"The future of surgery is not about blood and guts; the future of surgery is about bits and bytes.”
/Dr. Richard Satava/

Friday, April 18, 2014

Best Practices - Clinical guidelines

Hereby we launch a new series of posts on best practices. Time-to-time recommendations and eminent articles will be featured here hoping to help our readers in the various adjoin fields adjoin to science and technology behind medical robots. 

Have you ever wondered about the evaluation and quality of guidelines and protocols? 
Here is a great article on "What makes a good clinical guideline?" from Rebecca Broughton and Barrie Rathbone. you can also find an evalauation sheet there for further use. 

Guidelines "reduce unacceptable or undesirable variations in practice and provide a focus for discussion among health professionals and patients. They enable professionals from different disciplines to come to an agreement about treatment and devise a quality framework, against which
practice can be measured. Guidelines can help commissioners and purchasers to make informed decisions and provide managers with a useful framework for assessing treatment costs."
Not to be mixed with protocols (that are to set out "precise, rigid, sequence of activities to be adhered to in the management of a specific condition.") or Care Pathways (that "determine locally agreed, multidisciplinary practice, based on guidelines and evidence for a specific patient group. Form part/all of the clinical record which documents care given and helps to evaluate outcomes.")

Good clinical guidelines should be:
● "Valid– leading to the results expected of them.
● Reproducible– if using the same evidence, other guideline groups would come to the same results.
● Cost-effective – reducing the inappropriate use of resources.
● Representative/multidisciplinary– by involving key groups and their interests.
● Clinically applicable– patient populations affected should be unambiguously defined.
● Flexible– by identifying the expectations relating to recommendations  as well as patient preferences.
● Clear– unambiguous language, which is readily understood by clinicians and patients, should be used.
● Reviewable– the date and process of review should be stated.
● Amenable to clinical audit– the guidelines should be capable of  translation into explicit audit criteria."

So where are we regarding Guidelines for medical robots? Not too far...
If you know of more initiatives, let us know!

Wednesday, April 16, 2014

Video Wednesday


An earlier showcase of the ARTAS robot.

Sunday, April 13, 2014

Flickstop

Another president trying the da Vinci.

Image credit: DNA

Friday, April 11, 2014

Enabling Medical Robotics for the Next Generation of Minimally Invasive Procedures

A brief analysis of the case of single port surgery from Howie Choset and Marco Zenati (Biorbotoics Lab, CMU): 

Minimally invasive interventions have the potential to revolutionize surgical practice by offering reduced pain, faster recovery, and fewer complications. We believe the key to achieving such potential is to eliminate the need for multiple (up to 8) ports by using natural orifices, when available, or single port entry, when a natural orifices are not present. Single port access approaches may facilitate existing procedures but perhaps more importantly, they will enable new ones, and at a lower cost. This reduced cost has the added benefit of making therapies available to a larger portion of the general public.
Already, we have seen the single port trend with the introduction of natural orifice transluminal endoscopic surgery (NOTES) where a procedure is performed with a minimally invasive surgical device or endoscope that enters a natural orifice, such as the mouth, nasal passage, vagina, or anus, and then passes through an internal incision to access anatomical targets deep in the body
For the heart, the closest thing to natural orifice access is to reach the pericardium space via a single port in the subxyphoid process using a linear rigid device; this approach does not require general anesthesia nor a heart-lung machine while providing access to a beating heart.
The common denominator for single port entry is the need for dedicated robotic technology that can operate without access limitation and full feedback from a single entry point. Although they have great visual feedback, conventional surgical robots, such as the Intuitive Surgical’s DaVinci System, are not adequate for single port entry because the three or four large robot arms manipulate linear chop-stick laparoscopic-like devices which have limited access to line-of-sight regions from the ports. A small articulated device or a miniature mobile/crawling unit, not a conventional robot, is key to accessing many anatomical targets from a single port..."

Image credit: Medrobotics

Monday, April 7, 2014

NASA turns again to robotic surgery - with Robonaut 2

After 40 years, NASA is turning back to the idea of telerobotics in space through its most advances telerobotic interface, Robonaut 2.
"Robonaut 2, NASA's humanoid robot currently inhabiting the International Space Station, hasn't done much exciting work up there since its arrival three years ago.
But according to a doctor at Houston Methodist Hospital who has been training the robot on telemedicine, the plan is to equip NASA's space-age machine to eventually perform surgery.
"The idea is for him to be the best medic, nurse and physician," Dr. Zsolt Garami told the BBC. "Our plan is to use Robonaut as a telemedicine doctor in remote areas." That would include space.
Robonaut 2, a collaboration between NASA, General Motors and Oceaneering Space Systems engineers, arrived at the International Space Station in 2011 on space shuttle Discovery as part of the STS-133 mission."



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Source: CBSNews, BBC, Yahoo News

Friday, April 4, 2014

Flickstop

What else could it be than the brand new da Vinci Xi system.
Image credit: Intuitive