Robotic Techniques Research Articles

Robotic mitral surgery: recent advances and outcomes.

This review explores recent advancements in robotic cardiac surgery, specifically focusing on its application in diverse mitral valve surgeries. The aim is to provide an overview of current clinical practices and supporting evidence in this evolving field. A literature review indicates a 30% surge in robotic mitral valve repair from 2015 to 2021, paralleled by a decline in sternotomy-based repair per the STS database. Robotic mitral valve repair consistently shows effective and safe outcomes, with comparable mortality but lower morbidity risks than sternotomy and thoracotomy. The robotic approach exhibits lower conversion to valve replacement, shorter ICU stays, and reduced 30-day readmissions. For experienced programs, robotic techniques prove versatile in various pathologies, including rheumatic heart valve disease, infective endocarditis, ischemic cardiomyopathy, and mitral annular calcification necessitating valve replacement. Literature supports their selective use in high-risk scenarios, including redo surgeries and elderly patients. Recent evidence supports the growing use of robotic approaches in mitral valve surgery, highlighting their efficacy with comparable mortality rates but lower morbidity risks. Robotic techniques consistently yield positive outcomes across various pathologies and patient profiles, signaling a potential paradigm shift in mitral valve interventions.

Does Robotic Assisted Technique Improve Patient Utility in Total Knee Arthroplasty? A Comparative Retrospective Cohort Study.

Even if robotic assisted total knee arthroplasty (RATKA) is a widely used technique, there is still a gap of knowledge about whether this technology is effective in improving the patient utility. This measure is of paramount importance for conducting cost effectiveness analysis. The aim of this study was to compare the utility measure derived from self-reported outcomes questionnaires in patients who underwent RATKA compared to patients who underwent the manual surgery. We compared 72 patients operated with a robotic technique with 70 operated with traditional technique. The utility data were collected with the WOMAC (Western Ontario and McMaster University Osteoarthritis index) self-administrated questionnaire that investigates pain, stiffness and functionality of the patients, an then mapped to a utility value through a validated transforming function. We performed three surveys: the first one before the intervention (t0), the second one 1 year after the surgery (t1) and the third one at the 2 year follow up (t2). we observed higher utility values in both groups. In detail, the mean utility score in the RATKA group increased from 0.37 to 0.71 (t1) and 0.78 (t2), while in the conventional group it increased from 0.41 to 0.78 (t1) and 0.78 (t2). The fixed effect coefficients of t1 and t2 were found to be 0.37 and 0.363 (p < 0.001 for both). The coefficient of the robotic technique, along with its interaction with the t1 and t2 time effect was non-significant. Even if at t1 the utility of patient who underwent RATKA were lower, at longer follow up (t2) we found no significant difference compared to traditional technique, leaving the superiority of robotic assisted technique yet to be proved. Our results may be useful for calculating the gained or lost Quality Adjusted Life Years (QALYs), so that the health care system (or an insurance company) could make an appropriate decision whether to fund the robotic approach or not, after a careful assessment of the incremental costs incurred.

Comparative analysis of dental implant placement accuracy: Semi-active robotic versus free-hand techniques: A randomized controlled clinical trial.

Robot-assisted implant surgery has emerged as a novel digital technology, and the accuracy need further assessment. This study aimed to compare the accuracy of single dental implant placement between a novel semi-active robot-assisted implant surgery (RAIS) method and the conventional free-hand implant surgery (FHIS) method through a multicenter, randomized controlled clinical trial. Patients requiring single dental implant placement were recruited and randomized into RAIS and FHIS group. Deviations at the platform, apex, and angle between the planned and final implant positions were assessed in both groups. Additionally, the evaluation of instrument and surgical complications was examined. A total of 140 patients (median age: 35.35 ± 12.55 years; 43 males, 97 females) with 140 implants from four different research centers were included, with 70 patients (70 implants) in the RAIS group and 70 patients (70 implants) in the FHIS group. In the RAIS and FHIS groups, the median platform deviations were 0.76 ± 0.36 mm and 1.48 ± 0.93 mm, respectively (p < 0.001); median apex deviations were 0.85 ± 0.48 mm and 2.14 ± 1.25 mm, respectively (p < 0.001); and median angular deviations were 2.05 ± 1.33° and 7.36 ± 4.67°, respectively (p < 0.001). Similar significant difference also presented between RAIS and FHIS group in platform vertical/horizontal deviation, apex vertical/horizontal deviation. Additionally, implants with self-tapping characteristics exhibited significantly larger deviations compared with those without self-tapping characteristics in the RAIS group. Both RAIS and FHIS methods demonstrated comparable morbidity and safety pre- and post-operation. The results indicated that the RAIS method demonstrated superior accuracy in single dental implant placement compared with the FHIS method. Specifically, RAIS exhibited significantly smaller deviations in platform, apex, and angular positions, as well as platform and apex vertical/horizontal deviations. This clinical trial was not registered prior to participant recruitment and randomization. https://www.chictr.org.cn/showproj.html?proj=195045.

Safety of robotic double-flap technique following proximal gastrectomy in the introductory phase compared with laparoscopic procedure: a propensity score-matched analysis.

Proximal gastrectomy (PG) is recommended for upper-third gastric cancer and esophagogastric junction (EGJ) cancer, preserving organ function while reducing postoperative symptoms. The double-flap technique (DFT) is one approach to minimize reflux after PG. However, laparoscopic PG with DFT (LPG-DFT) has drawbacks of increased complexity, such as hand sutures for anastomosis. Robotic surgery offers potential advantages for DFT reconstruction, but the safety of robotic DFT following PG (RPG-DFT) in the introductory phase is unknown. This retrospective study compared the outcomes of RPG-DFT with LPG-DFT. Data from 402 patients (321 LPG-DFT, 81 RPG-DFT) between 2009 and 2023 were analyzed. Propensity score matching balanced patient demographics and tumor characteristics. Surgical parameters, complications, and long-term outcomes were assessed. The surgery time of LPG-DFT has stabilized in patients since 2016. Thus, LPG-DFT from 2016 was defined as a stable procedure. RPG-DFT was started in 2019, after minimally invasive DFT reconstruction had been mastered at our center. Therefore, we compared the surgical outcomes of introductory RPG-DFT with stable LPG-DFT. Matched analysis revealed that RPG-DFT in the introductory phase had significantly longer surgery times but less bleeding and shorter reconstruction times and hospital stays than stable LPG-DFT. Frequencies of short-term complications and reflux esophagitis were comparable in both groups. Although RPG-DFT in the introductory phase exhibited higher incidence of anastomotic stenosis than stable LPG-DFT, the incidence of anastomotic stenosis decreased over time. This study demonstrated the safety of RPG-DFT in the introductory phase for EGJ and upper-third stomach tumors, with outcomes comparable to stable LPG-DFT. RPG-DFT offers shorter reconstruction time and less blood loss compared with LPG-DFT. However, anastomotic stenosis is a complication to monitor in early robotic surgery.

Review on Security Range Perception Methods and Path-Planning Techniques for Substation Mobile Robots

The use of mobile robots in substations improves maintenance efficiency and ensures the personal safety of staff working at substations, which is a trend in the development of technologies. Strong electric and solid magnetic fields around high-voltage equipment in substations may lead to the breakdown and failure of inspection devices. Therefore, safe operation range measurement and coordinated planning are key factors in ensuring the safe operation of substations. This paper first summarizes the current developments that are occurring in the field of fixed and mobile safe operating range sensing methods for substations, such as ultra-wideband technology, the two-way time flight method, and deep learning image processing algorithms. Secondly, this paper introduces path-planning algorithms based on safety range sensing and analyzes the adaptability of global search methods based on a priori information, local planning algorithms, and sensor information in substation scenarios. Finally, in view of the limitations of the existing range awareness and path-planning methods, we investigate the problems that occur in the dynamic changes in equipment safety zones and the frequent switching of operation scenarios in substations. Furthermore, we explore a new type of barrier and its automatic arrangement system to improve the performance of distance control and path planning in substation scenarios.

A New Era in Perforator Flap Surgery for Breast Reconstruction: A Comparative Study of Robotic versus Standard Harvest of Bilateral Deep Inferior Epigastric Artery Perforator Flaps.

Traditional deep inferior epigastric artery perforator (DIEP) flap harvest splits the anterior sheath, weakening the abdominal wall and predisposing patients to bulge or hernia. Abdominal wall morbidity may be decreased using minimally invasive techniques. We refined a transabdominal approach to the robotic harvest of bilateral DIEP flaps. A retrospective medical record study involving all patients who underwent bilateral or bipedicled robotic DIEP (rDIEP) or standard DIEP (sDIEP) flap harvest between July 2021 and September 2022. Outcomes included abdominal wall morbidity, total operative time, length of stay (LOS), and complications. Forty-seven patients were included (48 sDIEP flaps, 46 rDIEP flaps) with no significant difference in patient characteristics. Fascial incision length in the rDIEP group was shorter (4.1 vs. 11.7 cm, p < 0.001). Mesh reinforcement of the abdominal wall was used in 13/24 sDIEP and none in rDIEP patients (p < 0.001). Operative time was longer in the rDIEP cohort (739 vs. 630 minutes, p = 0.013), although subanalysis showed no difference in the second half of the cohort. The average robotic dissection time was 135 minutes, which decreased significantly with the surgeon's experience. There were no intraoperative complications from using the robot. LOS was shorter with rDIEP but not statistically significant (3.9 vs. 4.3 days, p = 0.157). This study represents the most extensive cohort analysis of bilateral rDIEP flap harvest, offering a comprehensive comparison to traditional sDIEP. The initial results underscore the viability of robotic techniques for flap harvesting, highlighting potential advantages including reduced fascial incision length and decreased abdominal disruption. Furthermore, using robotics may obviate the necessity for fascial reinforcement with mesh.

Effectiveness of microsurgical palatal tonsillectomy in patients with oropharyngeal cancer and metastases of squamous cell carcinoma into the cervical lymph nodes without identified primary lesion

Introduction. Metastasis without an identified primary lesion is an unresolved and complex problem in clinical oncology. The issue of the necessity of primary lesion identification remains controversial. According to some studies, detection of the primary tumor potentially reduces the dose of radiation therapy and therefore prevents development of toxic reactions that reduce the quality of life of the patient, and in some cases completely eliminates the need for adjuvant therapy. Widespread development and application of robotic, microsurgical, and laser transoral techniques make it possible to verify latent oropharyngeal cancer. The detection of overexpression of p16 protein in metastatic affected lymph nodes may indicate the association of this pathology with human papillomavirus.Aim. To investigate the efficacy of microsurgical palatal tonsillectomy (using a surgical microscope) in diagnosis and treatment of occult oropharyngeal cancer in patients with cervical lymph node metastases of undetected primary site, determine the frequency of expression of the surrogate marker of human papillomavirus – protein p16.Materials and methods. The study was based on the results of diagnosing 82 patients with cervical lymph node metastases of undetected primary site. The inclusion criteria were morphologically verified cervical lymph node metastases of squamous cell carcinoma, absence of a primary tumour after a standard clinical examination. 10 patients underwent palatal tonsillectomy using a surgical microscope and cervical lymph node dissection based on the results of clinical examination and instrumental diagnostics.Results. The use of microsurgical palatal tonsillectomy in patients with metastases of squamous cell carcinoma in the cervical lymph nodes without identified primary lesion allowed to diagnose cancer of the palatine tonsil in 12.1 % of cases, cancer of this location associated with human papilloma virus in 70 % of cases.Conclusion. Microsurgical palatal tonsillectomy using a surgical microscope allowed us to not only verify occult palatine tonsil cancer, but also to establish accurate diagnosis and stage of the disease with subsequent determination of the scope of adjuvant therapy.

Efficacy and Safety of Robotic Surgery vs. Open Surgery for Hilar Cholangiocarcinoma: A Comprehensive Review.

Hilar cholangiocarcinoma, a rare and aggressive bile duct malignancy, presents significant challenges in surgical management. Traditionally treated with open surgery, the emergence of robotic surgery has introduced a new dimension to surgical approaches for this condition. This review aims to systematically compare the efficacy and safety of robotic surgery versus open surgery for hilar cholangiocarcinoma. We conducted a comprehensive review of the literature, including clinical studies, case series, and comparative analyses of robotic and open surgical techniques. Data on oncological outcomes, functional recovery, survival rates, complications, and cost-effectiveness were extracted and analyzed to provide a detailed comparison of the two surgical approaches. Robotic surgery offers several potential advantages over open surgery, including reduced intraoperative blood loss, smaller incisions, and shorter recovery times. However, it requires specialized training and has a higher initial cost. Open surgery, while more established and broadly practiced, remains associated with longer recovery periods and higher complication rates. Oncological outcomes, such as R0 resection rates and survival, appear comparable between the two approaches, though robotic surgery may offer improvements in functional recovery and postoperative quality of life. Both robotic and open surgery have their merits in the treatment of hilar cholangiocarcinoma. Robotic surgery presents promising benefits in terms of reduced invasiveness and improved recovery, while open surgery continues to be a reliable and well-established option. The choice of surgical approach should be guided by patient-specific factors, surgeon expertise, and institutional resources. Further research is needed to refine surgical techniques and establish long-term outcomes, which will aid in optimizing treatment strategies for this challenging malignancy.

Robotic sleeve gastrectomy through medial approach for severe obesity: Safe introduction, technical description and case series.

The use of robotic surgery has increased worldwide and has the potential to amplify the surgeon's skill owing to its versatile functions. However, robotic surgery requires specific skills that differ from laparoscopic surgery, and the field of robotic surgery training systems is underdeveloped. Therefore, to ensure patient safety, a task protocol should be prepared before the introduction of novel robotic surgeries. This article provides the pioneering description of performing robotic sleeve gastrectomy (RSG) through the medial-to-lateral approach, utilising our newly revised protocol. The preliminary clinical results of 10 patients who underwent RSG using the stapling-first technique between June 2021 and March 2023 showed that RSG is safe and feasible and that the implementation of a task protocol is an effective strategy for the safe introduction of a novel robotic surgical technique.

Surgical Outcomes and Utilization of Laparoscopic Versus Robotic Techniques for Elective Colectomy in Asian American and Native Hawaiian-Pacific Islanders (AAPI) Diagnosed With Colon Cancer

IntroductionAsian American and Native Hawaiian-Pacific Islanders (AAPI) are the fastest growing racial-ethnic group, with 18.9 million people in 2019, and is predicted to rise to 46 million by 2060. Colorectal cancer (CRC) is the most common cancer in AAPI men and the third most common in women. Treatment techniques like laparoscopic colectomy (LC) emerged as the standard of care for CRC resections; however, new robotic technologies can be advantageous. Few studies have compared clinical outcomes across minimally invasive approaches for AAPI patients with CRC. This study compares utilization and clinical outcomes of LC versus robotic colectomies (RCs) in AAPI patients. MethodsWe queried the American College of Surgeons National Surgical Quality Improvement Program database for elective RC and LC in AAPI patients from 2012 to 2020. Outcomes included unplanned conversion to open, operative time, complications, 30-d mortality, and length of stay. Multivariable logistic regression analyses assessed the association between outcomes and the operative approach. ResultsBetween 2012 and 2020, 83,841 patients underwent elective LC or RC. Four thousand six hundred fifty-eight AAPI patients underwent 3817 (82%) LCs and 841 (18%) RCs. In 2012, all procedures were performed laparoscopically; by 2020, 27% were robotic. Mean operative time was shorter in LC (192 versus 249 min, P < 0.001). On multivariable logistic regression, there was no difference in infection (odds ratio [OR] 0.8, 95% confidence interval [CI] 0.59-1.12), anastomotic leak (OR 0.97, 95% CI 0.59-1.61), or death (OR 0.9, 95% CI 0.31-2.61). Length of stay was shorter for RC (−0.44 d, 95% CI −0.71 to −0.18 d). ConclusionsOverall, AAPI postoperative outcomes are similar between LC and RC. Future studies that evaluate costs and resource utilization can assist hospitals in determining whether implementing robotic-assisted technologies in their hospitals and communities will be appropriate.

Revolutionizing Organ Transplantation With Robotic Surgery.

The aim of this study was to evaluate the impact of robotic techniques on organ transplantation outcomes. The evolution of organ transplantation is becoming influenced by the adoption of minimally invasive techniques, transitioning from laparoscopic to robotic methods. Robotic surgery has emerged as a significant advancement, providing superior precision and outcomes compared with traditional approaches. This perspective includes a systematic review of the literature, original data from a high-volume center, as well as an international survey focusing on perceptions related to robotic versus laparoscopic and open approaches. The systematic review and meta-analysis revealed lower morbidity with robotic donor nephrectomy, recipient kidney transplant and donor hepatectomy. Our center's experience, with over 3000 minimally invasive transplant procedures (kidney, liver, donor, and recipient), supports the superiority of robotic transplant surgery (RTS). The global survey confirms this shift, revealing a preference for robotic approaches due to their reduced morbidity, despite challenges such as access to the robotic system and cost. This comprehensive overview including a systematic review, original data, and perceptions derived from the international survey demonstrate the superiority of robotic transplant surgery (RTS) across a range of organ transplantations, for both donors and recipients. The future of RTS depends on the efforts of the surgical community in addressing challenges such as economic implications, the need for specialized surgical training for numerous surgeons, as well as wide access to robotic systems worldwide.

Semantic mapping techniques for indoor mobile robots: Review and prospect

With the continuous development of robotics and computer vision technology, mobile robots have been widely applied in various fields. In this process, semantic maps for robots have attracted considerable attention because they provide a comprehensive and anthropomorphic representation of the environment. On the one hand, semantic maps are a tool for robots to depict the environment, which can enhance the robot’s cognitive expression of space and build the communication bond between robots and humans. On the other hand, semantic maps contain spatial location and semantic properties of entities, which helps robots realize intelligent decision-making in human-centered indoor environments. In this paper, we review the primary approaches of semantic mapping proposed over the last few decades, and group them according to the type of information used to extract semantics. First, we give a formal definition of semantic map and describe the techniques of semantic extraction. Then, the characteristics of different solutions are comprehensively analyzed from different perspectives. Finally, the open issues and future trends regarding semantic maps are discussed in detail. We wish this review provides a comprehensive reference for researchers to drive future research in related field.

A Critical Review of Emerging Technologies for Flash Flood Prediction: Examining Artificial Intelligence, Machine Learning, Internet of Things, Cloud Computing, and Robotics Techniques

There has been growing interest in the application of smart technologies for hazard management. However, very limited studies have reviewed the trends of such technologies in the context of flash floods. This study reviews innovative technologies such as artificial intelligence (AI)/machine learning (ML), the Internet of Things (IoT), cloud computing, and robotics used for flash flood early warnings and susceptibility predictions. Articles published between 2010 and 2023 were manually collected from scientific databases such as Google Scholar, Scopus, and Web of Science. Based on the review, AI/ML has been applied to flash flood susceptibility and early warning prediction in 64% of the published papers, followed by the IoT (19%), cloud computing (6%), and robotics (2%). Among the most common AI/ML methods used in susceptibility and early warning predictions are random forests and support vector machines. However, further optimization and emerging technologies, such as computer vision, are required to improve these technologies. AI/ML algorithms have demonstrated very accurate prediction performance, with receiver operating characteristics (ROC) and areas under the curve (AUC) greater than 0.90. However, there is a need to improve on these current models with large test datasets. Through AI/ML, IoT, and cloud computing technologies, early warnings can be disseminated to targeted communities in real time via electronic media, such as SMS and social media platforms. In spite of this, these systems have issues with internet connectivity, as well as data loss. Additionally, Al/ML used a number of topographical variables (such as slope), geological variables (such as lithology), and hydrological variables (such as stream density) to predict susceptibility, but the selection of these variables lacks a clear theoretical basis and has inconsistencies. To generate more reliable flood risk assessment maps, future studies should also consider sociodemographic, health, and housing data. Considering future climate change impacts, susceptibility or early warning studies may be projected under different climate change scenarios to help design long-term adaptation strategies.

Enhancing Robot Behavior with EEG, Reinforcement Learning and Beyond: A Review of Techniques in Collaborative Robotics

Collaborative robotics is a major topic in current robotics research, posing new challenges, especially in human–robot interaction. The main aspect in this area of research focuses on understanding the behavior of robots when engaging with humans, where reinforcement learning is a key discipline that allows us to explore sophisticated emerging reactions. This review aims to delve into the relevance of different sensors and techniques, with special attention to EEG (electroencephalography data on brain activity) and its influence on the behavior of robots interacting with humans. In addition, mechanisms available to mitigate potential risks during the experimentation process such as virtual reality are also be addressed. In the final part of the paper, future lines of research combining the areas of collaborative robotics, reinforcement learning, virtual reality, and human factors are explored, as this last aspect is vital to ensuring safe and effective human–robot interactions.

Advancements and limitations in integrating robotics into medicine: A comprehensive review

The integration of robotics into medicine represents a groundbreaking advancement with transformative potential across various medical domains. This comprehensive review delves into both the remarkable advancements and the significant limitations associated with this integration. Advancements in robotic medicine include precision surgery, which facilitatesintricate procedures with enhanced accuracy and minimal invasiveness. Robotic systems enable teleoperation, allowing surgeons to perform procedures remotely, and expanding access to specialized care. Enhanced imaging and navigation capabilities further augment surgical precision and efficiency. Additionally, robotics play a vital role in rehabilitation therapy, aiding in personalized patient recovery. However, these advancements have substantial limitations. The cost of acquiring and maintaining robotic systems poses a significant barrier to widespread adoption, particularly in resource-constrained healthcare settings. Moreover, mastering robotic surgical techniques demands extensive training, contributing to a steep learning curve for healthcare professionals. Technical challenges such as system reliability and interoperability also present hurdles to seamless integration. Ethical considerations surrounding patient autonomy, accountability, and data privacy must be carefully addressed. Legal frameworks and regulatory standards are essential to ensure patient safety and mitigate liability risks associated with robotic-assisted interventions. Furthermore, disparities in access to robotic technology may exacerbate existing healthcare inequalities. Addressing these limitations requires concerted efforts from healthcare stakeholders, policymakers, and technology developers. Collaborative initiatives are needed to overcome financial, educational, technical, ethical, and regulatory barriers to integrating robotics into mainstream medical practice. By navigating these challenges, the full potential of robotics in medicine can be realized, ushering in an era of enhanced precision, efficiency, and accessibility in healthcare delivery.

The Current Role of Single-Site Robotic Approach in Liver Resection: A Systematic Review.

Liver resection is a critical surgical procedure for treating various hepatic pathologies. Minimally invasive approaches have gradually gained importance, and, in recent years, the introduction of robotic surgery has transformed the surgical landscape, providing potential advantages such as enhanced precision and stable ergonomic vision. Among robotic techniques, the single-site approach has garnered increasing attention due to its potential to minimize surgical trauma and improve cosmetic outcomes. However, the full extent of its utility and efficacy in liver resection has yet to be thoroughly explored. We conducted a comprehensive systematic review to evaluate the current role of the single-site robotic approach in liver resection. A detailed search of PubMed was performed to identify relevant studies published up to January 2024. Eligible studies were critically appraised, and data concerning surgical outcomes, perioperative parameters, and post-operative complications were extracted and analyzed. Our review synthesizes evidence from six studies, encompassing a total of seven cases undergoing robotic single-site hepatic resection (SSHR) using various versions of the da Vinci© system. Specifically, the procedures included five left lateral segmentectomy, one right hepatectomy, and one caudate lobe resection. We provide a summary of the surgical techniques, indications, selection criteria, and outcomes associated with this approach. The single-site robotic approach represents an option among the minimally invasive approaches in liver surgery. However, although the feasibility has been demonstrated, further studies are needed to elucidate its optimal utilization, long-term outcomes, and comparative effectiveness against the other techniques. This systematic review provides valuable insights into the current state of single-site robotic liver resection and underscores the need for continued research in this rapidly evolving field.

Enhancing 3D object detection by using neural network with self-adaptive thresholding

Robust 3D object detection remains a pivotal concern in the domain of autonomous field robotics. Despite notable enhancements in detection accuracy across standard datasets, real-world urban environments, characterized by their unstructured and dynamic nature, frequently precipitate an elevated incidence of false positives, thereby undermining the reliability of existing detection paradigms. In this context, our study introduces an advanced post-processing algorithm that modulates detection thresholds dynamically relative to the distance from the ego object. Traditional perception systems typically utilize a uniform threshold, which often leads to decreased efficacy in detecting distant objects. In contrast, our proposed methodology employs a Neural Network with a self-adaptive thresholding mechanism that significantly attenuates false negatives while concurrently diminishing false positives, particularly in complex urban settings. Empirical results substantiate that our algorithm not only augments the performance of 3D object detection models in diverse urban and adverse weather scenarios but also establishes a new benchmark for adaptive thresholding techniques in field robotics.

Enhancing 3D object detection by using neural network with self-adaptive thresholding

Robust 3D object detection remains a pivotal concern in the domain of autonomous field robotics. Despite notable enhancements in detection accuracy across standard datasets, real-world urban environments, characterized by their unstructured and dynamic nature, frequently precipitate an elevated incidence of false positives, thereby undermining the reliability of existing detection paradigms. In this context, our study introduces an advanced post-processing algorithm that modulates detection thresholds dynamically relative to the distance from the ego object. Traditional perception systems typically utilize a uniform threshold, which often leads to decreased efficacy in detecting distant objects. In contrast, our proposed methodology employs a Neural Network with a self-adaptive thresholding mechanism that significantly attenuates false negatives while concurrently diminishing false positives, particularly in complex urban settings. Empirical results substantiate that our algorithm not only augments the performance of 3D object detection models in diverse urban and adverse weather scenarios but also establishes a new benchmark for adaptive thresholding techniques in field robotics.

Strategies to build a robotic liver surgery program

Over the past few decades, an increasing proportion of abdominal surgeries are performed through minimally invasive platforms. In contrast, adaptation of minimally invasive techniques for liver surgery has garnered slower attraction due to the complexity and associated morbidity and mortality with these operations. Compared to laparoscopy, the robotic-assisted surgical system provides a three-dimensional operative view and instruments with articulation that mimic and extend wrist movement. These elements improve operative dexterity making dissection and suturing easier. Additionally, robotic surgery improves operative ergonomics and decreases physical and mental fatigue. Studies show that the robotic platform is safe and versatile with many technical advantages for complex operations, improved short-term outcomes compared to open surgery, and comparable oncologic outcomes. As such, hepatobiliary surgeons are increasingly adapting robotic techniques in their practice. It is crucial that as more hospitals adopt this technology, patient safety monitoring and quality initiatives are maintained. Establishing a robotic liver surgery program revolves around three pillars: designing a curriculum to overcome the learning curve, building a strong clinical and administrative team, and appropriate patient selection.

Acquisition and Development of Scrub Nursing Skills in Robotic-Assisted Cranial and Spinal Neurosurgical Procedures

Introduction. In high-tech operative specialties, including neurosurgery, the rise of interest in robotic systems is observed, since these techniques are hoped to increase the precision of the operation. However, for the optimal implementation of these solutions, the close cooperation between surgeon and perioperative nursing team as well as adequate coordination of their actions is required. These skills needs to be gained and trained. Aim. The following report describes the single center experience of the operating team in launching the robotic navigation in neurosurgical procedures from the vantage point of nursing team. Material and Methods. This work contains a phenomenological analysis of learning process and of optimalisation in cooperating the work of the involved operating team during early phase of introducing the robotic neurosurgical procedures (both cranial and spinal). Here, the typical problems during implementation of these techniques with separate analysis of single steps of preparing and applying the tool sets are described, where critical points and the potential of failure elimination is highlighted. Results. The preparing of the robotic surgical tool set is not demanding and differs only slightly from the preparation of standard sets designed for neuronavigation plus targeted cranial biopsy or percutaneous spine instrumentation, respectively. The key point is to synchronize the actions of the operating surgeon (-s), perioperative nurses and radiologic technicians. Conclusions. Implementation of robotic techniques is a challenge for the whole neurosurgical team, including the scrub/circulating nurses. What is more important in the initial phase than (usually intuitive) operation of the devices, is the coordination of single team members’ actions and developing the communication skills regarding the planned course of the surgery and potential modification of its course, needed before the surgery starts. (JNNN 2024;13(1):29–35)