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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
21

Avaliação do tempo cirúrgico e de recuperação pós-operatória nas pacientes submetidas à histerectomia robótica e outras técnicas de histerectomia no Hospital de Clínicas de Porto Alegre

Gutierrez, Ana Luiza January 2015 (has links)
Base Teórica: A histerectomia ainda é um procedimento cirúrgico frequente. Nos últimos 25 anos, muitos esforços foram feitos para reduzir o número de histerectomias abdominais, como o avanço tecnológico, que permitiu cirurgias menos invasivas. Visando ampliar o uso da cirurgia minimamente invasiva, foi desenvolvida a cirurgia robótica, com a vantagem de facilitar o uso da laparoscopia proporcionando movimentos mais ergonômicos e precisos. Apesar de ser tecnologia recente e do alto custo, vem ganhando cada vez mais espaço na prática clínica. Dados sobre tempo cirúrgico e tempo de internação pós-operatória tem sido alvo de várias publicações, uma vez que afetam os custos do procedimento. Objetivo: O presente projeto visa à documentação da experiência inicial do Hospital de Clínicas de Porto Alegre na realização da histerectomia robótica, e comparação dos seus dados com outras vias de histerectomia já realizados no nosso meio. Métodos: Foi realizado estudo caso-controle para comparação de dados pré-operatórios, operatórios (como tempo cirúrgico total e sangramento) e pós-operatórios (tempo de recuperação pós-operatória, complicações, dor nas primeiras 24 horas após a cirurgia), em 80 pacientes, submetidas à histerectomia para tratamento de patologias uterinas benignas. Nós incluímos quatro grupos de pacientes: robótico, vaginal, abdominal e laparoscópico. O grupo robótico foi composto pelas primeiras 20 cirurgias realizadas em nosso hospital, e os grupos controle foram selecionados retrospectivamente a partir da data da última cirurgia robótica, constituindo uma amostragem não probabilística. Também foi realizado estudo transversal utilizando apenas as pacientes submetidas à cirurgia robótica em nosso serviço, para fins de documentação de nossa experiência inicial. Resultados: O grupo robótico foi responsável pelo maior tempo cirúrgico total (180,7 minutos), e pelo menor tempo de recuperação pós-operatória (23,7 horas), entre os quatro grupos. Não houve diferença entre os grupos na análise do sangramento transoperatório e das complicações pós-operatórias. Dados analisados sobre a dor pós-operatória não diferiram entre os grupos. No estudo transversal, foi demonstrada curva de aprendizado em tempo de docking e undocking, e houve correlação forte entre tempo cirúrgico total e índice de massa corporal da paciente. Conclusão: Análise do tempo cirúrgico total e do tempo de recuperação pós-operatória são relevantes, pois podem ser ferramentas necessárias para redução dos custos da cirurgia robótica. Nossa experiência inicial demonstra curva de aprendizado em alguns aspectos. / Background: Hysterectomy is a frequent surgical procedure. In the last 25 years, many efforts have been made to reduce the number of abdominal hysterectomies, such as the technological advances, which allowed less invasive procedures. Aiming to increase the use of minimally invasive surgery, the robotic surgery was developed, which advantage of more precise and ergonomic movements than laparoscopy. Although it is a recent and expensive technology, robotic surgery is gaining more space in clinical practice. Data from Total Surgical Time and Time of Postoperative Recovery has been target of publications, once they can affect the costs. Objective: The purpose of this study is to compare the surgical outcomes of patients undergoing robotic hysterectomy for benign cases to patients undergoing another types of hysterectomy performed in our institution. Methods: It was performed a case-control study to compare pre-operative, operative (as Total Surgical Time and bleeding) and postoperative (Time of Postoperative Recovery, complications, and pain at the first 24 hours after the surgery) in 80 patients undergoing hysterectomy for treatment of various benign uterine conditions. We have included four groups of patients: robotic, vaginal, abdominal and laparoscopic. The robotic group was composed by the first twenty patients undergoing robotic hysterectomy at our hospital, and the control groups were retrospectively selected from the date of the last robotic surgery, constituting a non-probabilistic sample. We also performed a crosssectional study with the 20 patients of robotic group, to document our initial experience. Results: The robotic group was responsible for the longer Total Surgical Time (180.7 minutes), and for the shortest Time of Postoperative Recovery (23.7 hours) among the four groups. There were no difference between the groups in analysis of estimated blood loss and postoperative complications. Data related to postoperative pain showed no difference between the groups. At cross-sectional study, it was demonstrated learning curve of docking and undocking times, and was found a strong correlation between Total Surgical Time and body mass index. Conclusion: Analysis of Total Surgical Time and Time of Postoperative Recovery are relevant, because they can be necessary tools to reduce the costs of robotic surgery. Our initial experience demonstrated learning curve in some ways.
22

Avaliação do tempo cirúrgico e de recuperação pós-operatória nas pacientes submetidas à histerectomia robótica e outras técnicas de histerectomia no Hospital de Clínicas de Porto Alegre

Gutierrez, Ana Luiza January 2015 (has links)
Base Teórica: A histerectomia ainda é um procedimento cirúrgico frequente. Nos últimos 25 anos, muitos esforços foram feitos para reduzir o número de histerectomias abdominais, como o avanço tecnológico, que permitiu cirurgias menos invasivas. Visando ampliar o uso da cirurgia minimamente invasiva, foi desenvolvida a cirurgia robótica, com a vantagem de facilitar o uso da laparoscopia proporcionando movimentos mais ergonômicos e precisos. Apesar de ser tecnologia recente e do alto custo, vem ganhando cada vez mais espaço na prática clínica. Dados sobre tempo cirúrgico e tempo de internação pós-operatória tem sido alvo de várias publicações, uma vez que afetam os custos do procedimento. Objetivo: O presente projeto visa à documentação da experiência inicial do Hospital de Clínicas de Porto Alegre na realização da histerectomia robótica, e comparação dos seus dados com outras vias de histerectomia já realizados no nosso meio. Métodos: Foi realizado estudo caso-controle para comparação de dados pré-operatórios, operatórios (como tempo cirúrgico total e sangramento) e pós-operatórios (tempo de recuperação pós-operatória, complicações, dor nas primeiras 24 horas após a cirurgia), em 80 pacientes, submetidas à histerectomia para tratamento de patologias uterinas benignas. Nós incluímos quatro grupos de pacientes: robótico, vaginal, abdominal e laparoscópico. O grupo robótico foi composto pelas primeiras 20 cirurgias realizadas em nosso hospital, e os grupos controle foram selecionados retrospectivamente a partir da data da última cirurgia robótica, constituindo uma amostragem não probabilística. Também foi realizado estudo transversal utilizando apenas as pacientes submetidas à cirurgia robótica em nosso serviço, para fins de documentação de nossa experiência inicial. Resultados: O grupo robótico foi responsável pelo maior tempo cirúrgico total (180,7 minutos), e pelo menor tempo de recuperação pós-operatória (23,7 horas), entre os quatro grupos. Não houve diferença entre os grupos na análise do sangramento transoperatório e das complicações pós-operatórias. Dados analisados sobre a dor pós-operatória não diferiram entre os grupos. No estudo transversal, foi demonstrada curva de aprendizado em tempo de docking e undocking, e houve correlação forte entre tempo cirúrgico total e índice de massa corporal da paciente. Conclusão: Análise do tempo cirúrgico total e do tempo de recuperação pós-operatória são relevantes, pois podem ser ferramentas necessárias para redução dos custos da cirurgia robótica. Nossa experiência inicial demonstra curva de aprendizado em alguns aspectos. / Background: Hysterectomy is a frequent surgical procedure. In the last 25 years, many efforts have been made to reduce the number of abdominal hysterectomies, such as the technological advances, which allowed less invasive procedures. Aiming to increase the use of minimally invasive surgery, the robotic surgery was developed, which advantage of more precise and ergonomic movements than laparoscopy. Although it is a recent and expensive technology, robotic surgery is gaining more space in clinical practice. Data from Total Surgical Time and Time of Postoperative Recovery has been target of publications, once they can affect the costs. Objective: The purpose of this study is to compare the surgical outcomes of patients undergoing robotic hysterectomy for benign cases to patients undergoing another types of hysterectomy performed in our institution. Methods: It was performed a case-control study to compare pre-operative, operative (as Total Surgical Time and bleeding) and postoperative (Time of Postoperative Recovery, complications, and pain at the first 24 hours after the surgery) in 80 patients undergoing hysterectomy for treatment of various benign uterine conditions. We have included four groups of patients: robotic, vaginal, abdominal and laparoscopic. The robotic group was composed by the first twenty patients undergoing robotic hysterectomy at our hospital, and the control groups were retrospectively selected from the date of the last robotic surgery, constituting a non-probabilistic sample. We also performed a crosssectional study with the 20 patients of robotic group, to document our initial experience. Results: The robotic group was responsible for the longer Total Surgical Time (180.7 minutes), and for the shortest Time of Postoperative Recovery (23.7 hours) among the four groups. There were no difference between the groups in analysis of estimated blood loss and postoperative complications. Data related to postoperative pain showed no difference between the groups. At cross-sectional study, it was demonstrated learning curve of docking and undocking times, and was found a strong correlation between Total Surgical Time and body mass index. Conclusion: Analysis of Total Surgical Time and Time of Postoperative Recovery are relevant, because they can be necessary tools to reduce the costs of robotic surgery. Our initial experience demonstrated learning curve in some ways.
23

ENHANCE ROBOTIC-ASSISTED SURGERY WITH A SENSING-BASED ADAPTIVE SYSTEM

Jing Yang (16361256) 15 June 2023 (has links)
<p>The advancement of robotic-assisted surgery (RAS) has revolutionized the field by enabling surgeons to perform intricate procedures with enhanced precision, improved depth perception, and more precise control. Despite these advancements, current RAS systems still rely on teleoperation, where surgeons control the robots remotely. The complexity of the master-slave control mechanism, along with the technical challenges involved, can impose significant mental workloads on surgeons. As excessive mental workload (MWL) can adversely affect performance and increase the likelihood of errors, addressing operator mental overload has become crucial for successful operation in RAS. To tackle this problem, there has been increased interest in developing robots that can provide operators with varying levels of assistance based on their MWL (i.e., adaptive system) during task execution. However, the research in this area is notably limited, primarily due to two key factors: the absence of a real-time MWL assessment framework and the lack of effective intervention strategies to mitigate MWL in RAS.</p> <p>This Ph.D. dissertation aims to fill these gaps by designing the adaptive system in RAS and exploring its impact on surgical task performance. The dissertation comprises three studies. The first study demonstrated the feasibility of the adaptive system in RAS by introducing an MWL-triggered semi-autonomous suction tool as a proof-of-concept. Building upon the insights gained from the first study, the second study focused on enhancing the adaptive system's adaptability to more complex RAS tasks. In particular, the second study proposed a task-independent MWL model that had potential to be applied to various RAS tasks. Additionally, more intelligent interventions were investigated. Furthermore, the third study aimed to investigate the benefits of adaptive system in RAS training by introducing a personalized and adaptive training program based on human MWL profile. The findings of this dissertation revealed evidence supporting the effectiveness of the adaptive system in moderating subjects’ MWL, and its potential in enhancing task performance in RAS. This dissertation highlights the potential of incorporating adaptive systems into future RAS platforms, so that to provide valuable support and assistance to surgeons during critical moments and facilitate surgical training by identifying and addressing the specific needs of surgeons.</p>
24

Comparison of minimally invasive surgery with open surgery for remnant gastric cancer: A Multi-institutional Cohort Study / 残胃癌切除における低侵襲手術と開腹手術の比較、多施設共同観察研究

Aoyama, Ryuhei 23 May 2023 (has links)
京都大学 / 新制・課程博士 / 博士(医学) / 甲第24799号 / 医博第4991号 / 新制||医||1066(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 武藤 学, 教授 石見 拓, 教授 川口 義弥 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM
25

Classification, detection and prediction of adverse and anomalous events in medical robots

Cao, Feng 24 August 2012 (has links)
No description available.
26

MINIMALLY INVASIVE SURGICAL DEVICES WITH MICRO FORCE SENSORS: A SMART SCALPEL AND DISSECTOR TOOL

HADLOCK, NATHANIEL A. January 2006 (has links)
No description available.
27

Performance, Workload, Stress, and Coping Profiles in First Year Medical Students' Interaction with the Endoscopic/Laparoscopic and Robot-Assisted Minimally Invasive Surgical Techniques

KLEIN, MARTINA INGE 25 August 2008 (has links)
No description available.
28

Stewart Platform Actuator for Direct Access Cochlear Implant

Patil, Gaurav 08 September 2015 (has links)
No description available.
29

Using Collapsible Systems to Mitigate Buckling in Thin Flexible Instruments in Robotic Surgery

Sargent, Brandon Scott 01 April 2018 (has links)
Robotic surgery procedures may include long, thin flexible instruments that are inserted by the robot into the patient. As the robot inserts these devices, due to their geometry, they are prone to buckling failure. To mitigate buckling failure, a support system is needed on the robot. This system supports the device but also adapts to the varying ex vivo length of the device as it is inserted. This work presents four collapsible support systems designed to mitigate buckling failure of long, thin instruments while accounting for changing length. The Ori-Guide is an origami-inspired system that has enabled a part reduction from traditional rigid systems with over 70 parts to 3 parts. This system was enabled through the development of a novel origami pattern that integrates both actuation and support into the same pattern. This system was made from PET and performed as well as a rigid system. The PET used in the Ori-Guide was thermo-processed to hold a folded shape. The heat treatment put the Ori-Guide into tension and enabled a stiffer support system. Work was done to investigate the effect of thermo-processing on PET films used in origami-inspired engineering applications. It was discovered that there is a strong correlation between crystallization and the stiffness of a crease in the polymer film. The Zipper-Tube Reinforcement (ZTR) was developed to provide constant support along the entire length of the device, something that no other support device provides. This enables higher loads on the device and thinner and more flexible devices. It was developed as a tube that envelopes the device and zips to provide a tube to support the device then unzips to lay flat rolled about a mandrel for storage. The Wires in Tension concept was developed by focusing on adding tension to the support system. It provided support to the device but required high levels of force on the robot arm so the Orthogonal Beams was developed. The Orthogonal Beams employs geometry as the primary support rather than tension and therefore could provide higher support with less force on the robot. These systems all proved effective ways to support flexible devices. The concepts could also find application in other fields. The merits of each system are discussed in detail, including a discussion on other possible applications.
30

Development of a low cost secondary slave manipulator for a minimally invasive robotic surgical system

Worst, Siebert Christo 12 1900 (has links)
Thesis (MScEng)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Minimally Invasive Surgery (MIS) in human beings is performed by making small incisions in the abdominal region of the patient and inflating the abdominal cavity with CO2. This procedure enables the surgeon to manipulate long rigid surgical instruments inside the patient in order to perform the surgery. Unfortunately the current methods of insertion and assembly of MIS instruments limit the surgeon to only five (of a possible seven) Degrees of Freedom (DOF). Along with this, the surgeon’s movements are mirrored (called the Fulcrum effect) and scaled around the point of incision. Minimally invasive surgical robots attempt to alleviate these drawbacks by eliminating the Fulcrum effect, as well as improving dexterity and accuracy. These robots’ abilities to improve the surgeon’s hand-eye coordination, enables the surgeon to perform surgeries using their natural movements with reduced fatigue. As a result of this, the risk to both patient and surgeon is reduced. Existing MIS robotic systems are extremely expensive and large, and as a result they are not widely used. In this thesis a new, lower cost, seven DOF robotic manipulator is further developed. The thesis focuses on the external three DOF Secondary Slave Manipulator (SSM) and combines it with the Primary Slave Manipulator (PSM) that was developed by a previous Masters student. Tests done on the SSM showed that the manipulator has a minimum resolution of 0.7 ± 0.2 mm (mean ± standard deviation) on the shoulder joint’s yaw rotation and 0.5 ± 0.2 mm in pitch rotation. The linear actuator used for insertion has a minimum resolution of 0.2 ± 0.2 mm. A strength test was also conducted and showed that the manipulator is easily capable of producing a 10 N actuation force as required during Minimally Invasive Robotic Surgery (MIRS) procedures. In conclusion the complete system has potential as a viable alternative to the existing systems due to its accuracy and lower cost. Future work will include the development of a user interface and control system for the complete robot. / AFRIKAANSE OPSOMMING: Minimaal Indringende Chirurgie (MIC) op mense word uitgevoer deur klein insnydings in die pasiënt se buik te maak en dan die abdominale holte met CO2 te vul. Dit stel die chirurg in staat om lang, onbuigbare instrumente binne die pasiënt te manipuleer om sodoende die operasie uit te voer. Die manier waarop die MIC instrument ontwerp is en die pasiënt binnegaan, laat egter slegs vyf vryheidsgrade toe, terwyl die chirurg self sewe vryheidsgrade in sy handbewegings het. Verder veroorsaak hierdie instrumente ook dat die chirurg se aksies in spieëlbeeld vertolk word (Fulcrum effek) en geskaleer is. Chirurgiese robotika poog om hierdie nadele teen te werk deur die Fulcrum effek te verwyder, en ook om handvaardigheid en akkuraatheid te bevorder. Die robot se potensiaal om die chirurg se hand-oog koӧrdinasie te verbeter, maak dit moontlik vir die chirurg om op ’n meer natuurlike en gemaklike manier te werk te gaan en bring minder vermoeienis mee. Dit verminder die risiko’s vir beide die pasiënt en die chirurg. Bestaande robotiese stelsels is egter baie duur en groot, en word dus nie meer algemeen gebruik nie. In hierdie tesis word ‘n nuwe sewe-vryheidsgraad robotiese manipuleerder ontwikkel. Die tesis fokus op die eksterne drie-vryheidsgraad Sekondêre Slaaf Manipuleerder (SSM) en kombineer dit met die Primêre Slaaf Manipuleerder (PSM) wat deur ʼn vorige Meestersstudent ontwikkel is. Toetse wat uitgevoer is op die SSM het getoon dat dit ’n minimum resolusie van 0.7 ± 0.2 mm (gemiddeld ± standaard afwyking) op die skouer se afwyking en 0.5 ± 0.2 mm om die onderskeie skouer aslyne toon. Die linieêre aktueerder wat vir inlassing gebruik word het ’n minimum resolusie van 0.2 ± 0.2 mm. ’n Sterktetoets is uitgevoer en het getoon dat die manipuleerder maklik die nodige 10 N krag soos benodig in Minimaal Indringende Robotiese Chirurgie (MIRC) prosedures kan lewer. Ter afsluiting, die volledige stelsel het die potensiaal as lewensvatbare alternatief tot die bestaande stelsels vanweë die akkuraatheid en laer koste verbonde. Toekomstige navorsing kan moontlik die ontwikkeling van ʼn gebruikerkoppelvlak en beheerstelsel vir die volledige robot insluit.

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