“Re: Luca Cindolo, Stefano Gidaro, Fabiola R. Tamburro, Luigi Schips. Laparo-Endoscopic Single-Site Left Transperitoneal Adrenalectomy. Eur Urol. In press. doi:10.1016/j.eururo.2009.07.001.”
Autorino, R., R. J. Stein, et al.
“Pediatric single-port-access nephrectomy for a multicystic, dysplastic kidney.”
Johnson, K. C., D. Y. Cha, et al. (2009).
Journal of Pediatric Urology 5(5): 402-404.
Major urologic surgery via a single port has emerged as the latest progression in laparoscopy and robotics. While current literature highlights the single-port approach to the surgical treatment of cholecystitis, appendicitis and varicoceles, this technique has never been employed to perform a nephrectomy on a child. We herein report a case of a pediatric patient who underwent nephrectomy via single-port-access.
“Navigation systems and platforms in natural orifice translumenal endoscopic surgery (NOTES).” Karimyan, V., M. Sodergren, et al. (2009).
International Journal of Surgery 7(4): 297-304.
Introduction: The latest evolution in minimally invasive surgery is to avoid skin incisions by using natural orifices, called natural orifice translumenal endoscopic surgery (NOTES). However, to safely and efficiently perform NOTES, the requirements of the operating platform used need to be modified from the conventional endoscope. The aim of this paper is to systematically review specialised operating platforms used or in development for NOTES procedures. Methods: A review of the literature was conducted using Ovid EMBASE, Ovid MEDLINE, ISI Current Contents Connect and PubMed, a search tool of the National Library of Medicine and the national institute of Health, until the 1st of December 2008. Data was extracted to specifically characterise the available platforms, their availability, advantageous characteristics and potential disadvantages. Results: There were 9 studies included in this review describing 6 different navigation platforms and 3 robotic systems for NOTES. Based on this analysis, it is our opinion that although the described surgical systems and navigation platforms possess some attractive characteristics, such as maneuverability, stability, enhanced optics, and the ability to provide triangulation and insufflation with proper suction/irrigation maintenance, there does not appear to be one platform which is clearly superior to others. Conclusion: Current instruments are not suited for effective surgery in a NOTES environment. There are several important requirements for NOTES platform: 1) to provide safe access to the peritoneal cavity; 2) to provide a stable channel for instrumentation passageway and safe navigation, 3) to provide good visualization and illumination, thereby decreasing disorientation, 4) to maintain proper insufflation and suction/irrigation, and 5) to provide maneuverability and triangulation of the instruments. Effective collaborations between clinicians, engineering departments and industry are essential to maximise and expedite the innovative process in producing an optimal NOTES platform. © 2009 Surgical Associates Ltd.
“Rise of the machines.”
Basu, I. (2009).
International Journal of Surgery 7(4): 399-400.
“[Navigation and robotics of the lateral skull base.].”
Caversaccio, M., C. Stieger, et al. (2009).
Computer-aided microscopic surgery of the lateral skull base is a rare intervention in daily practice. It is often a delicate and difficult minimally invasive intervention, since orientation between the petrous bone and the petrous bone apex is often challenging. In the case of aural atresia or tumors the normal anatomical landmarks are often absent, making orientation more difficult. Navigation support, together with imaging techniques such as CT, MR and angiography, enable the surgeon in such cases to perform the operation more accurately and, in some cases, also in a shorter time. However, there are no internationally standardised indications for navigated surgery on the lateral skull base. Miniaturised robotic systems are still in the initial validation phase.
“The future of robotics in hand surgery.”
Liverneaux, P., E. Nectoux, et al. (2009).
Chirurgie de la Main.
Robotics has spread over many surgical fields over the last decade: orthopaedic, cardiovascular, urologic, gynaecologic surgery and various other types of surgery. There are five different types of robots: passive, semiactive and active robots, telemanipulators and simulators. Hand surgery is at a crossroad between orthopaedic surgery, plastic surgery and microsurgery; it has to deal with fixing all sorts of tissues from bone to soft tissues. To our knowledge, there is not any paper focusing on potential clinical applications in this realm, even though robotics could be helpful for hand surgery. One must point out the numerous works on bone tissue with regard to passive robots (such as fluoroscopic navigation as an ancillary for percutaneous screwing in the scaphoid bone). Telemanipulators, especially in microsurgery, can improve surgical motion by suppressing physiological tremor thanks to movement demultiplication (experimental vascular and nervous sutures previously published). To date, the robotic technology has not yet become simple-to-use, cheap and flawless but in the future, it will probably be of great technical help, and even allow remote-controlled surgery overseas. © 2009 Elsevier Masson SAS. All rights reserved.