Invasive Technology Research Articles

Robotic surgical techniques and methods for treating renal cell carcinoma with inferior vena cava tumor thrombus

Abstract Purpose of Review Renal cell carcinoma with inferior vena cava (IVC) tumor thrombus (RCC-IVCTT) has a high mortality rate, and surgery is the only promising treatment. Open surgery has been the gold standard treatment for several decades. However, with the development of minimally invasive surgical technologies, the advantages of robotic surgery have gradually emerged. The classic Mayo Clinic Classification system has certain limitations in guiding robotic surgery. Therefore, a new classification system that is compatible with robotic surgery is urgently needed. Advancements in robotic surgery must be systematically summarized and evaluated. Recent Findings Since Abaza's initial report on robotic surgery, the exploration of robotic radical nephrectomy (RRN) with IVC thrombectomy has resulted in numerous related techniques and approaches, including surgical positions and approaches, control of blood vessels, assisted exposure, step-by-step strategy, and preoperative and intraoperative auxiliary technology and equipment. Our team proposed a new tumor thrombus classification system termed the “301 Classification” based on RRN with venous thrombectomy, which matches each level of tumor thrombus with a distinct robotic surgical strategy. Summary With advances in technology and accumulated experience, RRN with IVC thrombectomy holds promise as the preferred surgical option for RCC-IVCTT. Although “301 Classification” can provide objective advantages in robotic surgery, more cases are needed to be optimized for guiding surgery accurately. The overview provided in this paper aims to serve as a reference and inspiration for future research and clinical practice regarding RCC-IVCTT.

Advancing Brain Organoid Electrophysiology: Minimally Invasive Technologies for Comprehensive Characterization

AbstractHuman brain organoids, which originate from pluripotent stem cells, serve as valuable tools for a wide range of research endeavors, replicating brain function. Their capacity to replicate cellular interactions, morphology, and division provides invaluable insights into brain development, disease modeling, and drug screening. However, conventional morphological analysis methods are often invasive and lack real‐time monitoring capabilities, posing limitations to achieving a comprehensive understanding. Therefore, advancing the comprehension of brain organoid electrophysiology necessitates the development of minimally invasive measurement technologies with long‐term, high‐resolution capabilities. This review highlights the significance of human brain organoids and emphasizes the need for electrophysiological characterization. It delves into conventional assessment methods, particularly focusing on 3D microelectrode arrays, electrode insertion mechanisms, and the importance of flexible electrode arrays to facilitate minimally invasive recordings. Additionally, various sensors tailored to monitor organoid properties are introduced, enriching the understanding of their chemical, thermal, and mechanical dynamics.

Methodical Conflict among the Ways for Drying out of Historic Masonry

The purpose of this paper is to give a focus on evaluation of effectiveness of technologies aimed on remedy of unwanted moisture in masonry constructions of historic architectural heritage buildings standing under architectural heritage protection. There are many ways how to achieve the wonted state of the constructions, but some of them are quite invasive, some are not that much invasive and some of them are doubtful. The usual resistance of a group of officers of Heritage authorities to invasive technologies makes the practise complicated, as the, so called invasive technologies are usually the most effective. Officers usually welcome not that much invasive technologies and a special place in their understanding of this problem is held by the Method of Sequential Steps. This method is based on step by step introduced ways of solving of the problem, which should start with minimal interventions and continue towards more intervening interventions. This approach might be relatively sensitive to the structures, but it takes a lot of time and a success is not ensured.

EARLY DIAGNOSIS OF ALZHEIMER’S DISEASE USING A SIMPLE AND SENSITIVE NANOBIOSENSOR

Abstract Existing diagnostic methods for Alzheimer’s disease (AD), such as PET/MRI imaging and cerebrospinal fluid tests, are invasive and/or costly. Recent studies have demonstrated that exosomes (nanoscale extracellular vesicles carrying specific biomarkers that can traverse blood-brain barrier) are ideal sources of AD biomarkers, which can be conveniently collected from peripheral body fluids like blood and saliva. Detection of AD exosomal biomarkers opens a new avenue for non-invasive diagnosis of AD. However, the concentrations of AD exosomal biomarkers in body fluids are extremely low. Therefore, highly sensitive analytical techniques such as mass spectrometry are required to measure the exosomal biomarkers accurately. Unfortunately, these sensitive techniques come with high costs and can be cumbersome, limiting their widespread use in clinical settings. In this research, we report a simple and low-cost nano-biosensor for ultrasensitive detection of AD exosomal biomarkers. The nano-biosensor relies on metal nanoparticles as labels or signal transducers. After conjugation of the metal nanoparticles with bioreceptors specific to AD exosomal biomarkers, the nanoparticle-bioreceptor conjugates can specifically catalyze the formation of colorimetric signal that can be conveniently quantified by an inexpensive spectrophotometer. The nano-biosensor is expected to be able to detect AD exosomal biomarkers from blood and/or saliva samples, representing a minimally invasive and accessible technology for early diagnosis of AD.

A Novel Transcatheter Posterior Ventricular Anchoring Neochordoplasty Mitral Valve Repair Device.

Advancements in minimally invasive technologies to decrease postoperative morbidity and recovery times represent a large opportunity for mitral valve repair operations. However, current technologies are unable to replicate gold standard surgical neochord implantation. We developed a novel neochordal repair device, Minimally Invasive Ventricular Anchoring Neochordoplasty (MIVAN), which operates via transcatheter, trans-septal anchoring to the posterior ventricular wall. We evaluated MIVAN in an ex vivo heart simulator and compared it with surgical neochordal repair and MitraClip using a prolapse model. Upon MIVAN repair of the model (n = 5), regurgitant fraction was reduced from 19.46 ± 1.77% to 7.30 ± 0.99% (p = 0.01). Surgical neochordal repair reduced regurgitant fraction to 5.65 ± 0.66%, but there was no significant difference between MIVAN and surgical repair (p = 0.22). Unpaired MitraClip repair had significantly higher regurgitant fraction of 11.9 ± 1.40%, compared with those of neochord (p < 0.01) and MIVAN (p = 0.03) repairs. MIVAN represents a high-value opportunity for minimally invasive mitral valve repair. The benefits of the percutaneous, trans-septal approach for implantation on the posterior ventricular wall necessitate the expanded exploration of this device as a treatment alternative.

A multicenter, randomized, parallel-controlled clinical trial protocol to evaluate the safety and efficacy of irreversible electroporation compared with radiofrequency ablation for the treatment of small hepatocellular carcinoma

BackgroundAt present, the main clinical application of local ablation therapy, such as radiofrequency ablation (RFA), is to heat the tissue to a certain temperature. However, high temperature will cause thermal damage. Irreversible electroporation (IRE) is a novel minimally invasive local ablation technology for tumors. By high-frequency pulse, the tumor cell membrane can be irretrievably perforated, resulting in the destruction of the intracellular environment, which can preserve important structures in the treatment area. However, there are no randomized controlled clinical trials comparing the efficacy of IRE with traditional local ablation in the treatment of liver cancer.AimsThis study aims to conduct a randomized controlled clinical trial comparing the efficacy of IRE with RFA in the treatment of liver cancer.MethodsWe will conduct a multicenter, randomized, parallel-controlled non-inferiority clinical trial to compare the efficacy and safety of IRE and RFA for hepatocellular carcinoma (HCC). One hundred and ninety patients with HCC from five academic medical centers will be enrolled. The patients will be randomized into treatment arm (IRE) and control arm (RFA). The primary outcome is the progress -free survival (PFS) and the key secondary outcome is the Overall survival (OS).ResultsForty-eight patients had been recruited from 5 centers, of which, 33 patients (median age, 59.1 years) with 38 tumors had completed the 1-month follow-up and 21 patients have complete the 3-month follow up, with 2.3 months median follow up period. The mean largest tumor diameter is 3.9 cm. No end point was observed for PFS or OS in both groups, and the complete ablation rate was 100% in both groups. The lesions in the IRE group showed obvious shrinkage 1 month after procedure. One major adverse event (AE) was occurred in the control group.ConclusionThis is the first randomized controlled clinical trial to compare the clinical effects of IRE and RFA. The preliminary results suggest that both RFA and IRE are effective in the treatment of HCC, which can provide strong evidence for the use of IRE in HCC and provide more options for the treatment of patients with HCC.Clinical Trial RegistrationClinicalTrials. gov, identifier NCT05451160.

Patents, gendered bodies and innovation: a case study on contraceptives

Abstract The Anthropocene, while a recently popularized term, is part of a long history theorizing human impact globally. Since the 1970s, a chief focus of modulating this impact was population control. While the Anthropocene is about the human impact on the Earth, to date, the contraceptive burden lies with women, using invasive technologies that can have highly detrimental side effects. This article uses patent records to consider the sources of this disparity, including how post-grant patent law theories based on incentives to innovate ignore gender narratives and the varying ways in which society evaluates different bodies, and how this has different consequences for invention and innovation. As we are not yet in a post-gender world, it is important that our post-grant patent theory considers gender. This is necessary if we are to meet the challenges that face all of humankind.

Research on the Exoskeleton Enhancing Human Touch

The integration of brain-computer interfaces (BCIs) with exoskeleton systems offers a unique potential to enhance and restore human sensory and motor capabilities. This review delves into both invasive and non-invasive BCI technologies, with a special emphasis on the practical application of electroencephalography (EEG). It critically assess the effectiveness and limitations of EEG in controlling exoskeletons, while providing a detailed comparison of various control methods, including direct neuromuscular stimulation, neurofeedback, and machine learning-based intelligent strategies. Additionally, this review addresses the technical challenges faced by integrated systems, particularly in performing complex tasks and delivering real-time feedback, such as the intricacies of signal decoding, system stability, and user adaptability. The conclusion underscores the importance of future research in enhancing system reliability and accuracy, refining user interfaces, and developing novel algorithms to improve performance and user experience. This review aims to equip researchers in the field with a robust theoretical framework and practical insights, facilitating further advancements in the synergy between BCI and exoskeleton technologies.

Textured-piezoelectric-ceramic-based focused intravascular ultrasonic transducer with improved image quality and uniformity

Intravascular ultrasound (IVUS) imaging is a minimally invasive medical technology that plays a critical role in diagnosis, treatment guidance, and post-treatment assessment of coronary artery diseases. As a crucial component of the IVUS system, conventional IVUS transducers are designed to be planar and unfocused to adequately cover the region of interest. However, this design comes at the cost of spatial resolution. Here, we developed a high-performance focused IVUS transducer using Pb(In1/2Nb1/2)O3-Pb(Sc1/2Nb1/2)O3-PbTiO3 (PIN-PSN-PT) textured ceramics with both high electromechanical performance (thickness-mode electromechanical coupling factor kt: ∼60%) and high Curie temperature (TC: ∼250 °C). Benefiting from the relatively low clamped dielectric constant (ε33S/ε0: ∼450) of PIN-PSN-PT-textured ceramics in contrast to currently used soft piezoelectric ceramics (&amp;gt;1000), we designed a relatively large aperture for the focused IVUS transducer, with a goal of enhancing lateral resolution across a larger depth of field, ranging from 1 to 5 mm. The developed focused IVUS transducer operates at 42 MHz with an −6 dB bandwidth of 72%, featuring a 0.6 × 0.6 mm2 aperture while maintaining an electrical impedance of approximately 40–60 Ω. The axial and lateral resolutions characterized by wire phantom imaging are 45 and 208 μm, respectively. The acoustic pressure generated by the focused IVUS transducer is 1.4 times higher than that of its planar counterpart. Ex vivo porcine coronary artery imaging demonstrates that our focused IVUS transducer offers improved image quality and uniformity for the visualization of intravascular structures. Our work shows great potential of PIN-PSN-PT-textured ceramics for creating high-frequency miniaturized focused transducers.

Shifting Paradigms in Hemorrhoid Management: The Emergence and Impact of Cap-Assisted Endoscopic Sclerotherapy.

Hemorrhoidal disease (HD) is a prevalent proctological condition that has puzzled people since ancient times, and the most common symptom is painless bleeding. Traditional treatments include conservative treatment, nonsurgical office-based treatments, and surgery. Sclerotherapy is one of the oldest forms of nonoperative intervention and is widely used to treat internal hemorrhoids with the development of endoscopy technology. However, sclerotherapy is always accompanied by complications such as bleeding, pain, abscess, etc., when the sclerosant is injected into the wrong site. Cap-assisted endoscopic sclerotherapy (CAES), a new minimally invasive technology, was first time coined in 2015 for the treatment of hemorrhoidal disease. The left-posterior-right-anterior (LPRA) anus positioning method under endoscopy provides reliable methodological support for advancing hemorrhoidal treatment via endoscopy. The current trend is that treatment for HD has shifted from being performed predominantly by the Department of Proctology Surgery to being managed mostly by the Department of Gastroenterology. This review reviewed the shifting paradigms of sclerotherapy for HD and discussed the emerging development of CAES.

Blood pressure monitoring using telemedicine technologies in patients with chronic heart failure

Continuous monitoring of cardiovascular patients is one of the most important tasks in modern cardiology. Monitoring chronic heart failure (CHF) patients is critical because of instability, high prevalence and life-threatening nature of this disease. Currently, active search and development of optimal devices and programs for medical telemonitoring continues. This review presents the results of Russian and foreign studies on the use of invasive and non-invasive technologies for monitoring blood pressure (BP) levels and demonstrates their clinical significance. Innovative cuffed and cuffless BP monitoring devices are evaluated. The effectiveness of hypertension and CHF management using remote monitoring is compared with standard practice. The relationship between the risk of hospitalization for CHF and the monitoring is demonstrated. The paper presents data on the cost-effectiveness of using telemedicine technologies such as BP monitoring for CHF management.

LAPAROTOMIC AND MINIMALLY INVASIVE SURGICAL INTERVENTIONS IN THE TREATMENT OF PYOGENIC LIVER ABSCESSES

Summary. The purpose of the study: to study the epidemiology of pyogenic liver abscesses, to evaluate the indications and results of laparotomy and minimally invasive operations. Material and methods. The epidemiology of pyogenic liver abscesses (LA) in 62 patients was studied. Research results and their discussion. The causes of LA in 25 (40.4 %) patients were acute surgical diseases, in 19 (30.5 %) – liver injury, in 6 (9.7 %) – purulent liver cyst, in 2 (3.2 %) – destructive appendicitis, in 2 (3.2 %) – penetration of a chronic stomach ulcer in the liver, in 1 (1.6 %) – pelvic abscess, in 2 (3.2 %) – a rare pathology (small-small intestinal intussusception-1 , perforation by a fish bone of the stomach and liver-1), in 5 (8.1 %) - the cause is not established. According to absolute indications, laparotomy and LA drainage were performed in 49 (79 %) patients, of which 23 (46.9.5 %) underwent additional correction of acute surgical pathology. Various variants of liver resection were performed in 11 (29 %) patients. Postoperative complications occurred in 16 (32.6 %) patients, 4 (8.2 %) died. Minimally invasive surgical interventions were performed in 13 (21 %) patients without complications or mortality. Conclusions. Laparotomy operations were performed according to absolute indications. Minimally invasive technologies have reduced postoperative complications and mortality.

Modified screw-rod fixation for management of posterior pelvic ring fractures: a retrospective study

BackgroundPelvic fractures are often associated with life-threatening damage and mechanical instability. Surgical therapy is a prior choice. To minimize surgical invasion and risk, bilateral screws combined with curved rod were applied to stabilize posterior pelvic ring. This study was aim to explore the clinical effect of this procedure.MethodsFrom January 2018 to January 2022, 27 patients with posterior pelvic fracture were included retrospectively. There were 12 males and 15 females with an average age of 56.3 ± 14.2 years. The prognosis of pelvis was evaluated by Matta and Majeed scores. Relevant clinical evaluation indications include the time of fracture healing, limb function and complications.ResultsThe average follow-up time was 14.2 ± 5.4 month. Matta scoring standard: excellent in 18 cases, good in 7 cases, the good rate was 92.6%. The average healing time was 8.4 months. The standard of Majeed score in 6 months after operation: excellent in 14 cases, good in 10 cases, the good rate was 88.8%. At the last follow-up, the functional recovery of the affected limb was satisfactory. No deep infection occurred after operation. The neurological symptoms of patients with caudal sacral nerve injury were recovered 6 months after operation.ConclusionThe results indicated that screw-rod system is a safe technique. Minimally invasive technology reduced frequency of fluoroscopy. It provides a simple and safety method for posterior pelvic fracture.

Improved intracochlear biopolymeric drug delivery system: an in vivo study

Background The delivery of drugs into the inner ear is a challenging field of study due to the complex cochlear anatomy and physiology. The creation of an intracochlear device that allows for short- and long-term intracochlear delivery of the drugs with a minimal invasive technology is needed to prevent or treat conditions that can potentially prevent the development of permanent hearing loss. Aim This study intends to test the efficacy of DXM-infused PLGA microneedles created in our laboratory in an in vivo animal model of acute ototoxic injury. Material and Methods Twenty-four male Norway Brown rats were randomized into four groups, three of which groups received an intratympanic injection of ethacrynic acid and kanamycin. Two of these groups underwent the placement of an intracochlear microneedle blended or not with dexamethasone, and two groups underwent implantation of a plain microneedle, one of without prior exposure to the ototoxic agent to confirm in vivo biocompatibility. Animals were then followed with a weekly auditory brainstem response testing until day 28 after surgical intervention. Result and Conclusion Our intracochlear device demonstrated biocompatibility and produced no hearing changes after its implantation in the control group. Inserted DXM-blended microneedles prevented hearing deterioration in those animals exposed to an ototoxic environment.

Laser Application in Surgical Treatment of Benign Prostatic Hyperplasia

Benign prostatic hyperplasia (BPH) is a prevalent condition among middle-aged and elderly men, often causing lower urinary tract symptoms (LUTS). Current treatment options encompass watchful waiting, pharmacological therapy, and surgical intervention. Among these, surgical treatment rapidly alleviates LUTS and enhances quality of life, making it the most effective approach for moderate to severe BPH. In recent years, with the rapid development and clinical application of various laser technologies, transurethral resection of the prostate (TURP), once considered the "gold standard," has faced controversies due to its higher surgical morbidity and limitations in treating large prostate volumes. Laser technologies, with their remarkable surgical efficacy, safety, and reduced morbidity, have increasingly gained favor among clinicians. This article primarily delves into the clinical advancements of diode laser minimally invasive technology in BPH treatment, aiming to provide a theoretical basis for clinicians in addressing clinical challenges.

From photonic technologies to microfluidics-A review on the techniques which revolutionize liquid biopsy, opening a new era in cancer therapy.

Cancer therapy is one of the most researched upon medical field in the world. Non invasive technologies such as liquid biopsy are gaining more importance in cancer therapy because of their manifold advantages over traditional invasive biopsy methods. Liquid biopsy is used to analyze nucleic acids such as ctDNA, cfDNA and RNA, cellular and subcellular components such as proteins, extracellular vesicles and circulating tumor cells in various biological fluids such as blood, urine, cerebrospinal fluid, pleural fluid and ascites fluid for diagnosis of cancer. Liquid biopsy has a wide range of applications such as assessment of residual diseases and tumors which cannot be biopsied easily and prediction of CAR-T response and response to immune checkpoint inhibitors. It can also be used to know the efficacy of cancer drugs in a patient by analyzing multiple samples. Liquid biopsy is becoming more popular as it allows biopsy of those samples in which solid tumor biopsies are challenging or impracticable. To achieve comprehensive insight on the status of cancer in a patient, various cutting edge liquid biopsy techniques have been developed. Microfluidics and photonic technologies, along with PCR, next generation sequencing, advanced and innovative molecular and cell biology approaches and imaging techniques have expanded the domain of liquid biopsy and elevated the accuracy of liquid biopsy results. This review discusses about the contributions of some widely used methods along with microfluidics and photonic technologies in detection of cancer biomarkers by liquid biopsy.

Laparoscopic surgery and mortality in perforated peptic ulcer (correlation and regression

Aim of the study is to evaluate the relationship between the number of laparoscopic operations and mortality in patients with perforated peptic ulcer. Materials and methods: The functional relationships between the number of performed laparoscopic operations and the levels of hospital and postoperative mortality were studied based on the analysis of the results of surgical treatment of patients with a perforated ulcer in 2018. Results: An analysis of the functional relationships between the number of laparoscopic operations performed and mortality was carried out based on the results of primary statistical information (2 189 patients with a perforated ulcer). Strong direct correlations have been established, which can be most reliably described within the framework of polynomial regression models (r2 = 0.917 and r2 = 0.889). Conclusion: An assessment of trends in the reduction in hospital and postoperative mortality with an increase in number of laparoscopic operations will be determined only with standardized approaches to the usage of minimally invasive technologies in all areas of the Russian Federation.

A modified endoscopic full-thickness resection for early colorectal cancer: An expanded application based on super minimally invasive surgery technology.

A modified endoscopic full-thickness resection for early colorectal cancer: An expanded application based on super minimally invasive surgery technology.

Laparoscopic Access in Radical Surgical Treatment of Complicated Gastric Cancer: a Single-Center Experience

Over the past decades, there has been an active introduction of minimally invasive surgical technologies in the treatment of various diseases, including gastric cancer. In Asian countries and Europe, laparoscopic gastrectomy is an alternative to open gastrectomy for early gastric cancer, with a tendency to displace the latter. In the Russian Federation, laparoscopic gastrectomy is performed in a few specialized centers. From 2013 to 2022, the surgeons of our Center treated 141 patients diagnosed with gastric cancer at different stages (64 men, 39 women, mean age of 60.5±10 years). Of these, 52 patients (50.5%) underwent open surgeries (group I), 51 (49.5%) — laparoscopic surgeries (group II). The study included patients diagnosed with gastric cancer complicated by bleeding or gastric outlet/cardioesophageal junction obstruction, over 18 years of age, who signed consent for the processing of personal data and inclusion of their clinical data in the research and underwent surgical treatment. We analyzed such parameters as the duration of surgical intervention and the duration of hospital stay, the rates of hospital/relapse-free 2-year survival, and uncomplicated postoperative period. Laparoscopic-assisted surgeries lasted longer; however, due to more precise technique and better visualization of anatomical structures, there was a smaller volume of intraoperative blood loss. During laparoscopic-assisted radical gastrectomy, it is possible to perform more precise lymph node dissection, increase the number of harvested lymph nodes and, thus, increase the probability of detecting lymph nodes with metastases; which, in turn, has a direct impact on increasing the 2-year relapse-free and 2-year overall survival of patients. There was no significant difference in the incidence or severity of postoperative complications and mortality. These data are an important indicator of the effectiveness of the minimally invasive surgical method of treatment, which indicates greater safety of the laparoscopic method compared to intervention from laparotomy access.

Liquid biopsy—A biomarker‐based revolutionising technique in cancer therapy

AbstractBackground and AimsCancer has grabbed the attention of scientists and medical professionals all over the world much more than any other disease. In the past few decades, the medical field has improved quite a lot but progress in the path to find a solution for cancer is very less. As the popularity of invasive technologies is diminishing in cancer treatment, scientists have come up withminimally invasive or non‐invasive alternatives, among which liquid biopsy, by far is the most suitable.MethodsLiquid biopsy is used to analyse nucleic acids, subcellular components and circulating tumour cells in various biological fluids for diagnosis of cancer. It can also be used to know the efficacy of cancer drugs in a patient by analysing multiple samples.OutcomesLiquid biopsy is becoming standard of care as it allows biopsy of those samples in which solid tumour biopsies are not possible. The diversity of sampling procedures, such as collection of urine for urothelial carcinoma or bladder or prostate cancer and phlebotomy for other types of cancer, make liquid biopsy one of the best methods for diagnosis of cancer.ConclusionThis review aims in discussing the several techniques used for the detection of cancer biomarkers and some clinical manifestations due to the changes in the biomarkers which are analysed by liquid biopsy.