Group Of Robots Research Articles

Left colectomy for diverticular disease: systematic review and meta-analysis comparing robotic and laparoscopic resections

BackgroundAround 50% of people aged 60 years and above are affected by diverticular disease, and 25% of these individuals will require surgical intervention. Our objective is to compare the results of left colonic resection for sigmoid diverticular disease using both robotic and laparoscopic approaches. Our primary aim is to conduct a meta-analysis while investigating the rates of conversion to open surgery, stoma and complications between the two methods.MethodologyA systematic review was conducted following the PRISMA guidelines. A meta-analysis was performed using RevMan Version 5.4 software. The random-effect model was employed to pool dichotomous outcomes and estimate risk and odds ratios (OR).ResultsEight studies were thought to fulfil the eligibility criteria: 1892 patients (49.2%) had robotic surgery, and 1952 patients (50.84%) underwent a laparoscopic approach. There were fewer conversions to open surgery in the robotic group when compared to the laparoscopic group (P < 0.00001), a lower rate of postoperative ileus (P = 0.005), shorter length of stay (mean difference (MD) 0.18 P = 0.003) and fewer morbidities (P = 0.002). There were similar rates of stoma formation (4.7%, P = 1.00), anastomotic leak (2.6%, P = 0.85) and mortality (0.3% vs 0.2%, P = 0.59). The operative time was shorter in the robotic approach, although the difference was not significant (P = 0.47).ConclusionRobotic surgery is feasible for diverticular disease compared to laparoscopic left colectomy. Our study observed a reduction in the conversion to open rate, reduced morbidity, and less ileus while demonstrating similar rates of stoma formation, anastomotic leak, and mortality. However, more high-quality research needs to be conducted to investigate this further.The study is registered in Prospero (reg # CRD42023440509).

Online Planning for Data Collection in Multi-Robot Systems

Wireless sensors networks have been used for data collection in various civil and military applications. We consider a system where a group of mobile robots and a set of stationary wireless sensor nodes are sparsely deployed in a large unbounded area. In such scenarios, all sensor nodes may not be connected via a communication network. Furthermore, no pair of sensor nodes may be within the transmission range of each other. Therefore, many relay nodes are needed to guarantee the connectivity of the network. However, this approach will affect the lifetime of the system due to the energy consumption by data transmission. In this paper, we study the problem of data collection from the deployed sensors utilizing the robots. The robots do not know the locations of each other and the sensor nodes. Moreover, the sensor nodes do not know the locations of each other and the robots. We propose an online algorithm in which the robot explores the area to find the sensor nodes and collect their stored data. Depending on whether the number of robots is known by the robots in advance or not, we investigate and compare two cases of the problem. In simulations, we empirically evaluate the performance of our algorithm and show that it quantifies as a function of the environment size, the number of robots, and the communication range when both the number of robots and the number of sensors are not known in advance.

Superior accuracy of femoral bone tunnel drilling in robot-assisted anterior cruciate ligament reconstruction: a multicenter, randomized, controlled trial.

To assess the efficacy and safety for bone tunnel drilling in anatomic anterior cruciate ligament (ACL) reconstruction with the assistance of a surgical navigation robot system. A total of 79 patients were randomized to either surgical navigation robot group (robot group, n =39) or traditional handheld locator group (control group, n =40). The robot group underwent anatomic ACL reconstruction using a surgical navigation robot, while the control group underwent the procedure using a traditional handheld locator. Postoperative three-dimensional computed tomography was used to measure the tibial and femoral tunnel position, as well as the tibial and femoral tunnel length. The success rate of femoral tunnel positioning was defined as the proportion of cases in which the femoral tunnel was placed accurately within the ideal anatomical position. The success rate of femoral tunnel positioning in the robot group was significantly higher than that in the control group (82.1% vs 50%, P =0.003). The surgical time in the robot group was significantly longer than that in the control group (122.8 min±34.9 min vs 84.0 min±28.3 min, P =0.05). The incidence rate of adverse events did not show statistical significance between the two groups (P =0.830). There were no adverse events associated with the instruments or any serious adverse events, and no patients withdrew from the trial due to adverse events. The success rate for femoral tunnel positioning in anatomic ACL reconstruction was higher with surgical navigation robots compared to the traditional handheld locator. Surgical navigation robot systems are safe tools in anatomic ACL reconstruction surgery.

Reptile Honey Badger Optimization Algorithm‐Based Deep Quantum Neural Network for Task Allocation in Multi‐Robot Systems

ABSTRACTTask allocation in multi‐robot systems has been a critical area of research, with applications spanning various industries, such as logistics, agriculture, and manufacturing. The allocation of tasks to multi‐robots improves the system performance, which generally minimizes total resource consumption or cost needed for performing a group of tasks. In dynamic multi‐robot systems, efficient task allocation is critical for optimizing system performance, especially in response to environmental changes like faults or the actions of other robots. Therefore, a new approach called reptile honey badger optimization algorithm_deep quantum neural network (RHBA_DQNN) is framed for task allocation in multi‐robot systems. At first, the tasks are grouped utilizing the fuzzy local information C‐means (FLICM) clustering model. Then, the assignment of tasks for the group of robots is conducted using the devised RHBA, where monetary cost, distance, time, and completion time are considered objective functions. The proposed RHBA is the combination of the reptile search algorithm (RSA) and honey badger algorithm (HBA). Finally, the penalty cost is decided based on the deep quantum neural network (DQNN). Moreover, the RHBA_DQNN has obtained a minimum overall cost, execution time, distance, and monetary cost of 81.251, 9.99, 1.600, and 0.249, respectively.

Cyber–Physical Multi-Robot Formation with a Communication Delays and a Virtual Agent Approach

A cyber–physical multi-robot system integrates robotic agents that share data over communication networks in real time to achieve common objectives by making decisions collectively based on the knowledge of their surroundings. This work introduces a formation control strategy for two groups of mobile robots placed in two separate workspaces connected by a communication network. The control technique generates two similar formations on each workspace using virtual agents that mirror the behavior of the corresponding physical robot in the opposite workspace. Control laws are derived for a single integrator and unicycle-type real and virtual robots that converge to the desired formation, even in the presence of communication delays. The numerical simulations performed show the convergence of the control strategy. A low-cost cyber–physical micro-robot platform was developed to run experiments with real robots. The setup uses a camera as a position and orientation sensor and the MQTT protocol for server communication and data exchange. Results obtained on this platform show the feasibility of the approach in an actual physical setting.

Robotic-assisted sleeve gastrectomy: an analysis of cost, peri-operative outcomes and learning curve in a prospective cohort study.

Minimally invasive sleeve gastrectomy as a treatment for individuals living with severe obesity remains the most common operation in bariatric and metabolic surgery. With the introduction of robotic-assisted surgery, an increasing proportion of sleeve gastrectomies are performed using the da Vinci robotic surgical platform. To date, the evidence to support or contest this practice is still unclear although meta-analyses have shown safety and feasibility. Here we present a prospective cohort study comparing 101 consecutive patients who had either robotic-assisted or laparoscopic sleeve gastrectomy for obesity. Short-term outcomes, including length of stay and thirty-day complication rates, as well as the total consumable cost for both the laparoscopic and robotic-assisted procedures were collected. We also assessed the learning curve associated with robotic-assisted sleeve gastrectomy. The cohort had similar baseline characteristics in terms of BMI and co-morbidity. The mean operative time, post-operative CRP and complication rates were the same in both groups. Length of stay was statistically shorter for the robotic-assisted cohort in comparison to the laparoscopic cohort; 1.3days versus 1.9days, respectively (p < 0.005). The percentage of patients requiring only a single night admission was significantly higher at 82% in the robotic-assisted group, compared to 32% in the laparoscopic group (p < 0.005); in the context of a nurse-led-discharge protocol. Total consumable cost was significantly lower in the robotic group at an average of £2310, compared to £2665 in the laparoscopic group (p < 0.001). The learning curve for the procedure was found to be 26 cases, predominantly driven by the resectional component of the procedure. Robotic-assisted sleeve gastrectomy on the 4th generation da Vinci system utilising robotic advanced energy and Sureform stapling is safe and effective. This cohort study suggests that using the robotic platform is favourable in terms of overall consumable cost and may reduce length of stay. In the context of previous robotic experience, the observed learning curve is relatively short.

A Retrospective Study Comparing the Operative Outcomes of Extraperitoneal, Retrorectus Access Laparoscopic and Robotic-Assisted Ventral Hernia Repairs.

This retrospective study aims to evaluate the operative outcomes of laparoscopic and robotic extraperitoneal repair of abdominal wall defects via enhanced view total extraperitoneal (eTEP) retrorectus space access. A medical chart review was performed on consecutive eTEP cases from our unit, focused on collecting perioperative outcomes. One hundred and twenty cases were collected, 73 in the robotic group and 47 in the laparoscopic group. Approximately 38% of the robotic and 64% of the laparoscopic arms required component separation. In the overall population (irrespective of defect size and technique used), the robotic arm versus the laparoscopic arm had (a) significantly higher (P<0.001) mean hernia defect, (b) shorter operating time (P<0.001), (c) significantly fewer postoperative complications (P=0.039), (d) significantly fewer pain scores at 24 hours and 14 days postsurgery (P=0.002 and P<0.001, respectively), and (e) better patient well-being scores (P=0.001). The length of hospital stay and analgesic usage were comparable. A subgroup analysis by defect size (<7cm, 7-10cm, and>10cm) revealed that approximately 51% of patients needed component separation in the laparoscopic group for defects<7cm, and 100% of patients needed it for hernias>7cm in this group. In the robotic group, no patient (0%) needed component separation for defects<7cm, and approximately 43% needed it for defects>7cm. This study reports encouraging short-term outcomes for the robotic-assisted eTEP approach in Indian settings. The robotic-assisted approach has the potential to reduce the requirement of component separation in patients with large ventral hernia defects. However, future prospective, randomized studies with long-term follow-up on recurrence will be needed to validate our findings.

A study on the safety and efficacy of a robotic-assisted navigation and positioning system in CT-guided percutaneous biopsy of thoracic and abdominal tumors.

To compare the safety, accuracy, and application efficacy of a computed tomography (CT)-guided robotic-assisted navigation system and conventional CT-guided percutaneous puncture biopsy techniques for thoracic and abdominal tumor puncture biopsies. A total of 140 patients with thoracic or abdominal tumors who were scheduled to undergo CT-guided percutaneous puncture biopsy were randomly assigned to the robotic navigation system puncture group and the traditional step-by-step puncture group. Postoperative tissue specimens and pathological diagnosis results were obtained. The success rate of localization, number of adjustments, localization time, and number of CT scans were used as evaluation indicators. In addition, the surgical safety indicators were observed, and the homogeneity differences between the two groups were compared. The robotic navigation group had significantly higher success rates of localization (84.1% vs. 43.7%), fewer adjustment times (1.51 ± 1.48 vs. 3.51 ± 3.05), and fewer CT scan times (4.99 ± 2.11 vs. 7.11 ± 3.74) than the traditional puncture group (P < 0.05). However, no statistically significant differences were observed in the localization times of chest operation and the occurrence of complications between the two groups. The robotic puncture navigation system improves the success rate of localization and reduces the number of puncture adjustments and CT scans; therefore, it is superior to the traditional step-by-step puncture method.

Evaluation of hemorrhage risk and the volume-outcome relationship following vertical sleeve gastrectomy amidst robotic-assisted surgery adoption.

Robotic-assisted surgery (RAS) holds promise for maintaining bariatric outcomes, while offering a shorter adoption learning curve relative to conventional laparoscopy. However, low RAS procedure volume relative to a laparoscopic approach has limited our understanding of its impact, and the transition from laparoscopic to RAS entails a volume-outcome relationship that is not fully characterized. This is a retrospective cohort study in a MBSAQIP accredited, bariatric surgery program. The incidence of hemorrhage following vertical sleeve gastrectomy (VSG) was observed from 2020 to 2023. This period was divided into an early adoption period (RAS 31% of cases) and a late adoption period (RAS 82% of cases). A total of 1250 patients underwent VSG over the study period. Laparoscopic VSG (L-VSG) and robotic-assisted VSG (RA-VSG) groups were similar in age, sex, and risk factors for postoperative bleeding. They differed in race (P < 0.0001) and ASA category (P = 0.007). The overall postoperative hemorrhage rate was 1.04% (n = 13). Hyperlipidemia was predictive of hemorrhage on univariate analysis (P = 0.045). The relative risk of hemorrhage in the robotic group dropped from 4.38 (CI 0.577-3.24) during the early adoption period to 0.28 (CI 0.083-0.96, P = 0.063) during the late adoption period. This shift with respect to hemorrhage risk was not associated with a significant reduction of hemorrhage in the RA-VSG approach (1.5% vs. 0.98%; P = 0.636), but with an increase in L-VSG risk (0.35% vs. 3.5%, P = 0.0245). As RA-VSG became the more frequently utilized approach within a single program, the risk of hemorrhage with L-VSG significantly increased. This suggests an unanticipated risk associated with a transition to the robotic approach. Specifically, the risk of complication increased when performing L-VSG in a practice dominated by RA-VSG.

Early impact of robot-assisted total knee arthroplasty on the treatment of varus knee arthritis

To investigate the clinical efficacy and advantages of robot-assisted total knee arthroplasty (TKA) in patients with varus knee osteoarthritis. Between October 2022 and June 2023, a total of 59 patients with severe knee osteoarthritis resulting in varus were treated with total knee arthroplasty, aged from 59 to 81 years with an average (70.90±4.63) years, including 19 mals and 40 females. The patients were divided into two groups based on the surgical method used:28 patients in the robot group and 31 patients in the traditional group. The robot group consisted of 8 males and 20 femalse patients, with an average age of (70.54±4.80) years and an average disease duration of (14.89±8.72) months. The traditional group consisted of 11 males and 20 females patients, with an average age of (71.39±4.5) years and an average disease duration of (12.32±6.73) months. The operative duration, amount of bleeding during the operation, postoperative activity time after the operation, hip-knee-ankle angle (HKA), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), and complications were compared between the two groups before and after the operation. Lateral tibia component (LTC), frontal tibia component (FTC), frontal femoral component (FFC) and lateral femoral component (LFC) were measured 6 months after operation Additionally, the degree of knee joint motility, American Knee Society score (KSS), and visual analogue scale(VAS) were compared before and after the operation. All patients had gradeⅠwound healing without any complications, and all patients were followed up for 6 to 8 months, with an average of (6.5±1.5) months. There were no significant differences preoperative imaging evaluation indexes (including HKA, LDFA, and MPTA), preoperative knee mobility, preoperative VAS, and preoperative KSS between the two groups (P>0.05). Comparing the operation time (109.11±7.16) min vs. (83.90±7.85) min, length of the incision (16.60±2.33) cm vs. (14.47±1.41) cm, intraoperative bleeding (106.93±6.15) ml vs. (147.97±7.62) ml, postoperative activity time (17.86±1.84) h vs. (21.77±2.68) h, between the two groups showed statistically significant differences (P<0.05). There were significant differences in FFC (88.96±0.84)° vs. (87.93±1.09)° and LFC (88.57±1.10)° vs. (87.16±1.2)° between the two groups at 6 months after operation (P<0.05). The robotic group 1, 3, 6 months after KSS (75.96±3.96), (81.53±3.78), (84.50±3.29) scores, VAS (3.68±0.67), (2.43±0.79), (0.54±0.64), knee joint mobility (113.32±4.72) °, (123.93±3.99) °, (135.36±2.34) °;Traditional group KSS (73.77±4.18), (76.48±3.60), (80.19±3.28) scores, VAS (4.16±1.04), (3.03±0.75), (1.42±0.76) scores, knee joint mobility (109.19±6.95) °, (119.94±6.08) °, (134.48±2.14) °. Compared to before surgery, both groups showed significant improvement in KSS, VAS and knee mobility during the three follow-up visits (P<0.001). Additionally, postoperative HKA (180.39±1.95)° vs. (178.52±2.23)°, LDFA (89.67±0.63) ° vs. (89.63±0.63)°, and MPTA (89.44±0.55)° vs. (89.29±0.60)° were significantly improved in both groups compared to before surgery (P<0.001). The robotic group had higher KSS than the traditional group at 1, 3, and 6 months after surgery (P<0.05). The robotic group also had lower VAS than the traditional group at 1, 3, and 6 months after surgery (P<0.05). Furthermore, knee mobility was higher in the robotic group than those in the traditional group at 1 and 6 months after surgery (P<0.05), but there was no significant difference between the two groups at 6 months after surgery. Robot-assisted total knee arthroplasty is a safe and effective method for total knee replacement. The use of robotics can improve the limb axis and prosthesis alignment for patients with preoperative varus deformity, resulting in better clinical and imaging outcomes compared to the conventional group.

Enhanced accuracy and reduced complications: robot-assisted navigation for retrograde intramedullary nailing in distal femoral fractures.

This research investigates the benefits of robot-assisted navigation systems in retrograde intramedullary nailing for distal femoral fractures and contrasts their outcomes with conventional surgical methods. This is a retrospective clinical study designed to compare the outcomes of these two approaches. This study included 56 distal femoral fracture patients treated between February 2020 and May 2023. Among them, 28 patients underwent robot-assisted retrograde intramedullary nailing (robot group), while 28 received conventional retrograde intramedullary nailing (traditional group). Surgical duration, intraoperative fluoroscopy frequency, number of guidewire insertions into the femoral medullary cavity, and intraoperative blood loss were recorded. Healing progress and fixation stability status were observed, and postoperative articular function was assessed using Neer's scoring system at a one year follow-up. Baseline characteristics were comparable between the two groups, showing no statistically significant differences.The robot group demonstrated shorter operative time, fewer guidewire placements, reduced intraoperative hemorrhage and incision size compared to the traditional group (P < 0.05). While the Neer's score for postoperative joint function showed a higher excellent-to-good rate in the robot group, no significant difference was observed between the group (P > 0.05). Compared with traditional surgical methods, robot-assisted retrograde intramedullary fixation for fractures of the distal femur offers advantages of being minimally invasive, more precise, requiring shorter operative times, and resulting in reduced blood loss, fluoroscopy exposure, and guidewire insertion attempts. These benefits may contribute to a reduction in postoperative complications.

Lokomat vs. Conventional Therapy-Impact on Gait Symmetry in Hemiparetic Patients: Preliminary Clinical Study.

Background/Objectives: One of the primary goals of neurorehabilitation after stroke is gait reeducation, as it provides the patient with greater autonomy and enhances their safety in daily activities. A preliminary clinical study was undertaken to determine whether robotic gait reeducation using the Lokomat device is more effective than conventional therapy in achieving gait symmetry. Methods: The research group consisted of 107 patients, with an average age of 63.54 years, all in the subacute stage of hemiparesis. These patients underwent 4 weeks of neurorehabilitation and were assigned into experimental and control groups. The patients in the experimental group underwent neurorehabilitation (20 sessions) and twice-weekly walking on the Lokomat device (10 sessions). The control group received equivalent neurorehabilitation and conventional gait reeducation. We monitored the return of ideal limb loading (to a 50:50 ratio) and the restoration of the step length on the paretic limb to a physiological length (73 cm), as well as the subsequent restoration of gait symmetry. The measurements were performed using the HP Cosmos Zebris Treadmill FDM-T device. The Wilcoxon Signed Rank test was conducted within each group to analyze the effectiveness of gait reeducation before and after therapy. To compare the results between the two groups, the Mann-Whitney test (α = 0.05) was employed. Results: There was no significant difference between the robotic and conventional therapy groups (p = 0.432 (>0.05)). A significant change occurred only in the control group in the 50:50 limb loading parameter (p = 0.042). There were no significant changes in the other parameters. Conclusions: Under the conditions of our study, robot-guided gait reeducation did not appear to be more effective than conventional therapy. The monthly duration of gait reeducation is insufficient to achieve a symmetrical gait in patients with spastic hemiparesis.

Standardized Intraoperative Robotic Laxity Assessment in TKA Leads to No Clinically Important Improvements at 2 Years Postoperatively: A Randomized Controlled Trial.

Joint stability is a major factor associated with success after TKA. However, most assistive technologies, such as robotic-assisted TKA, do not incorporate a standardized laxity assessment. To address this gap, we opted to perform a randomized controlled trial comparing the results of a manual versus a robot-assisted TKA system with standardized laxity assessment. (1) Does robot-assisted TKA with a standardized laxity assessment provide superior patient-reported outcomes compared with conventional TKA with a manual tensioner, and does it result in a higher percentage of patients achieving the patient acceptable symptom state (PASS) thresholds 2 years after surgery? (2) Does robot-assisted TKA with a standardized laxity assessment provide different coronal alignment or coronal laxity compared with conventional TKA with a manual tensioner after surgery? This was a prospectively registered randomized trial performed at a single center in Belgium. Patients with end-stage knee osteoarthritis unresponsive to conservative treatment were eligible. Exclusion criteria included severe deformity, limited ROM, prior fractures, infection, ligament insufficiency, and neurologic conditions. Between September 2020 and August 2022, we randomized 60 patients to receive TKA either with a manual tensiometer (n = 30) or a robotic-assisted TKA with an imageless system using a standardized laxity system (distraction of the tibiofemoral joint with 80N throughout ROM; n = 30). Of those, 100% (30 of 30) and 90% (27 of 30) of patients were available for follow-up at 2 years in the robotic-assisted and conventional groups, respectively. In both groups, a posterior stabilized implant was used. Patient-reported outcome measures (Knee Society Score [KSS], WOMAC, and 5-level EuroQol 5-domain scores) were obtained preoperatively and at 2 years postoperatively. Coronal alignment and implant position were evaluated on full-leg weightbearing radiographs. Stress radiographs were obtained to assess coronal laxity in 10° of flexion. There were no differences between the groups in baseline characteristics of age, BMI, side, gender, hip-knee-ankle axis, ROM, or patient-reported outcome measures. To account for multiple comparisons in this study, a Bonferroni correction was applied. All differences between both groups were evaluated considering minimum clinically important difference values for patients who have undergone TKA. The power analysis indicated 80% power to detect a clinically meaningful difference of 9.7 points in KSS function score, with an alpha of 0.05. We found no clinically important differences in patient-reported outcomes 2 years after surgery between the conventional and the robotic group (for example, the KSS function score in those groups was 66 ± 20 versus 74 ± 24, respectively, mean difference 8 [95% confidence interval (CI) -3 to 21]; p = 0.18), and no difference in the proportion of patients in those groups who achieved the PASS on any outcomes score (for example, the percentage of patients achieving the PASS for the WOMAC was 4% [1 of 27] versus 3% [1 of 30], respectively, OR 0.9 [95% CI 0 to 15]; p > 0.99). Likewise, there were no differences in postoperative hip-knee-ankle axis between the conventional and the robotic groups, respectively (1° ± 2° varus versus 1° ± 3° varus; p > 0.99) or in coronal-plane laxity (6° ± 3° versus 7° ± 2° in the conventional cohort; p = 0.73). Based on the absence of clinically important differences in outcome scores or any differences in the proportion of patients who achieved the PASS on those scores (as well as the absence of meaningful differences in alignment or soft tissue tension), we recommend against the routine use of robotic TKA with objectified laxity assessment because it adds costs and time to these procedures without delivering benefits that patients might perceive. Future studies might, however, be able to identify patient-specific laxity targets to improve patient outcomes. Level I, therapeutic study.

Is it time to define the scope of safety for robotic resection in perihilar cholangiocarcinoma surgery? A propensity score matching based analysis of a single center experience.

Robotic surgery for perihilar cholangiocarcinoma is in the developmental and exploratory phase. The objective of this study was to compare the short-term outcomes and survival rates of robotic versus open resection for perihilar cholangiocarcinoma in a single center, and to determine the reliable scope of robotic interventions. A comparative analysis of outcomes from open and robotic resections at a single center was conducted using propensity score matching (PSM). The balance of covariates was assessed using standardized mean differences, and the robotic resection procedures adhered to the standards of open surgery. PSM was effectively applied between 41 robotic and 82 open resections. No differences were observed in blood loss, overall and severe morbidity, 90-day mortality, or length of hospital stay. Robotic resections were longer but resulted in better immediate oncological outcomes. Median overall survival for the robotic and open groups was 44 and 30 months (p = 0.259) before PSM and 44 and 29 months (p = 0.164) after PSM respectively. Conversion was required in 8 cases. A subgroup analysis excluding conversions revealed no differences in immediate and long-term outcomes. All patients undergoing robotic resection for Bismuth types I and II were alive at a mean follow-up of 37 months. The robotic approach is comparable to open resection regarding immediate outcomes and survival in select patients with perihilar cholangiocarcinoma. For patients with Bismuth type I and II tumors and early (stages I and II) TNM stages, robotic resection is a reliable treatment option when aligned with the principles of open surgery.

Comparing robot-assisted versus laparoscopic Ladd's procedure in children with congenital intestinal malrotation.

The aim of this study was to perform a comparative analysis of robot-assisted versus laparoscopic Ladd's procedure on peri- and postoperative outcomes. All Ladd's procedures performed on patients with congenital intestinal malrotation between January 2020 and December 2023 were identified. Peri- and postoperative data were collected and compared between robot-assisted and laparoscopic groups. Fifty-seven robot-assisted and 38 laparoscopic Ladd's procedure cases were identified and compared for outcomes. No robotic cases were converted to open procedure, while four laparoscopic cases were converted to open procedure (p = 0.048). Although robotic cases suffered higher hospitalization costs (p < 0.001), the postoperative complication rate was lower for the robotic group compared to the laparoscopic group (p = 0.038). Robot-assisted Ladd's surgery is safe and effective for the treatment of congenital intestinal malrotation in children, reducing the difficulty of surgery, but at increased cost.

Survivorship in robotic total knee arthroplasty compared with conventional total knee arthroplasty: A systematic review and meta-analysis

BackgroundTotal knee arthroplasty (TKA) is the gold standard surgical management for end-stage knee osteoarthritis (OA). Robotic TKA (rTKA) was developed to improve bone preparation accuracy and increase reproducibility. In many settings internationally, rTKA systems have significantly higher costs for patients, and survivorship outcomes are unclear. There are several prior meta-analyses, but these focused on clinical and radiologic outcomes, and to our knowledge, none have evaluated survival. Differences in survival between semi-active or active robotic systems are also not well investigated.Study DesignMeta-analysis.MethodsA random-effects meta-analysis was conducted on comparative studies between robotic-assisted TKAs and conventional TKAs (cTKAs) in patients undergoing TKA for primary knee OA. We searched MEDLINE, Embase, Cochrane Library, and SCOPUS from inception to 19 December 2024. Outcomes assessed were the implant survival in robotic-assisted TKA compared to conventional methods in standard primary knee OA cases, with subgrouping between active and semi-active systems performed. Secondary outcomes included associated complications, post-operative pain scores, and functional outcomes.ResultsA total of 20 comparative studies were included in the meta-analysis. Among them, 2,804 patients underwent cTKA, while 2,599 underwent rTKA. At two years, the pooled survivorship rate was 97.9% (95% CI: 96–99) in the conventional group and 98.3% (95% CI: 96.2–99.2) in the robotic group. There were no significant differences between the groups (P = 0.7). There were no significant differences between the robotic (semi-active) group and the conventional group (P = 0.5) on further unpaired T-Testing.Between 2 and 5 years, pooled survivorship rates in the conventional group were 96.8% (95% CI: 90.3–99) and 97.1% (95% CI: 91.3–99) in the robotic group. There were no significant differences between groups (P = 0.9). At ten years postoperatively, pooled survivorship rates in the conventional group were 96.9% (95% CI: 95–98) and 97.8% (95% CI: 96.7–98.5) in the robotic group. There were no significant differences between the groups (P = 0.3).ConclusionConventional TKA is non-inferior to rTKA at short and long-term follow-up with regard to implant survival, complications, and postoperative pain scores, while rTKA shows subtle improvements in functional outcome measures.Trial registrationCRD42024540997.

Unravelling the mystique of recurrence: A comparative analysis of surgical approaches for early-stage endometrial cancer.

Unravelling the mystique of recurrence: A comparative analysis of surgical approaches for early-stage endometrial cancer.

Multi-robot architecture based on hybridized blockchain model

Multi-robot systems (MRS) are groups of robots that coordinate to complete a given task. In communication-based systems, the integrity of the information shared between robots becomes highly important as any security threat due to a malicious node in the system can cause a chain reaction to compromise the entire system. This paper proposes a hybridized blockchain model-based architecture (HBMA) built on robot operating system (ROS) which offers a semi-decentralized environment into which any communication-based algorithm can be plugged in. A security monitoring system is also provided with the architecture that identifies and shuts down malicious robots while also sending out alerts about the threat. This architecture is used to create secured, coupled approaches to localization of multi-robots and multi-robot path planning. This approach is validated on both physical robots and simulations run on ROS.

Comparison of robotic and conventional laparoendoscopic single-site hysterectomy for large uterus using da Vinci Xi system: A propensity score matching analysis.

Comparison of robotic and conventional laparoendoscopic single-site hysterectomy for large uterus using da Vinci Xi system: A propensity score matching analysis.

Robotic sleeve gastrectomy has higher complication rates compared to laparoscopic: 8-year analysis of robotic versus laparoscopic primary bariatric surgery.

Robotic sleeve gastrectomy has higher complication rates compared to laparoscopic: 8-year analysis of robotic versus laparoscopic primary bariatric surgery.