Description

This paper presents hand-impedance measurements during laparoscopic training with physically interactive manipulators. We develop a co-manipulated robotic system allowing hand-impedance measurements in an active manipulation task with occasional environmental contact. Six professional, four trainee surgeons, and ten novice subjects participated in our experimental program for a suturing activity where the novice subjects were involved in a five weeks training practice. Variable admittance controlled robots, attached to the tools with force sensors, applied step vice velocity disturbances while subjects were trying to set the needle perpendicular to the surgical driver.

Hereby, impedances of the left and right hands were computed in four different directions. Then, the measured impedance parameters across all subjects were compared with respect to the participants’ level of proficiency and skill progression via statistical analyses to demonstrate effectiveness of the system. Results indicate that hand-impedance in the direction of the suturing-line demonstrates a consistent change throughout training and across different levels of expertise in laparoscopy. Therefore, hand-impedance information, proposed here, can pave the way for future development of robotic assessment or assistance in laparoscopy training programs. In patients with advanced-stage epithelial ovarian cancer (EOC), a Diagnostic Laparoscopy (DLS) to determine treatment regime prevents futile laparotomies and seems cost-neutral. The uptake of DLS in current practice is unknown. We evaluated the clinical application of routine DLS in treatment planning in patients with advanced-stage EOC in the Netherlands. Penetrating abdominal trauma (PAT) poses a significant challenge to trauma surgeons. Laparotomy is still the most popular procedure for managing PAT but has high morbidity and mortality rates. Presently, laparoscopy aims to provide equal or superior visualization compared to open approaches but with less morbidity, postoperative discomfort, and recovery time. The aim of this research is to assess the impact of laparoscopy on the management of PAT. Most studies exploring the role of staging laparoscopy in gastric cancer are limited by low sample size and are predominantly conducted in Asian countries. This study sets out to determine the value of staging laparoscopy in patients with advanced gastric cancer in a Western population.

Kindly submit your manuscript through https://www.imedpub.com/submissions/reproductive-endocrinology-infertility.html

With Regards
Eshuis

Journal Coordinator
Journal of Reproductive Endocrinology & Infertility