Augmenting Haptic Perception in Surgical Tools
Terry M. Peters, Cristian A. Linte, Ziv Yaniv, Jacqueline Williams in Mixed and Augmented Reality in Medicine, 2018
Microsurgery refers to the set of surgical techniques that are performed beyond the limits of unassisted human eyesight (Yap and Butler 2007). As opposed to MIS, clinicians still make incisions to directly access tissues of interest, but in general they operate on relatively small structures, such as nerves, vessels, and thin membranes, and employ correspondingly smaller forces (Patkin 1977; Tsai et al. 2013). For example, Jagtap and Riviere (2004) measured average axial forces during in vivo microvascular puncture tasks to be as low as 75 mN. Furthermore, movements in microsurgery are performed on such a small scale that kinesthetic afferent signals are generally not differentiable (Jones 2000), and tremor becomes a significant additional component to the intended movement.
History of Reconstructive Surgery
John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford in Head & Neck Surgery Plastic Surgery, 2018
The late 1960s and early 1970s heralded the era of reconstructive microsurgery. The concept of free tissue transfer had been developed years earlier but was limited by the quality and availability of microvascular sutures, quality instruments and magnification. Jacobson and Suarez21 first described the repair of vessels under 2 mm in 1960. The first free tissue transfer of a composite of skin was performed by Taylor and Daniels in 1973.22 Subsequent developments in reconstructive microsurgery have resulted in the description of a plethora of free tissue transfers available for head and neck reconstruction, championed by a number of extremely gifted reconstructive microsurgeons including Harii, Buncke, Manktelow and many others.
What is difference in management of primary lymphedema between adults and children, and how much?
Byung-Boong Lee, Peter Gloviczki, Francine Blei, Jovan N. Markovic in Vascular Malformations, 2019
Microsurgery can be performed in the pediatrics patient population. But the main concern is based on a fact that a vessel of these sizes can provide variable degrees of the transport capacity of that system. It would be necessary to do many anastomoses and also to consider performing it on malformed vessels if it is technically feasible, or with a deficient muscle (leiomyomatosis). The lymph node–vein anastomosis can be done, but the drawback is to achieve a lymphovenous pressure gradient that remains persistent in time at the level of the anastomosis. The vascularized lymph node transfer is also technically possible and also useful, but it is risky or insufficient if the lymphatic pathology is a systemic condition.1, 5–7
The future of virtual reality in cataract surgical training
Published in Expert Review of Ophthalmology, 2020
Daniel Josef Lindegger, Nouf Alnafisse, Ann Sofia Skou Thomsen, Abison Logeswaran, George M. Saleh
Microsurgery is a highly technical skill, taking years to master in an ergonomically challenging environment (requiring all four limbs to function independently), all whilst using an indirect viewing platform [45]. The backbone of current surgical education is still the mentor-apprentice Halstead model, and this will remain albeit with significant enhancements [46]. Transformational changes to cataract surgical tutorage, and the virtual reality technology deployed to enhance it, will emerge in the near future [47,48]. Facilitated by accelerating developments in this sphere, these technologies will, in our opinion, offer a rapidly improved array of skills acquisition options, in a personalized fashion, delivered flexibly and remotely, reflecting a deeper understanding of modern learning theories.
Review of the role of robotic surgery in male infertility
Published in Arab Journal of Urology, 2018
Mohamed Etafy, Ahmet Gudeloglu, Jamin V. Brahmbhatt, Sijo J. Parekattil
Robot-assisted microsurgery also allows for novel microsurgical approaches; it allows microsurgery to be performed in locations of the body that would otherwise be difficult to access with open and standard microscopic techniques. Trost et al. [18] described the first bilateral intracorporeal RAVV in a patient who had bilateral iatrogenic vasal obstruction from prior bilateral inguinal hernia repair. They reported a successful minimally invasive bilateral intracorporeal anastomosis. This procedure requires a very large abdominal incision with standard microsurgical and open approaches but with the robotic approach it can be performed with only four small skin incisions (port sites, <1 cm each). Barazani et al. [19] reported the first case of intra-abdominal RAVV used to repair obstructive azoospermia resulting from prior laparoscopic vasectomy.
Data analytics interrogates robotic surgical performance using a microsurgery-specific haptic device
Published in Expert Review of Medical Devices, 2020
Amir Baghdadi, Hamidreza Hoshyarmanesh, Madeleine P. de Lotbiniere-Bassett, Seok Keon Choi, Sanju Lama, Garnette R. Sutherland
The design specifications of neuroArmPLUSHD are described previously by Hoshyarmanesh et al. [24,25]. In brief, neuroArmPLUSHD is a haptic hand-controller with (7 + 2) degrees-of-freedom (DOF) positional sensing (average resolution: 0.06 deg; accuracy: 0.9 mm), 3 DOF force feedback (peak force: 15 N; force resolution in x, y, and z directions: 0.1 N, 0.35 N, and 0.3 N), a large dexterous workspace (translational: 850 × 830 × 1312 mm; rotational: 180 × 160 × 180 deg.) and weight of 35 kg designed specifically for microsurgery (Figure 1). An actuator is incorporated at the tip in order to convey force interactions in the surgical environment. The hand-controller is designed to recreate the act of performing surgery with an anthropometry-driven structure mimicking the human upper extremity, i.e. serial linkage design in order to maximize the device intuitiveness and dynamic weight compensation to avoid interference of the device with natural arm movement. Furthermore, in microsurgery it is imperative to accurately perceive, plan, and execute the act of fine surgical tasks, e.g. pinching/grasping, dissection forces, and tool roll. Accordingly, the pitch, roll, and yaw of the handpiece end-effector are optimized in order to reflect the movements required by a surgeon’s hand [30]. In spite of the existing haptic devices that have generic multifunctional handles without considering the tool specifications suitable for executing the desired surgical tasks, neuroArmPLUSHD modular handle incorporates microsurgical instruments (Figure 1).
Related Knowledge Centers
- Anastomosis
- Neurosurgery
- Surgery
- Operating Microscope
- General Surgery
- Ophthalmology
- Orthopedic Surgery
- Gynecological Surgery
- Otorhinolaryngology
- Oral & Maxillofacial Surgery