to pay attention to duodenum-preserving pancreatic head resection (DPPHR). The purpose of this article is to summarize our experience in minimally invasive DPPHR.</p></div><div><h3>Methods</h3><p>We retrospectively collected outcome data of twenty consecutive cases of laparoscopic or robotic DPPHR performed between June 2021 and January 2022 in the Fudan University Shanghai Cancer Center.</p></div><div><h3>Results</h3><p>All patients successfully completed the operation under minimally invasive procedures, and in no case conversion to laparotomy or pancreaticoduodenectomy was required. The average operation duration was 293 ​± ​41 ​min (range: 216–393 ​min); the intraoperative blood loss was 163 ​± ​70 ​ml (range: 50–300 ​ml), and no intraoperative blood transfusion was required. A total of ten patients (50%) developed postoperative complications, including one patient who suffered a Clavien-Dindo complication grade ​≥ ​III. The average postoperative length of stay was 16.6 ​± ​5.4 days (range:10–33 days).</p></div><div><h3>Conclusions</h3><p>Minimally invasive DPPHR for benign or low-grade malignant tumors of the head of the pancreas is a safe and effective operation, which can improve the long-term quality of life of patients, and is worthy of clinical application.</p></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"5 ","pages":"Pages 12-15"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666676622001132/pdfft?md5=8c638c057ddab4c80eb2720b459a3072&pid=1-s2.0-S2666676622001132-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82516469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of da Vinci surgery in hepatectomy","authors":"Shiliu Lu ,&nbsp;Guandou Yuan ,&nbsp;Biao Lei ,&nbsp;Bin Chen ,&nbsp;Bangyu Lu ,&nbsp;Shuiping Yu ,&nbsp;Songqing He","doi":"10.1016/j.isurg.2022.09.001","DOIUrl":"10.1016/j.isurg.2022.09.001","url":null,"abstract":"<div><p>The first laparoscopic hepatectomy was performed over 30 years ago, and its safety and short-term and long-term outcomes are comparable to those of traditional laparotomy. Minimally invasive surgery is important for liver surgery. However, due to the limitations of its instruments and technology, laparoscopic surgery still has certain challenges in the field of liver resection, which is also an important reason for the relatively slow implementation of laparoscopic liver resection. The advent of the da Vinci robotic surgical system has helped to overcome the shortcomings of laparoscopy, such as the difficulty in exposing some special liver segments and performing sutures and reconstruction. Based on the experience of the authors’ surgical team, this paper explores the application value and breakthrough of the da Vinci robot in minimally invasive hepatectomy from the aspects of perioperative evaluation, lesion localization, bleeding control, surgical approaches, and precautions for complications.</p></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"5 ","pages":"Pages 6-11"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666676622000813/pdfft?md5=2437829efadfeab78230cb0faf7f9da2&pid=1-s2.0-S2666676622000813-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80588129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic liver resection from exploration to maturity—single center experience","authors":"Ben Ma ,&nbsp;Shurui Wu ,&nbsp;Rong Liu,&nbsp;Minggen Hu","doi":"10.1016/j.isurg.2022.09.002","DOIUrl":"10.1016/j.isurg.2022.09.002","url":null,"abstract":"<div><p>By 2022, more than 2000 cases of robotic liver surgeries have been completed in our medical center. Based on the large number of robotic operation experience, recommendations on how to perform robotic liver resection were summarized in this paper. Robotic hepatectomy is a safe and feasible technique. Firstly, a patterned trocar placement scheme and individualized adjustment method are established. Secondly, an improved intracorporeal Pringle maneuver is founded. Thirdly, with reasonable combined use of three-dimensional reconstruction, indocyanine green (ICG) fluorescent staining, intraoperative ultra-sound image and intrahepatic/extrahepatic landmarks, an ideal hepatectomy plane would be more likely obtained. In this paper, robotic liver surgeries are divided into three types according to the difficulty of learning and a safe and feasible advanced learning process is proposed. Experiences in this paper may provide some help to those centers planning to carry out robotic liver surgery.</p></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"5 ","pages":"Pages 20-25"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666676622001120/pdfft?md5=797d43d34e3c23ea03bd52bc857a2ecc&pid=1-s2.0-S2666676622001120-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78741913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-assisted transvaginal natural orifice transluminal endoscopic surgery for a 32-year-old patient with early-stage endometrial carcinoma: A case report (with video)","authors":"Yanna Liu,&nbsp;Li Sun,&nbsp;Keyao Chen,&nbsp;Heyang Xu,&nbsp;Yu Guo","doi":"10.1016/j.isurg.2022.08.004","DOIUrl":"10.1016/j.isurg.2022.08.004","url":null,"abstract":"<div><p>Robot-assisted transvaginal natural orifice transluminal endoscopic surgery (vNOTES) for patients with early-stage endometrial carcinoma has not been reported previously. The following case report is a robot-assisted vNOTES for a 32-year-old female with early-stage endometrial carcinom.We successfully performed hysterectomy and bilateral salpingectomy with sentinel lymph node mapping,spending 165 minutes and estimated blood loss was 50mL. No significant postoperative adverse events were observed. The good perioperative outcome indicated it is a safe and feasible procedure. Various techniques used for successful completion of the surgery, are described in detail in the following report.</p></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"5 ","pages":"Pages 16-19"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666676622000795/pdfft?md5=30d4cb5af7ce8b3733e6a134c36daf65&pid=1-s2.0-S2666676622000795-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74886236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic transvaginal NOTES: A step-by-step approach to surgical technique","authors":"Brooke Thigpen ,&nbsp;Jing Sun ,&nbsp;Xiaoming Guan","doi":"10.1016/j.isurg.2022.06.002","DOIUrl":"10.1016/j.isurg.2022.06.002","url":null,"abstract":"","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"4 ","pages":"Pages 1-8"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666676622000588/pdfft?md5=614c7bf8749d86e5e1107249927db1b9&pid=1-s2.0-S2666676622000588-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74265517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suture technique and material selection in Da Vinci robotic biliary reconstruction surgery","authors":"Hao Zou,&nbsp;Chengzhan Zhu,&nbsp;Mengling Ji,&nbsp;Zejiang Xu,&nbsp;Chuandong Sun","doi":"10.1016/j.isurg.2022.08.001","DOIUrl":"10.1016/j.isurg.2022.08.001","url":null,"abstract":"<div><p>Roux-en-Y hepaticojejunostomy is an important component of robotic biliary reconstruction surgery. High-quality hepaticojejunostomy is inseparable from a number of key factors.These factors include the incision of bile duct stump, the handling of the bowel, anastomosis method selection, and selection of anastomotic threads, etc. More attention should be paid to the improvement of biliary reconstruction techniques in the direction of refinement and homogeneity.</p></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"4 ","pages":"Pages 9-11"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666676622000680/pdfft?md5=4cf1a426e653d5ebf248c82de493c258&pid=1-s2.0-S2666676622000680-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84488382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}