Monday, September 26, 2016
"The EndoVESPA project (Endoscopic Versatile robotic guidancE, diagnoSis and theraPy of magnetic-driven soft-tethered endoluminAl robots) aims at developing an integrated robotic platform for the navigation of a soft-tethered colonoscope capable of performing painless diagnosis and treatment. Colorectal cancer is one of the major causes of mortality but survival rate dramatically increase in case of early diagnosis. Current screening colonoscopy is limited due to a variety of factors including invasiveness, patient discomfort, fear of pain, and the need for sedation; these factors consistently limit the pervasiveness of mass screening campaigns. Built around a novel robotic colonoscope and designed to make its use straightforward for the endoscopist and ideal for mass screening, the EndoVESPA system has the potential to introduce in the clinical practice a disruptive new paradigm for painless colonoscopy. EndoVESPA combines a “front-wheel” magnetic–driven approach for active and smooth navigation with diagnostic and therapeutic capabilities for overcoming the limitations of current colonoscopy in terms of patient discomfort, dependence on operator skills, costs and outcomes for the healthcare systems. The acceptance and consolidation of robotics in the medical domain and the ever–growing development of endoscopic–driven technologies are the fundamental building blocks for the realization of the EndoVESPA platform which can take advantage of solid and IPR protected technologies provided by the Project Partners. Aim of the EndoVESPA Project is to bring the system to the market for an extensive clinical use. The EndoVESPA Consortium is a unique blend of internationally recognized European pioneers (in all the involved disciplines), which will guarantee a dramatic leap forward in the current technology through successful implementation in terms of scientific innovation, industrial engineering, certification, market analysis, and ultimately clinical deployment."
The research leading to these results received funding from the European Community's Horizon 2020 Framework Programme Proposal for ICT 24 - 2015: Robotics Item c - Innovation Actions: Technology transfer - Robotics use cases.An international patent on the proposed capsule technology has been already granted and is owned by the project coordinator - Scuola Superiore Sant'Anna: Magnetically guided robotic device for endoscopic procedures. Reference number: WO2012080947.
Sunday, September 25, 2016
Friday, September 23, 2016
Wednesday, September 21, 2016
Monday, September 19, 2016
An exciting open access article appeared in the most recent issue of Surgical Endoscopy: "Robotic surgery: disruptive innovation or unfulfilled promise? A systematic review and meta-analysis of the first 30 years" from Tan et al.
Robotic surgery has been in existence for 30 years. This study aimed to evaluate the overall perioperative outcomes of robotic surgery compared with open surgery (OS) and conventional minimally invasive surgery (MIS) across various surgical procedures.
MEDLINE, EMBASE, PsycINFO, and ClinicalTrials.gov were searched from 1990 up to October 2013 with no language restriction. Relevant review articles were hand-searched for remaining studies. Randomised controlled trials (RCTs) and prospective comparative studies (PROs) on perioperative outcomes, regardless of patient age and sex, were included. Primary outcomes were blood loss, blood transfusion rate, operative time, length of hospital stay, and 30-day overall complication rate.
We identified 99 relevant articles (108 studies, 14,448 patients). For robotic versus OS, 50 studies (11 RCTs, 39 PROs) demonstrated reduction in blood loss [ratio of means (RoM) 0.505, 95 % confidence interval (CI) 0.408–0.602], transfusion rate [risk ratio (RR) 0.272, 95 % CI 0.165–0.449], length of hospital stay (RoM 0.695, 0.615–0.774), and 30-day overall complication rate (RR 0.637, 0.483–0.838) in favour of robotic surgery. For robotic versus MIS, 58 studies (21 RCTs, 37 PROs) demonstrated reduced blood loss (RoM 0.853, 0.736–0.969) and transfusion rate (RR 0.621, 0.390–0.988) in favour of robotic surgery but similar length of hospital stay (RoM 0.982, 0.936–1.027) and 30-day overall complication rate (RR 0.988, 0.822–1.188). In both comparisons, robotic surgery prolonged operative time (OS: RoM 1.073, 1.022–1.124; MIS: RoM 1.135, 1.096–1.173). The benefits of robotic surgery lacked robustness on RCT-sensitivity analyses. However, many studies, including the relatively few available RCTs, suffered from high risk of bias and inadequate statistical power.
Our results showed that robotic surgery contributed positively to some perioperative outcomes but longer operative times remained a shortcoming. Better quality evidence is needed to guide surgical decision making regarding the precise clinical targets of this innovation in the next generation of its use."Surgical Endoscopy