Robotic Approach Research Articles

Resultados quirúrgicos en mujeres diagnosticadas de endometriosis profunda con afectación urológica

IntroductionThe prevalence of endometriosis is estimated to be about 10% among women of reproductive age. In about 5-10% of these patients, involvement of urological structures will be developed due to deep endometriosis. Urologists should be familiar with the management of these patients, who will require multidisciplinary care with medical and surgical treatment. Material and methodsRetrospective study of patients diagnosed with deep endometriosis involving urological structures who underwent surgery performed jointly with gynecology and colorectal surgery departments from June 2012 until June 2021 (60 cases). Urologic symptoms were grouped into 3 groupers for subsequent analysis (storage symptoms, voiding symptoms, and low back pain). ResultsStorage symptoms (frequency and urgency) are the most frequent urologic symptoms. Patients with storage symptoms and low back pain showed improvement after surgery. In contrast, patients with voiding symptoms did not improve with surgical treatment. ConclusionsThe prevalence of endometriosis and the likelihood of involving urologic structures require the urologic community to be aware of the pathology.Patients with storage symptoms will improve following excision of the endometriotic nodules. The need for Partial cystectomies with ureteral reimplantation can be safely performed by laparoscopic or robotic approach, even in previously operated patients, without compromising long-term function.

Atomic surface induced by novel green chemical mechanical polishing for aspheric thin-walled crucibles with large diameters

Aspheric thin-walled crucibles with large diameters are widely used for photovoltaics and semiconductor industries, while they have hard-brittle and aspheric characteristics. Nevertheless, these crucibles strictly require atomic surfaces and high material removal rate (MRR). This is a challenge for chemical mechanical polishing (CMP). To break this challenge, a novel green CMP was developed for fused silica, containing ceria, lanthana, hydrogen peroxide, diethylene triaminepentaacetic acid pentasodium, carboxymethyl cellulose sodium and guanidine carbonate. After CMP, surface roughness Ra of 0.115 is obtained at a scanning area of 5 × 5 μm2 measured by atomic force microscopy, and MRR is 563 nm/min. In such an atomic surface, the MRR is the highest compared with those published previously. Transmission electron microscopy confirms that the thickness of damaged layer after CMP is only 2.63 nm. A novel approach of robot floating polishing is proposed for aspheric crucibles with a diameter of 810 mm and a height of 580 mm. Using the developed CMP, surface roughness Sa of 0.178 nm on inner surface of an aspheric thin-walled crucible is achieved under a measurement area of 50 × 50 μm2. X-ray photoelectron spectroscopy (XPS) and electron paramagnetic resonance reveal that the content of Ce3+ increased from 28.54 to 43.76 %. Through Raman, XPS and Fourier transform infrared spectroscopy, CMP mechanisms are elucidated. Densified damaged layer on the surface of fused silica was induced by the transformation of surface structure from six-membered to four- or three-membered network. Ce-OH and Si-OH were formed between fused silica and ceria abrasives, forming Ce-O-Si by condensation reaction of dehydration. The developed green CMP and approach provide new pathway to polish and manufacture atomic surfaces for aspheric thin-walled crucibles with large diameters.

Robotic Technology in Emergency General Surgery Cases in the Era of Minimally Invasive Surgery

Although robotic surgery has become an established approach for a wide range of elective operations, data on its utility and outcomes are limited in the setting of emergency general surgery. To describe temporal trends in the use of laparoscopic and robotic approaches and compare outcomes between robotic and laparoscopic surgery for 4 common emergent surgical procedures. A retrospective cohort study of an all-payer discharge database of 829 US facilities was conducted from calendar years 2013 to 2021. Data analysis was performed from July 2022 to November 2023. A total of 1 067 263 emergent or urgent cholecystectomies (n = 793 800), colectomies (n = 89 098), inguinal hernia repairs (n = 65 039), and ventral hernia repairs (n = 119 326) in patients aged 18 years or older were included. Surgical approach (robotic, laparoscopic, or open) to emergent or urgent cholecystectomy, colectomy, inguinal hernia repair, or ventral hernia repair. The primary outcome was the temporal trend in use of each operative approach (laparoscopic, robotic, or open). Secondary outcomes included conversion to open surgery and length of stay (both total and postoperative). Temporal trends were measured using linear regression. Propensity score matching was used to compare secondary outcomes between robotic and laparoscopic surgery groups. During the study period, the use of robotic surgery increased significantly year-over-year for all procedures: 0.7% for cholecystectomy, 0.9% for colectomy, 1.9% for inguinal hernia repair, and 1.1% for ventral hernia repair. There was a corresponding decrease in the open surgical approach for all cases. Compared with laparoscopy, robotic surgery was associated with a significantly lower risk of conversion to open surgery: cholecystectomy, 1.7% vs 3.0% (odds ratio [OR], 0.55 [95% CI, 0.49-0.62]); colectomy, 11.2% vs 25.5% (OR, 0.37 [95% CI, 0.32-0.42]); inguinal hernia repair, 2.4% vs 10.7% (OR, 0.21 [95% CI, 0.16-0.26]); and ventral hernia repair, 3.5% vs 10.9% (OR, 0.30 [95% CI, 0.25-0.36]). Robotic surgery was associated with shorter postoperative lengths of stay for colectomy (-0.48 [95% CI, -0.60 to -0.35] days), inguinal hernia repair (-0.20 [95% CI, -0.30 to -0.10] days), and ventral hernia repair (-0.16 [95% CI, -0.26 to -0.06] days). While robotic surgery is still not broadly used for emergency general surgery, the findings of this study suggest it is becoming more prevalent and may be associated with better outcomes as measured by reduced conversion to open surgery and decreased length of stay.

Study International Multicentric Pancreatic Left Resections (SIMPLR): Does Surgical Approach Matter?

Minimally invasive surgery is increasingly preferred for left-sided pancreatic resections. The SIMPLR study aims to compare open, laparoscopic, and robotic approaches using propensity score matching analysis. This study included 258 patients with tumors of the left side of the pancreas who underwent surgery between 2016 and 2020 at three high-volume centers. The patients were divided into three groups based on their surgical approach and matched in a 1:1 ratio. The open group had significantly higher estimated blood loss (620 mL vs. 320 mL, p < 0.001), longer operative time (273 vs. 216 min, p = 0.003), and longer hospital stays (16.9 vs. 6.81 days, p < 0.001) compared to the laparoscopic group. There was no difference in lymph node yield or resection status. When comparing open and robotic groups, the robotic procedures yielded a higher number of lymph nodes (24.9 vs. 15.2, p = 0.011) without being significantly longer. The laparoscopic group had a shorter operative time (210 vs. 340 min, p < 0.001), shorter ICU stays (0.63 vs. 1.64 days, p < 0.001), and shorter hospital stays (6.61 vs. 11.8 days, p < 0.001) when compared to the robotic group. There was no difference in morbidity or mortality between the three techniques. The laparoscopic approach exhibits short-term benefits. The three techniques are equivalent in terms of oncological safety, morbidity, and mortality.

Postoperative outcomes and costs of laparoscopic versus robotic distal pancreatectomy: a propensity-matched analysis.

Minimally invasive distal pancreatectomy (MIDP) has established advantages over the open approach. The costs associated with robotic DP (RDP) versus laparoscopic DP (LDP) make the robotic approach controversial. We sought to compare outcomes and cost of LDP and RDP using propensity matching analysis at our institution. Patients undergoing LDP or RDP between 2000 and 2021 were retrospectively identified. Patients were optimally matched using age, gender, American Society of Anesthesiologists status, body mass index, and tumor size.Between-group differences were analyzed using the Wilcoxon signed-rank test for continuous data, and the McNemar's test for categorical data. Outcomes included operative duration, conversion to open surgery, postoperative length of stay, pancreatic fistula rate, pseudocyst requiring intervention, and costs. 298 patients underwent MIDP, 180 (60%) were laparoscopic and 118 (40%) were robotic. All RDPs were matched 1:1 to a laparoscopic case with absolute standardized mean differences for all matching covariates below 0.10, except for tumor type (0.16). RDP had longer operative times (268 vs 178min, p < 0.01), shorter length of stay (2 vs 4days, p < 0.01), fewer biochemical pancreatic leaks (11.9% vs 34.7%, p < 0.01), and fewer interventional radiological drainage (0% vs 5.9%, p = 0.01). The number of pancreatic fistulas (11.9% vs 5.1%, p = 0.12), collections requiring antibiotics or intervention (11.9% vs 5.1%, p = 0.12), and conversion rates (3.4% vs 5.1%, p = 0.72) were comparable between the two groups. The total direct index admission costs for RDP were 1.01 times higher than for LDP for FY16-19 (p = 0.372), and 1.33 times higher for FY20-22 (p = 0.031). Although RDP required longer operative times than LDP, postoperative stays were shorter. The procedure cost of RDP was modestly more expensive than LDP, though this was partially offset by reduced hospital stay and reintervention rate.

Determination of Whole Blood Loss From Minimally Invasive Myomectomy Using a Standardized Formula: A Pilot Study

Study ObjectiveTo determine the median perioperative blood loss (PBL) during minimally invasive surgical (MIS) myomectomy. DesignProspective pilot study. SettingLarge academic teaching hospital. PatientsThirty-one patients underwent laparoscopic or robotic myomectomy and completed a postoperative complete blood count (CBC) from November 2020 to August 2022. Patients had to have at least one fibroid greater than or equal to 3 cm on preoperative imaging. InterventionsA CBC was collected preoperatively within 7 days of surgery. Estimated blood loss (EBL) was determined by the surgeon intraoperatively. A repeat CBC was drawn between postoperative days 2 through 4. PBL was calculated using the equation PBL = (patient weight in kg × 65 cc/kg) × (preoperative hematocrit − postoperative hematocrit)/preoperative hematocrit. Measurements and Main ResultsMedian PBL (536.3 cc [270.0, 909.3]) was greater than median EBL (200.0 cc [75.0, 500.0]). PBL ranged from a net gain of 191.5 cc to net loss of 2362.5 cc. Median size of the largest fibroid on preoperative imaging was 8.8 cm (6.6, 11.5), and median weight of fibroids removed was 321 g (115, 519). About half of patients (51.6%) had one fibroid removed, and 48.4% had 2 or more fibroids removed. Five patients were converted to laparotomy, 4 from robotic approaches. Two patients required a blood transfusion. ConclusionCalculated PBL was greater than intraoperative EBL. This suggests there is continued blood loss post myometrial bed closure. Blood loss should be evaluated both during and after myomectomy, as intraoperative EBL underestimates total PBL.

Comparative analysis of robotically-assisted versus conventional sternotomy approach in left atrial-myxoma resection: A single-center retrospective observational study

BackgroundMinimally invasive surgery has emerged as a favorable alternative to conventional surgery for various cardiac conditions. This study aimed to compare the perioperative outcomes and follow-up results of the robotic approach versus the sternotomy approach for left atrial myxoma (LAM) resection. MethodWe retrospectively analyzed the perioperative outcomes and follow-up results of 94 patients who underwent left atrial myxoma resection using either the sternotomy approach (n = 64) or the robotic approach (n = 30) at our center between January 2017 and April 2023. Multiple linear regressions were employed to examine the actual impact of the surgical approach on perioperative outcomes while controlling for potential confounding factors. ResultsThere were no in-hospital deaths or follow-up deaths in the robotic group. Univariate analyses revealed that robotic LAM resection had a longer cardiopulmonary bypass (CPB) time (99.93 ± 22.30 vs. 76.28 ± 24.92, P < 0.001), longer aortic clamping time (57.80 ± 20.27 vs. 47.89 ± 18.10, P = 0.019), reduced postoperative drainage (P < 0.001), shorter mechanical ventilation time (P = 0.005), shorter postoperative bed-stay time (P < 0.001), shorter postoperative hospitalization time (P = 0.040), and higher hospital costs (P = 0.001) compared to the sternotomy group. After adjusting for baseline characteristics in a multiple regression model, a longer CPB time (B = 28.328; CI, 18.609–38.047; P < 0.001), longer aortic clamping time (B = 11.856; CI, 4.069–19.644; P = 0.003), reduced postoperative drainage (B = −200.224; CI, −254.962– –145.486; P < 0.001), shorter mechanical ventilation time (B = −3.429; CI, −6.562– –0.295; P = 0.032), shorter postoperative bed-stay time (B = −2.230; CI, −3.267– –1.193; P < 0.001), shorter postoperative hospitalization time (B = −1.998; CI, −3.747– –0.250; P = 0.026), and higher hospital costs (B = 2096.866, P = 0.002) were found in the robotic group. Furthermore, the robotic group exhibited a faster return to exercise compared to the sternotomy group (Log-Rank χ2 = 34.527, P < 0.001). ConclusionBoth the robotic and sternotomy approaches are viable and safe options for LAM resection. However, despite the higher costs, longer CPB time, and longer aortic clamping time associated with robotic LAM resection, this technique was correlated with reduced postoperative drainage and faster postoperative recovery compared to the sternotomy technique.

The current application and evidence for robotic approach in abdominal surgery: A narrative literature review.

The current application of robotic surgery is evolving at a high pace in the current years. The technical advantages enable several abdominal surgical procedures to be performed minimally invasive instead of open surgery. Furthermore, procedures previously performed successfully using standard laparoscopy are now performed with a robotic approach, with conflicting results. The present narrative review reports the current literature on the robotic surgical procedures typically performed in a typical Scandinavian surgical department: colorectal, hernia, hepato-biliary, and esophagogastric surgery.

Robotic-enhanced hybrid ablation for persistent and long-standing atrial fibrillation: Early assessment of feasibility, safety, and efficacy

ObjectivesTo assess feasibility, safety, and early efficacy of robotic-enhanced epicardial ablation (RE-EA) as first stage of a hybrid approach to patients with persistent (PsAF) and long-standing atrial fibrillation (LSAF). MethodsSingle-center, retrospective analysis of patients with documented PsAF and LSAF who underwent RE-EA followed by catheter-guided endocardial ablation. Postoperatively, patients were monitored for major adverse events and underwent rhythm follow-up at 3 and 12 months. ResultsBetween January 2021 and June 2023, we performed RE-EA in 64 patients (73.5% male, CHA2DS2-VASc 2.7 ± 1.6, BMI 34.1 ± 6.3 kg/m2). Mean AF preoperative duration and left atrial volume index were, respectively, 85 months and 47.5 mL/m2. Through the robotic approach, the intended lesion set was completed in all patients without cardiopulmonary bypass support, conversion to thoracotomy/sternotomy, blood transfusions, or perioperative mortality. The average LOS was 1.7 days, with only 1 patient requiring intensive care unit admission and >65% of patients discharged within 24 hours. At follow-up, 2 (3.1%) patients experienced new left pleural effusion or hemidiaphragm paralysis requiring treatment. There were no readmissions related to AF, stroke, thromboembolic events, or deaths. The mean interval between the epicardial and endocardial stages of the procedure was 5.9 months. Rhythm follow-up showed AF resolution in 73.4% and 71.9% of patients at 3 and 12 months, respectively. ConclusionsRE-EA is a feasible and safe, first-stage approach for the treatment of patients with PsAF and LSAF. It improves exposure of the intended targets, favors short hospital stay, and facilitates return to activity with satisfactory AF treatment in the short term.

Attentiveness Map Estimation for Haptic Teleoperation of Mobile Robot Obstacle Avoidance and Approach

Attentiveness Map Estimation for Haptic Teleoperation of Mobile Robot Obstacle Avoidance and Approach

A Self-Evacuation Approach for Robots in Fire Disasters

A Self-Evacuation Approach for Robots in Fire Disasters

Microfracture-coagulation for the real robotic liver parenchymal transection

The use of the robotic approach in liver surgery is exponentially increasing. Although technically the robot introduces several innovative features, the instruments linked with the traditional laparoscopic approach for the liver parenchymal transection are not available, which may result in multiple technical variants that may bias the comparative analysis between the different series worldwide. A real robotic approach, minimally efficient for the liver parenchymal transection, with no requirement of external tool, available for the already existing platforms, and applicable to any type of liver resection, counting on the selective use of the plugged bipolar forceps and the monopolar scissors, or “microfracture-coagulation” (MFC) transection method, is described in detail. The relevant aspects of the technique, its indications and methodological basis are discussed.

Multifunction Robot for Reducing Sensors Count in Greenhouse Monitoring

Abstract: Over the years, greenhouse systems have been utilized to regulate the ambient conditions of precious crops in an effort to increase agricultural productivity. The crucial elements of a typical greenhouse are the construction of a polyhouse, the placement of artificial lighting, the careful use of vents, watering methods, and the calculated application of insecticides and pesticides, among other things. Numerous factors are crucial for optimum plant development, including soil moisture, temperature, humidity, light intensity, greenhouse layout, and plant spacing. Various monitoring and control methods have been suggested and put into practice for automated greenhouses throughout the years. For parameter monitoring in different plots of a green house, a number of sensors are often needed in green house automation. The interface between these sensors and the monitoring device is crucial. In exchange for a fee, several wired and wireless sensor networking solutions are being tested. This paper focuses on adopting a robotic approach to reduce the sensor count in the automated greenhouse system. The need of multiple sensors is eliminated as the robot can move across the greenhouse to collect data at required locations.

Advancements in integrated robotic sensing: A European perspective.

Robotic Non-destructive Testing and Sensing stands at the forefront of technological innovation, offering capabilities in assessing structural integrity, safety, and material quality across diverse industries. This comprehensive review article provides a detailed exploration of the field, focusing on the substantial contributions of European researchers and institutions. The need for non-destructive testing has been a constant in industries that rely on structural integrity, including aerospace, manufacturing, energy, construction, and healthcare. Traditional testing methods, such as radiography, ultrasonic testing, magnetic particle testing, and dye penetrant testing, have been integral for quality control and safety assurance. However, the robotisation of such methods has marked a profound shift, enabling precise, fast, efficient, and repeatable testing while minimising human exposure to hazardous environments. European researchers and institutions have played an instrumental role in driving the evolution of integrated robotic sensing. The historical perspective of the field reveals the pioneering spirit of Europe, as collaborative initiatives led to the development of robotic platforms equipped with advanced sensors and testing techniques. A critical aspect of the European impact on robotic inspection applications lies in developing advanced sensors, innovative robotic platforms, novel robotic path-planning and control approaches and data collection and visualisation tools. These developments continue to influence the global landscape of robotic sensing. European researchers remain at the forefront of current trends and innovations as the field continues to evolve. This review article will delve into these recent advancements, highlighting Europe's pivotal role in pushing the boundaries of technology and application. The implications and applications of robotic sensing reverberate across multiple sectors worldwide. From inspecting critical aerospace components to ensuring the quality of manufactured goods, these technologies underpin safety and quality standards.

Thinking Beyond the Human: Design Approaches for Robots and AI in Opera

&#x0D; &#x0D; &#x0D; Opera has historically been a site for developing new and emerging technologies. More recently, opera has proven a rich environment for investigating future scenarios involving human-robot interaction and exploring the potential of robot performers. The explosion of enthusiasm for AI and the ubiquity of machine learning tools have created numerous possibilities for generating creative content in music, poetry, images, and choreography. This article outlines efforts to explore the creative possibilities of robots and AI through a dedicated workshop with researchers from diverse fields. Our goal is to begin thinking beyond the human to investigate what robot performers might look and behave like when designed from a relational rather than a representational approach. We provide a brief history of robots on stage, including the authors’ prior work developing original performances featuring robots and human performers. We describe our iterative design approach and low- fi prototypes, summarizing key insights from the workshop. Finally, we analyze the workshop outcomes and consider the trade-offs of working with existing robots and the possibilities for working with open, configurable systems. &#x0D; &#x0D; &#x0D;

The Rise and Fall of the Thoracoabdominal Incision in Urological Oncology

Objectives The thoraco-abdominal incision (TAI) has been used to provide maximal surgical exposure in the management of combined supra- and infra-diaphragmatic pathologic processes such as levels III or IV thrombi of the IVC. The TAI was once a cornerstone of urological oncology but is becoming increasingly uncommon in the era of robotic approaches to the renal hilum, suprahilar lymph node chain, and minimal access chest surgery to the supradiaphragmatic IVC. We wished to explore the complete history of the TAI, from first description to its height of popularity and its current utilization by contemporary urologic oncologists. Methods Primary source material included an interview with Donald Skinner, an early proponent of the TAI. We conducted a novel survey of active urologists in contemporary practice to investigate the usage of the TAI in practice. We reviewed documents from the Second Auxiliary Surgical Group (SASG) from 1941-1944; reports by military surgeon DF Marshall, recognized as performing the first TAI for a genitourinary indication during World War II; and records of the 8055th US Army (MASH) Unit in Korea, credited with improving the battlefield usage of the TAI; and secondary sources from the AUA’s WP Didusch Archive, PubMed, and Googlescholar. Results The thoraco-abdominal incision (TAI) can originally be traced back to French civilian usage in the latter 19th century, but the TAI was not adopted for battlefield trauma surgery until the Second World War. The safety and effectivness of the TAI increased greatly during the Korean War with teaching, organized outcomes analyses, and improvement efforts. Trauma indications during these conflicts allowed for later adoption in the field of urologic oncology due to the incision’s excellent exposure and became the hallmark of at least one fellowship in urologic oncology. Fewer than 15% of surveyed urologists in the contemporary era have used the TAI in the past 5 years. Conclusions The thoracoabdominal incision’s later adoption by the civilian population is a testament to the ingenuity and resourcefulness of military surgeons in the former part of the twentieth century. Their contributions should not be forgotten as urological surgery moves towards minimally invasive approach.

Robotic-assisted laparoscopic Malone appendicostomy: a 6-year perspective.

A robotic-assisted laparoscopic approach to appendicostomy offers the benefits of a minimally invasive approach to patients who would typically necessitate an open procedure, those with a larger body habitus, and those requiring combined complex colorectal and urologic reconstructive procedures. We present our experience performing robotic-assisted appendicostomies with a focus on patient selection, perioperative factors, and functional outcomes. A retrospective review of patients who underwent a robotic-assisted appendicostomy/neoappendicostomy at our institution was performed. Twelve patients underwent robotic-assisted appendicostomy (n = 8) and neoappendicostomy (n = 4) at a range of 8.8-25.8years. Five patients had a weight percentile > 50% for their age. Seven patients underwent combined procedures. Median operative time for appendicostomy/neoappendicostomy only was 185.0min. Complications included surgical site infection (n = 3), stricture requiring minor operative revision (n = 2), conversion to an open procedure due to inadequate appendiceal length (prior to developing our technique for robotic neoappendicostomies; n = 1), and granuloma (n = 1). At a median follow-up of 10.8months (range 1.7-74.3months), 91.7% of patients were consistently clean with antegrade enemas. Robotic-assisted laparoscopic appendicostomy and neoappendicostomy with cecal flap is a safe and effective operative approach. A robotic approach can potentially overcome the technical difficulties encountered in obese patients and can aid in patients requiring both a Malone and a Mitrofanoff in a single, combined minimally invasive procedure.

National outcomes of expedited discharge following esophagectomy for malignancy.

Expedited discharge following esophagectomy is controversial due to concerns for higher readmissions and financial burden. The present study aimed to evaluate the association of expedited discharge with hospitalization costs and unplanned readmissions following esophagectomy for malignant lesions. Adults undergoing elective esophagectomy for cancer were identified in the 2014-2019 Nationwide Readmissions Database. Patients discharged by postoperative day 7 were considered Expedited and others as Routine. Patients who did not survive to discharge or had major perioperative complications were excluded. Multivariable regression models were constructed to assess association of expedited discharge with index hospitalization costs as well as 30- and 90-day non-elective readmissions. Of 9,886 patients who met study criteria, 34.6% comprised the Expedited cohort. After adjustment, female sex (adjusted odds ratio [AOR] 0.71, p = 0.001) and increasing Elixhauser Comorbidity Index (AOR 0.88/point, p<0.001) were associated with lower odds of expedited discharge, while laparoscopic (AOR 1.63, p<0.001, Ref: open) and robotic (AOR 1.67, p = 0.003, Ref: open) approach were linked to greater likelihood. Patients at centers in the highest-tertile of minimally invasive esophagectomy volume had increased odds of expedited discharge (AOR 1.52, p = 0.025, Ref: lowest-tertile). On multivariable analysis, expedited discharge was independently associated with an $8,300 reduction in hospitalization costs. Notably, expedited discharge was associated with similar odds of 30-day (AOR 1.10, p = 0.40) and 90-day (AOR 0.90, p = 0.70) unplanned readmissions. Expedited discharge after esophagectomy was associated with decreased costs and unaltered readmissions. Prospective studies are necessary to robustly evaluate whether expedited discharge is appropriate for select patients undergoing esophagectomy.

Phased Array Ultrasonic Method for Robotic Preload Measurement in Offshore Wind Turbine Bolted Connections.

This paper presents a novel approach for preload measurement of bolted connections, specifically tailored for offshore wind applications. The proposed method combines robotics, Phased Array Ultrasonic Testing (PAUT), nonlinear acoustoelasticity, and Finite Element Analysis (FEA). Acceptable defects, below a pre-defined size, are shown to have an impact on preload measurement, and therefore conducting simultaneous defect detection and preload measurement is discussed in this paper. The study demonstrates that even slight changes in the orientation of the ultrasonic transducer, the non-automated approach, can introduce a significant error of up to 140 MPa in bolt stress measurement and therefore a robotic approach is employed to achieve consistent and accurate measurements. Additionally, the study emphasises the significance of considering average preload for comparison with ultrasonic data, which is achieved through FEA simulations. The advantages of the proposed robotic PAUT method over single-element approaches are discussed, including the incorporation of nonlinearity, simultaneous defect detection and stress measurement, hardware and software adaptability, and notably, a substantial improvement in measurement accuracy. Based on the findings, the paper strongly recommends the adoption of the robotic PAUT approach for preload measurement, whilst acknowledging the required investment in hardware, software, and skilled personnel.

Role of minimally invasive surgery in the management of localized pancreatic ductal adenocarcinoma: a review.

Pancreatic ductal adenocarcinoma (PDAC) remains a highly lethal malignancy with a minority of patients eligible for curative-intent surgical intervention. Pancreatic resections are technically demanding operations associated with considerable morbidity and mortality. Minimally invasive pancreatic resections (MIPRs), which include laparoscopic and robotic approaches, may enhance postoperative outcomes by lessening physiological impact of open surgery. A limited number of randomized-controlled trials as well as numerous retrospective reports have focused on MIPR outcomes and role in management of a variety of tumors, including PDAC. Today, MIPRs are generally considered acceptable alternatives to open surgery as a trend towards improved short-term metrics is observed. However, several questions remain regarding the oncological adequacy of MIPR's as long-term experience is less extensive compared to open techniques. This review aims to summarize existing evidence on MIPRs with a focus on PDAC.