Limited Workspace Research Articles

Current status of evaluation and treatment of early-stage remnant gastric cancer

Because of early diagnosis and improved prognosis, patients with gastric cancer are now surviving longer and remnant gastric cancer after gastrectomy is becoming more common. Remnant gastric cancer is traditionally considered a malignancy with a dismal outcome. However, recent advances in diagnostic and therapeutic strategies have improved outcomes. In recent years, the development of endoscopic therapy has provided us with new therapeutic ideas. Although with some drawbacks, such as limited working space, gastric fibrosis and staples under the suture line, endoscopic management is still an effective treatment option with potential long-term survival advantage. For gastrectomy patients, endoscopic surveillance should also be recommended, for prompt surveillance and detection in the early remnant gastric cancer. This review aims to provide an overview of remnant gastric cancer, especially focusing on its pathogenesis as well as new advances in the diagnosis and endoscopic treatment of early-stage remnant gastric cancer.

A Primary Study on the Applicability of Gel-Type Filler Materials to Root Pass Welds of the Thick Plate

Welding generally uses filler material to create deposited weld metal. Filler materials play a significant role in welding by providing the material needed to fill and form the joint. Existing filler materials are limited in the workspace and welding position and need help responding flexibly to welds of complex shapes. This study conducted primary research to develop a gel-type filler material with adhesion and flexibility that can cope with limited workspace and location. We attempted to provide a new approach to welding by mixing metal powder and binder to create a gel-type filler material. Root pass welding of thick plates was performed using a laser heat source. The bead appearance and cross-section of the weld zone were observed according to the type and composition of the metal powder, the binder content, and the method of synthesizing the metal powder. The physical characteristics of the weld were analyzed through observation of the hardness and microstructure of the weld.

Beyond the hospital walls: The lived experiences of Sidra's radiologists with home-based picture archiving and communication system during a global crisis

Objective: This study explores the adaptation of radiologists at Sidra Medicine, Qatar, to the home-based picture archiving and communication system (HPACS) during the COVID-19 pandemic. Methods: This qualitative study used a phenomenological methodology to delve into the experiences of radiologists using HPACS, which emerged as a crucial tool for remote radiology practice during the pandemic. It highlights the perceived benefits, barriers, and challenges of using HPACS, and emphasizes its role in ensuring continuity of patient care and diagnostics while adhering to safety protocols. Results: The study reveals how HPACS facilitated work efficiency and safety, and also presented challenges such as workspace limitations and technical issues. The findings suggest a transformative impact of HPACS on the field of radiology, and indicate a future marked by increasingly digital and decentralized practices. Conclusion: This research contributes to understanding the adaptation of healthcare professionals to remote work technologies and provides insights for improving remote radiology systems and preparing for future crises.

Implementation and outcomes in benign gynecological surgery with HUGO™ RAS system 12 months initial experience

We share our experience with the Hugo™ Robotic-Assisted Surgery system in benign gynecological surgeries. We retrospectively analyzed patients who underwent elective robotic surgeries for benign gynecological conditions at our surgical center from February 2023 to February 2024. Data collected included patient demographics, surgery indications, and outcomes. Perioperative data on port-placement time, arm configurations, docking, and console time were documented. Procedural outcome data including troubleshooting and overall satisfaction were also recorded. The primary outcome was perioperative data on port placement, docking time, arm configuration, and console time. The secondary outcome was defined as team satisfaction, system troubleshooting, arm repositioning, and complications graded 3–4 on the Clavien–Dindo Scale. A total of 60 patients underwent procedures for benign gynecological conditions using the Hugo™ RAS over the 12-month study period, primarily for pelvic endometriosis (53%), hysterectomies (27%), and adnexal surgery (10%). The mean port-placement time was 13 min and 41 s. In 31% of cases, low-port placement was used, with arm positioning being asymmetrical in 63% and symmetrical in 37%, demonstrating the system’s flexibility in customizing port configurations while optimizing cosmetic outcomes. Docking time averaged 5 min and 51 s, and console time was 1 h and 5 min. Operational challenges included arm tremors and limited workspace for the assistant. This study details our knowledge using the Hugo™ RAS. Learning curves of port placement, arm positioning, docking, and procedure time can be rapidly adapted in a well-trained team. Our experience suggests the technology is still in its learning curve period.

(122) RIGHTS-BASED REPRODUCTIVE SERVICES IN THE MEDICAL SCHOOLS IN THREE STATES IN INDIA: BASELINE FINDINGS OF A MIXED METHODS IMPLEMENTATION RESEARCH

Abstract Introduction Women’s sexual and reproductive health depends on their autonomy to decide, freedom to choose free from coercion, right to education and information, right to dignity, and equity in access to sexual and reproductive health services. These services, especially regarding family planning and abortion services, must be strengthened in the Indian medical schools. Hence, implementation research with baseline and endline comparison was conducted to strengthen reproductive rights and evidence-based practices related to family planning and abortion care services in these schools. This study presents the findings of baseline assessment. Objective To determine the status of reproductive rights and evidence-based family planning and abortion services in Indian medical schools Methods A concurrent mixed methods study design was used to conduct the baseline assessment in nine medical schools in Rajasthan, Gujarat, and Union territory in India from October 2018 to June 2019. Reproductive health services provided to 104 women during counseling for family planning (N=85) and abortion (N=19) were observed quantitatively using a predesigned, pre-tested checklist. In-depth interviews of 33 faculty members from the Department of Obstetrics and Gynecology were conducted to qualitatively explore their beliefs and practices regarding a rights-based approach to providing reproductive healthcare services. The Capability, Opportunity, and Motivation model of behaviors (COM-B) was used to qualitatively identify barriers and facilitators of reproductive rights while providing family planning and abortion services in medical schools. Results Family planning counseling services with a cafeteria approach were observed in 69.4% of cases. Among these, 7.1% were provided with couple counseling services. Auditory privacy could be provided to 22.2% of the family planning counseling sessions. The choice of three or more contraceptives was offered to 76.5% nullipara, 54.2% para one, and 75.6% multipara women. The average duration of counseling was 7.4 minutes. Counseling on family planning and abortion was provided to 31.6% of clients. For 36.8% of clients, sterilization/IUD insertion was kept as a pre-condition for abortion. Medical schools lacked space, staffing, and logistics to provide rights-based reproductive health services. Social barriers like the poor socio-economic status of the clients, lack of education and awareness of women's rights, less autonomy in decision-making, and social and gender bias compromised women's reproductive rights. As per the COM-B model, the reproductive rights-based approach facilitators included well-informed faculty regarding dignified and respectful care, ensuring total privacy and confidentiality. However, infrastructure gaps, limited space, high workload, insufficient human resources, and lack of standard operating procedures often compromise privacy and confidentiality during counseling. Conclusions Right-based reproductive services around family planning counseling and abortion services were delivered partially despite the medical schools' trained faculty. This was mainly due to limited workspace, high workload, less autonomy, and lower awareness of reproductive rights among women. Disclosure No.

Designing Actuated Medical Robots for Safe Human Interaction – A Real Challenge

Abstract The paper studies the influence of human factor and clinical constraints specific to mechanical devices for medical purpose. environment (with a limited workspace, inside or outside the patient body). A medical robot is usually a complex system including mechanical structure, human-machine interface (HMI), electronic components, and software controller. All these components are integrated to perform various tasks for daily medical applications. Because any failure may become very critical, medical robots must function safely and with high reliability, so that designing medical robots for safe human interaction can be considered a real challenge. In order to respect the clinical constrains, a safety real-time controller has been designed.

Application of Kaizen Principles to a Small Scale Industry in India

This case-study presents the application of Kaizen concept to Chempromech Engineers Pvt. Ltd. in Butribori, Maharashtra, India. The work carried out focuses on Kaizen approach to the Plant Layout of the industry to make it more efficient and desirable to work in as well as gives a formula to the industry to calculate its production in kg/hr theoretically. Chempromech Engineers Pvt. Ltd. Is a small scale industry present in the Butibori MIDC area in Nagpur, Maharashtra which specializes in manufacturing of circlip washer wires and washers. Being a small-scale industry, it is faced with problems pertaining to limited workspace, so a new layout is designed which helps groups machines based in their product type and thus freeing out space for future expansion. Product Based Plant Layout is preferred for this industry as its products vary in size and weight. Key words:- Kaizen, Plant Layout, Product Based Plant Layout, Washers and Washer wire.

Impedance control for a Stewart‐structure‐based wheel‐legged robotic system in wheel motion

SummaryAn impedance control scheme is proposed for a Stewart‐structure‐based wheel‐legged robotic system to strengthen the dynamic attitude adjustment stability in wheel motion. The wheel‐leg, which is driven by electrical cylinders in the Stewart structure, is analyzed in kinematics and dynamics. The rotation in the axial direction of every electric cylinder is calculated to improve the accuracy of the kinematic model. To fulfill the impedance demands, a passive structure with 6 degrees of freedom (DOF) is modeled. The mass of the mechanism has a coupling effect on the impedance model for each DOF, which is a nonlinear function. As motion decoupling in the workspace has been completed for the Stewart structure, an impedance control strategy with inner‐loop position tracking is employed. An extended state observer (ESO) is designed to estimate the disturbances arising from the nonlinear coupling effects. Based on the ESO observation outputs, an active disturbance rejection control that explicitly handles the workspace limit is designed with guaranteed practical stability. By reducing force interaction and body vibration, the wheel‐legged robotic system keeps wheel motion stability on uneven roads. Multiple comparative experimental results are presented to validate the stability and effectiveness of the proposed method.

Geophysics for the environment in Indonesia

This paper explores the hidden potential of geophysics for the environment, focusing on subsurface mapping activities in Indonesia. Geophysics plays a crucial role in understanding the Earth’s physical characteristics and addressing environmental challenges. It is particularly relevant in water-related environmental problems, such as groundwater contamination and infiltration monitoring. Geophysics is also used to detect metals in fertile soils and plants, providing insights into agricultural practices and potential health risks. However, applying geophysics in urban areas poses challenges due to physical obstructions, cultural noise, limited workspace, permits, and safety concerns. This article emphasizes the integration of geophysics with environmental studies, the need for further research on water-related environmental problems and metal detection, and the development of techniques tailored for urban environments. It suggests focusing on understanding the specific environmental challenges in Indonesia and leveraging advancements in technology for more accurate and efficient geophysical investigations. In the Indonesian context, geophysics has diverse applications, including energy exploration, seismology, and oceanography. However, it has not been properly utilized in the field of environmental studies, particularly in urban areas.

Design and Analysis of a Breast Biopsy Robot Based on TRIZ Theory

Background: In recent years, more and more medical robots have formally stepped into clinical applications and are gradually being accepted by patients. Magnetic resonance image (MRI)-guided breast intervention robot is the most advanced technology for breast cancer treatment. Still, the very limited working space within the MRI scanner restricts the development of breast intervention robots. Objective: In this paper, a compact breast biopsy robot in MRI environment is proposed based on TRIZ theory. Methods: The structure of the robot is optimized by using the curvilinear principle and the asymmetry principle of TRIZ theory to obtain a modified cartesian coordinates robot for breast biopsy. The coordinate systems of the robot are established using D-H method. Next, 3D visualization simulation of the robot is performed by SimMechanics of MATLAB, and then kinematic simulation and workspace simulation analysis are carried out. Results: The simulation results show that motion space of the end effector of the robot meets the requirements of breast intervention surgery, and the robot structure is simple and effective. Conclusion: In this paper, a compact breast biopsy robot in MRI environment is proposed. Through the Simulink module of MATLAB to analyze its workspace, it is obtained that its working range is 250mm × 300mm × 200mm, which can cover any position in breast tissue. At the same time, the simulation results of the workspace also show that the structure optimization of the breast biopsy robot based on TRIZ theory is reasonable.

Path planning for robots in preform weaving based on learning from demonstration

AbstractA collision-free path planning method is proposed based on learning from demonstration (LfD) to address the challenges of cumbersome manual teaching operations caused by complex action of yarn storage, variable mechanism positions, and limited workspace in preform weaving. First, by utilizing extreme learning machines (ELM) to autonomously learn the teaching data of yarn storage, the mapping relationship between the starting and ending points and the teaching path points is constructed to obtain the imitation path with similar storage actions under the starting and ending points of the new task. Second, an improved rapidly expanding random trees (IRRT) method with adaptive direction and step size is proposed to expand path points with high quality. Finally, taking the spatical guidance point of imitation path as the target direction of IRRT, the expansion direction is biased toward the imitation path to obtain a collision-free path that meets the action yarn storage. The results of different yarn storage examples show that the ELM-IRRT method can plan the yarn storage path within 2s–5s when the position of the mechanism changes in narrow spaces, avoiding tedious manual operations that program the robot movements, which is feasible and effective.

The Transabdominal Lumbar Approach (TALA) for Robotic Renal Surgery-A Retrospective Single-Center Comparative Study and Step-by-Step Description of a Novel Approach.

The transperitoneal approach (TP) and the retroperitoneal approach (RP) are two common methods for performing nephrectomy or partial nephrectomy. However, both approaches face difficulties, such as trocar placement and limited working space (RP). TP is impaired in the case of dorsal tumors and dissection of the renal artery can be challenging due to the anatomic localization dorsally to the renal vein. A hybrid approach that combines both methods has been previously reported in a case series, but not evaluated systematically. This study proposes a modified hybrid approach, which we call the transabdominal lumbar approach (TALA), involving late robotic docking after elaborating the retroperitoneum using conventional laparoscopy. The study compares the last 20 consecutive patients who underwent RP and the last 20 patients who underwent TALA at our institution. The investigated variables include operative time and amount of blood loss, hospitalization duration, postoperative analgesia requirement, and postoperative complications. The study found no significant difference in operative time, blood loss, ischemia time, or hospital stay between the two groups. The TALA group had fewer complications regarding Clavien-Dindo category 3, but one complication of category 4. In Conclusion, TALA is a safe and promising approach that combines the advantages of RP and TP.

Designing and Analyzing In-Place Motor Tasks in Virtual Reality With Goal Functions.

Goal functions make virtual goal-oriented motor tasks easier to analyze and manipulate by explicitly linking movement to outcome. However, they have only been used to study constrained (e.g., planar) upper limb movements. We present a design framework for integrating goal functions with unconstrained postural and upper limb movements in a virtual reality (VR) device. VR tasks designed with the framework can mimic unconstrained natural motions and thus train a range of functional movements yet remain analytically tractable. We created three in-place VR motor tasks: a bow-and-arrow, a reach-and-strike, and a punching bag task. Each task was adjusted to subject-specific workspace limits and anthropometrics. We studied the effects of 3 days of practice and 3 reach/lean distances on task performance in 12 healthy adults. Subjects performed all tasks on day 1 with moderate proficiency and improved with practice at all reach/lean distances. Task-specific results showed that performance decreased and movement variability increased near the edge of the reaching workspace; viewing angles and the imperfect depth cues in VR likely led to biases in performance and practice could attenuate the former effect; in reach-and-strike, subjects learned movement patterns similar to those seen in a real-world striking sport. These results show that our framework can deliver tasks useful for analyzing and training motor performance and can guide future in-place motor training. Post-hoc, we demonstrated the feasibility of generalizable methods that adjust required movement speeds and task difficulty for impaired populations.

Active collision avoidance for teleoperated multi-segment continuum robots toward minimally invasive surgery

Collision avoidance presents a challenging problem for multi-segment continuum robots owing to their flexible structure, limited workspaces, and restricted visual feedback, particularly when they are used in teleoperated minimally invasive surgery. This study proposes a comprehensive control framework that allows these continuum robots to automatically avoid collision and self-collision without interfering with the surgeon’s control of the end effector’s movement. The framework implements the early detection of collisions and active avoidance strategies by expressing the body geometry of the multi-segment continuum robot and the differential kinematics of any cross-section using screw theory. With the robot’s parameterized shape and selected checkpoints on the obstacle’s surface, we can determine the minimum distance between the robot and arbitrary obstacle, and locate the nearest point on the robot. Furthermore, we expand the null-space-based control method to accommodate redundant, non-redundant, and multiple continuum robots. An assessment of the avoidance capability is provided through an instantaneous and global criterion based on ellipsoids and possible movement ranges. Simulations and physical experiments involving continuum robots of different degrees of freedom performing various tasks were conducted to thoroughly validate the proposed framework. The results demonstrated its feasibility and effectiveness in minimizing the risk of collisions while maintaining the surgeon’s control over the end effector.

Robotic Slide Tracheoplasty for Pediatric Tracheal Stenosis in Three-Dimensional Printed and Pig Trachea Models

PurposePediatric long-segment tracheal stenosis often requires operative repair with a slide tracheoplasty performed through median sternotomy. We hypothesized that this operation can be performed through a transcervical approach with use of a single-port robotic system. DescriptionA transcervical single-port robotic slide tracheoplasty was performed in 2 models—a 3-dimensional (3D) printed pediatric tracheal stenosis model and a cadaveric pig trachea model. EvaluationSingle-port robotic slide tracheoplasty was successfully performed in both models. They were large enough that there were minimal issues with limited working space, although mediastinal structures around the trachea were not represented in the models. The advantage of the 3D printed model was the realistic anatomic tracheal stenosis; the advantage of the pig trachea model was the realistic tissue. ConclusionsTranscervical single-port robotic slide tracheoplasty was technically feasible in both our 3D printed and pig trachea models. However, given the limited working space, there are limits to the size of the patient for this technique. Further development is needed before this technique is ready for clinical use.

Design and analysis of a bionic adhesion coring sampler for space unstructured surface

The better application of robot technology in space unstructured scenes has become an important research topic. How to adapt to limited workspace and maintain high reliability sampling activities on unstructured surfaces with unknown geometric information and physical features poses high requirements for the implementation of automated sampling missions for extraterrestrial celestial bodies (ECBs). This work introduces a biomimetic adhesion sampler PBAS. It expects to achieve multisite core sampling activities on the unstructured surface of ECBs under astronaut assistance or unmanned automatic operation. Different from previous sampler, the system adopts novel modular structure design and has made improvements to the bionic adhesion mechanism, percussive and drilling mechanism, power transmission and sensing mechanism, and control mechanism. PBAS can firmly adhere to unstructured surfaces and efficiently obtain complete coring samples through penetration and drilling activities. It is compact and lightweight and has high portability, good reusability, excellent efficiency, as well as better performance in automatic sampling operations. Finally, to verify the effectiveness and reliability of the PBAS, a testing apparatus was designed. Relevant tests were conducted outdoors and in the laboratory. The experimental results indicate that PBAS can successfully adhere to surfaces with different characteristics and obtain coring samples with a length exceeding 50 mm.

A Novel Hybrid Gripper Capable of Grasping and Throwing Manipulation

Throwing motion is known for phenomenally fast rearrangement, sorting tasks, and placing the object outside the limited workspace with less effort. However, in the robotics domain, despite many simple yet versatile, mechanically intelligent grippers reported earlier, they focus primarily on achieving robust grasping and dexterous manipulation. This article presents a novel design of a single actuator driven hybrid gripper with mechanically coupled rigid links and elastic gripping surface; this arrangement provides the dual function of versatile grasping and throwing manipulation. The gripper comprises a latching mechanism (LM) that drives two passive rigid fingers by elongating/releasing the coupled elastic strip. Elongating the gripping surface enables the gripper to adapt to objects with different geometries, vary surface contact force characteristics, and store the energy in the form of elastic potential. A mechanism to discharge the stored potential energy gradually or instantaneously is essential when the intended task is to place the object free from impact or away from the limited reachable workspace. The proposed LM can swiftly shift from a quick release to a gradual release of the stored elastic potential for greater object's acceleration during throwing and no acceleration while placing. By doing so, the object can be placed at the desired location even farther than the manipulator's reachable workspace. We report the proposed gripper's design details, development, and experimentally demonstrate the versatile grasping, impact-free placing, and throwing capabilities.

A Forward Solution Algorithm of 6RUS Parallel Mechanism Based on Dual Quaternion Method

The 6RUS parallel manipulator is a highly versatile and widely used robotic mechanism with six degrees of freedom. Its intricate kinematic structure and its capability to perform complex motion tasks have garnered significant research interest in recent years. The kinematic analysis of the 6RUS mechanism plays a crucial role in understanding its operational characteristics and optimizing its performance for various applications. In this paper, we present a state-of-the-art kinematic algorithm for the 6RUS parallel manipulator. Our algorithm is aimed at addressing the challenges associated with accurately determining the pose and motion of the end-effector relative to the base, considering the complexity of the mechanism’s architecture. By leveraging advanced mathematical modeling techniques and utilizing efficient computational algorithms, our proposed algorithm offers improved accuracy, efficiency, and robustness in determining the kinematic parameters of the 6RUS mechanism. The key contributions of this work include the development of a comprehensive forward and inverse kinematic model for the 6RUS parallel manipulator, incorporating the effects of joint constraints, singularities, and workspace limitations. We also present a detailed analysis of the algorithm’s performance in comparison to existing approaches, demonstrating its superiority in terms of computational efficiency and accuracy. The proposed kinematic algorithm holds significant potential for enhancing the design, control, and trajectory planning of 6RUS parallel manipulators. It provides a solid foundation for advanced applications such as robotic surgery, industrial automation, and virtual reality systems. The results presented in this paper contribute to the growing body of knowledge in parallel manipulator research and pave the way for future developments in the field.

Human-Robot Collaboration: An Augmented Reality Toolkit for Bi-Directional Interaction

This work proposes an Augmented Reality (AR) application designed for HoloLens 2 which allows human operators, without particular experience or knowledge of robotics, to easily interact with collaborative robots. Building on the application presented in a previous work of the authors, the novel contributions are focused on a bi-directional interaction that manages the exchange of data from the robot to the human operator and, in the meantime, the flow of commands in the opposite direction. More in detail, the application includes the reading of the robot state, in terms of joint positions, velocities and torques, the visualization of the workspace and the generation and manipulation of the end-effector trajectory by directly moving a set of way-points displayed in the AR environment. Finally, the trajectory feasibility is verified and notified to the user by taking into account the workspace limits. A usability study of the AR platform has been conducted involving 45 participants with different ages and expertise in robot programming and Extended Reality (XR) platforms, comparing two programming methods: a classical kinesthetic teaching interface, provided by the Franka Emika Panda cobot, and the presented AR platform. Participants have reported the effectiveness of the proposed platform, experiencing less physical demand and higher intuitiveness and usability.

Telovelar versus Transvermian Approach in Management of Patients with Fourth Ventricular Tumors

Background Approaching the fourth ventricle surgically is particularly challenging due to the limited working space provided by the important surrounding cerebrovascular structures. Its close relationship to the surrounding neural structures, including the brainstem and cerebellum, is the major limitation for surgical access. Various surgical routes to the fourth ventricular space will be described in the literature, including the conventional transvermian approach. Recent clinical and anatomical studies have suggested that the telovelar approach will maximize the extent of surgical exposure and working angle while minimizing operative morbidity. Objectives Our primary objective is to evaluate the efficacy and outcome of each approach in handling tumors within different parts of 4th ventricle. Our secondary objective is to analyze approach related complication and limitations of application to find best surgical option for those patients with posterior fossa lesions. Methods The following electronic databases will be searched from 2000 to 2019: PubMed, Google scholar, Cocharne database of systematic reviews, EMBASE and Science direct using Keywords ''Telovelar approach'', ''Transvermian approach'', ''fourth ventricular tumours'', ''Medullary velum''. Studies will be eligible if they contain the target Keywords in title or abstract, addressing our subject. Afterwards the full text of the article will be reviewed to exclude full texts not fulfilling the criteria or deviating from the initial impression taken from the title/abstract reviewing. References\ bibliography of the selected article will be sorted by discussion between study team (Student, Director and Codirectors). Results A total of 130 study were screened for eligibility, 6 studies were included in our systematic review for comparing the Telovelar and Transvermian approach in reaching posterior fossa lesions located within 4th ventricle regarding efficacy, clinical outcome and improvement, safety and complication. It was found that each approach has its own merits and demerits with nearly no difference between them regarding efficacy and safety, however slight superiority was linked to Telovelar approach in minimizing post-operative posterior fossa syndrome and Hydrocephalic changes. Conclusion we concluded that, Both transvermian -without sustained retraction- and telovelar approaches have no significant difference in safety, feasibility of total tumor excision, clinical outcome, postoperative complications and cerebellar mutism. The choice of either approach depends mainly on the surgeon's skills and preference, However the telovelar approach is generally preferred.