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Sample records for robotic partial nephrectomy

  1. Robot-assisted partial nephrectomy: Superiority over laparoscopic partial nephrectomy.

    PubMed

    Shiroki, Ryoichi; Fukami, Naohiko; Fukaya, Kosuke; Kusaka, Mamoru; Natsume, Takahiro; Ichihara, Takashi; Toyama, Hiroshi

    2016-02-01

    Nephron-sparing surgery has been proven to positively impact the postoperative quality of life for the treatment of small renal tumors, possibly leading to functional improvements. Laparoscopic partial nephrectomy is still one of the most demanding procedures in urological surgery. Laparoscopic partial nephrectomy sometimes results in extended warm ischemic time and severe complications, such as open conversion, postoperative hemorrhage and urine leakage. Robot-assisted partial nephrectomy exploits the advantages offered by the da Vinci Surgical System to laparoscopic partial nephrectomy, equipped with 3-D vision and a better degree in the freedom of surgical instruments. The introduction of the da Vinci Surgical System made nephron-sparing surgery, specifically robot-assisted partial nephrectomy, safe with promising results, leading to the shortening of warm ischemic time and a reduction in perioperative complications. Even for complex and challenging tumors, robotic assistance is expected to provide the benefit of minimally-invasive surgery with safe and satisfactory renal function. Warm ischemic time is the modifiable factor during robot-assisted partial nephrectomy to affect postoperative kidney function. We analyzed the predictive factors for extended warm ischemic time from our robot-assisted partial nephrectomy series. The surface area of the tumor attached to the kidney parenchyma was shown to significantly affect the extended warm ischemic time during robot-assisted partial nephrectomy. In cases with tumor-attached surface area more than 15 cm(2) , we should consider switching robot-assisted partial nephrectomy to open partial nephrectomy under cold ischemia if it is imperative. In Japan, a nationwide prospective study has been carried out to show the superiority of robot-assisted partial nephrectomy to laparoscopic partial nephrectomy in improving warm ischemic time and complications. By facilitating robotic technology, robot-assisted partial nephrectomy

  2. Robot-assisted partial nephrectomy for complex renal masses.

    PubMed

    Patton, Michael W; Salevitz, Daniel A; Tyson, Mark D; Andrews, Paul E; Ferrigni, Erin N; Nateras, Rafael N; Castle, Erik P

    2016-03-01

    To determine whether the approach for partial nephrectomy is influenced by tumor complexity and if the introduction of robotic techniques has allowed us to treat more complex tumors minimally invasively. Data from 292 patients who underwent partial nephrectomy for renal masses from November 1999 to July 2013 at a tertiary referral center were retrospectively reviewed. Nephrometry scores and perioperative outcomes were stratified based on when robotic techniques were introduced. Mean follow-up time was 2.6 years. Preoperative RENAL nephrometry scores and perioperative outcomes were analyzed. Of the 292 patients, 31.5 % underwent robot-assisted partial nephrectomy, 46.2 % laparoscopic partial nephrectomy and 22.9 % open partial nephrectomy. Robot-assisted partial nephrectomy mean nephrometry score was significantly higher than laparoscopic and equivalent to open. Significant perioperative differences were estimated blood loss (p = 0.0001), length of stay (p = 0.0001) and Clavien score (p = 0.0069), all favoring robot-assisted partial nephrectomy. Limitations include retrospective design and single center data. Robot-assisted partial nephrectomy is a safe and effective surgical modality that allows for complex renal tumors that were previously reserved for open partial nephrectomy in the pure laparoscopic era to be managed with a minimally invasive approach.

  3. Review of robot-assisted partial nephrectomy in modern practice

    PubMed Central

    Weaver, John; Benway, Brian M.

    2015-01-01

    Partial nephrectomy (PN) is currently the standard treatment for T1 renal tumors. Minimally invasive PN offers decreased blood loss, shorter length of stay, rapid convalescence, and improved cosmesis. Due to the challenges inherent in laparoscopic partial nephrectomy, its dissemination has been stifled. Robot-assisted partial nephrectomy (RAPN) offers an intuitive platform to perform minimally invasive PN. It is one of the fastest growing robotic procedures among all surgical subspecialties. RAPN continues to improve upon the oncological and functional outcomes of renal tumor extirpative therapy. Herein, we describe the surgical technique, outcomes, and complications of RAPN.

  4. Current status of robotic laparoendoscopic single-site partial nephrectomy.

    PubMed

    Komninos, Christos; Tuliao, Patrick; Rha, Koon Ho

    2014-10-01

    Robotic laparoendoscopic single-site partial nephrectomy is increasingly carried out in an attempt to improve the cosmetic outcome of minimally-invasive procedures. However, the actual role of this novel technique remains to be determined. The present article reviews evidence and examines updates of robotic laparoendoscopic single-site partial nephrectomy outcomes reported in more contemporary studies. A comprehensive online systematic search of PubMed, Scopus and Web of Science databases according to Preferred Reporting Items for Systematic Reviews and Meta-analyses criteria recommendations was carried out in January 2014, identifying data from 2008 to 2014 regarding robotic laparoendoscopic single-site partial nephrectomy. The majority of medical evidence to date is based on case reports or retrospective studies. Current studies show that robotic laparoendoscopic single-site partial nephrectomy is a feasible procedure carried out in an acceptable length of operative time, and resulting in a desirable cosmetic outcome and less postoperative pain. However, comparable studies show that robotic laparoendoscopic single-site partial nephrectomy is inferior to the conventional approach, especially with regard to warm ischemia time. Furthermore, the numerous limitations that exist with the utilization of the current commercial single-site devices make robotic laparoendoscopic single-site PN more challenging and more complicated for surgeons compared with conventional procedures. Further significant improvements, along with more studies, are required in order to develop the ideal robotic laparoendoscopic single-site robotic platform and overcome the current limitations. For the time being, robotic laparoendoscopic single-site partial nephrectomy procedures could be applicable in patients with low tumor size and complexity, and should not be routinely applied in all cases.

  5. Robot-assisted partial nephrectomy: current perspectives and future prospects.

    PubMed

    Gautam, Gagan; Benway, Brian M; Bhayani, Sam B; Zorn, Kevin C

    2009-10-01

    The widespread adoption of laparoscopic partial nephrectomy (LPN) has been curtailed by its technical complexity. With the introduction of robotic technology, there is a potential for a shorter learning curve for minimally invasive nephron-sparing surgery (NSS). Initial published data on robot-assisted partial nephrectomy show promising perioperative outcomes comparable to large LPN series performed by highly experienced laparoscopic surgeons. Intraoperative parameters (operating room time, warm ischemia time, and blood loss) and short-term oncologic results demonstrate that this technique, unlike LPN, has a relatively short learning curve. Economic factors, as well as the necessity of an experienced bedside assistant, present the potential shortcomings of the procedure.

  6. Simultaneous robotic-assisted adrenalectomy and partial nephrectomy: technical aspects.

    PubMed

    Sharma, Aditya Prakash; Devana, Sudheer Kumar; Bora, Girdhar Singh; Mavuduru, Ravimohan; Mandal, Arup Kumar

    2016-06-01

    Robot-assisted partial nephrectomy has become a safe and feasible procedure for small renal masses (SRM). Similarly, robot-assisted adrenalectomy has also been well established. Robotic surgery has provided the possibility to manage complex cases that are considered technically challenging for traditional laparoscopy. We describe in this video the details of performing simultaneous robotic adrenalectomy with partial nephrectomy highlighting the technical aspects of the same. A 62-year-old gentleman presented to us with incidentally detected left renal complex cyst (Bosniak IIF) and a concomitant left adrenal mass. Hormonal evaluation of adrenal tumor revealed raised levels of serum estrogen and DHEAS. A robotic-assisted simultaneous procedure was planned. Patient was positioned in right lateral position. After port placement, robot was brought from the shoulder of the patient and docked. We first excised the adrenal tumor followed by the renal cyst. Total operative time was 180 min with warm ischemia time of 20 min for renal cyst excision. Drain was removed on post-operative day 2. Patient was discharged on post-operative day 3. Histopathology revealed adrenocortical adenoma and benign hemorrhagic renal cyst. We found simultaneous ipsilateral adrenalectomy with partial nephrectomy using robotic assistance is feasible and safe with minimal morbidity. Port placement in such cases should be individualized according to the location of the SRM. The robot provides the ergonomic advantage and 3D vision for better anatomic definition as compared to laparoscopy.

  7. Novel dynamic information integration during da Vinci robotic partial nephrectomy and radical nephrectomy.

    PubMed

    Bhayani, Sam B; Snow, Devon C

    2008-07-01

    With the increasing discovery of small renal neoplasms, minimally invasive excisional approaches have become more popular. Robotic partial nephrectomy is an emerging procedure. During robotic renal surgery, the console surgeon often has a need to view images or other data during the surgical dissection. Herein, we describe the preliminary use of integrative surgical imaging in the console surgical view during 20 cases of robotic partial and radical nephrectomy. Integration of this technology, termed Tilepro, allows the surgeon to view data within the robotic console and thus prevents disengagement. The success rate of transmission was 95% and the usefulness of the transmission was 89%. Complications included delayed transmission and cabling issues. This technology is useful in robotic renal surgery and may have benefits in telepresence or other surgical fields.

  8. Is robotic partial nephrectomy convenient for solitary kidney?

    PubMed Central

    Kaouk, Jihad H.; Malkoç, Ercan

    2016-01-01

    Nephron sparing surgery (NSS) is the gold standard treatment option for patients with a solitary kidney in order to preserve renal function. Open partial nephrectomy (OPN) has been long considered the standard care for NSS. Robotic partial nephrectomy (RPN) is being gradually used more commonly even for solitary kidney and complex tumors. There was no difference between RPN and OPN regarding the rate of intraoperative-postoperative complications and positive surgical margin (PSM) (RPN: 7.5%, OPN: 8%) for patients with solitary kidney who underwent partial nephrectomy for small renal masses. Warm ischemia time (WIT) in all of our studies was within the safe range of <25 minutes which is acceptable ischemia time for robotic approaches. More studies are needed in order to evaluate kidney function. In conclusion with increasing experience, solitary kidney tumors can be managed safely with robotic approach. For patients having complex tumors with a potential of WIT >25 minutes, administration of intracorporeal ice slush during surgery may be considered. PMID:27635284

  9. Robotic surgery and hemostatic agents in partial nephrectomy: a high rate of success without vascular clamping.

    PubMed

    Morelli, Luca; Morelli, John; Palmeri, Matteo; D'Isidoro, Cristiano; Kauffmann, Emanuele Federico; Tartaglia, Dario; Caprili, Giovanni; Pisano, Roberta; Guadagni, Simone; Di Franco, Gregorio; Di Candio, Giulio; Mosca, Franco

    2015-09-01

    Robot-assisted partial nephrectomy has been proposed as a technique to overcome technical challenges of laparoscopic partial nephrectomy. We prospectively collected and analyzed data from 31 patients who underwent robotic partial nephrectomy with systematic use of hemostatic agents, between February 2009 and October 2014. Thirty-three renal tumors were treated in 31 patients. There were no conversions to open surgery, intraoperative complications, or blood transfusions. The mean size of the resected tumors was 27 mm (median 20 mm, range 5-40 mm). Twenty-seven of 33 lesions (82%) did not require vascular clamping and therefore were treated in the absence of ischemia. All margins were negative. The high partial nephrectomy success rate without vascular clamping suggests that robotic nephron-sparing surgery with systematic use of hemostatic agents may be a safe, effective method to completely avoid ischemia in the treatment of selected renal masses.

  10. Impact of fellowship training on robotic-assisted laparoscopic partial nephrectomy: benchmarking perioperative safety and outcomes.

    PubMed

    Taylor, Abby S; Lee, Bruce; Rawal, Bhupendra; Thiel, David D

    2015-06-01

    To provide perioperative benchmark data for surgeons entering practice from formal robotic training and performing robotic-assisted laparoscopic partial nephrectomy (RAPN). Perioperative outcomes of the first 100 RAPN from a surgeon entering into practice directly from robotic fellowship training were analyzed. Postoperative complications were categorized by Clavien-Dindo grade. Surgical "trifecta scores" and Margin, Ischemia, and Complication (MIC) scoring were utilized to assess surgical outcomes. Statistical analyses were performed using SAS (version 9.2; SAS Institute, Inc., Cary, North Carolina). Median age of the cohort was 63 years (22-81 years), and 34 (34.3%) patients were over age 65. Forty-one (41.4%) patients had a BMI > 30. Thirteen (13.1%) had RENAL 10-12 tumors, 22 of which (22.2%) were >4 cm in size. Median warm ischemia time was 17 min, and 13 patients had resection without warm ischemia. Five patients were converted to open partial nephrectomy, and 1 patient was converted to laparoscopic nephrectomy. Twenty-one patients (21.2%) experienced a complication, 6 of whom had a major (Clavien grade 3 or higher) complication with one grade 5 complication. Operating room time decreased with experience, but surgical complications and hospital stay did not change with experience. MIC score of renal cell carcinoma (RCC) patients was 74.7%, while the surgical trifecta was reached in 71.3 % of RCC patients. Surgeons may enter practice directly from formal robotic training and perform RAPN with perioperative outcomes, surgical complications, surgical trifecta scores, and MIC scoring in line with those the most experienced robotic partial nephrectomists.

  11. Robot-assisted partial nephrectomy: current status, techniques, and future directions.

    PubMed

    Babbar, Paurush; Hemal, Ashok K

    2012-02-01

    Open partial nephrectomy for the treatment of small renal masses (SRMs) concerning for renal cell carcinoma has been increasingly utilized with the increased incidental detection of SRMs and the growing recognition of the benefits of renal preservation. Laparoscopic partial nephrectomy (LPN) is a minimally invasive technique that achieves comparable oncologic and improved morbidity outcomes when compared to the open procedure. However, LPN is a technically demanding procedure resulting in a long learning curve and a lack of widespread adoption. Robot-assisted partial nephrectomy (RAPN) overcomes many of the technical hurdles of the LPN and is now coming to the forefront for the minimally invasive surgical management of SRMs. To date, the short-term oncologic outcomes of RAPN have been comparable to the open operation while providing the improved morbidity outcomes of LPN. Although encouraging, we await the long-term oncologic results of this new and promising procedure. The current bottleneck is an issue of cost and reliance on a patient-side surgeon. Future developments in instrumentation, newer robots, cost reduction, more streamlined training, increased robotic experience, and adoption by more centers will lead to greater benefit for patients with SRMs requiring nephron-sparing surgery. This review will discuss techniques for RAPN and then delve into the current status of RAPN using parameters such as warm ischemia time, blood loss, hospital stay, oncological outcomes, complications, learning curve, and quality of life. There will be an exploration of potential disadvantages associated with RAPN followed by a look at evolving techniques in regard to this groundbreaking procedure.

  12. An effective visualisation and registration system for image-guided robotic partial nephrectomy.

    PubMed

    Pratt, Philip; Mayer, Erik; Vale, Justin; Cohen, Daniel; Edwards, Eddie; Darzi, Ara; Yang, Guang-Zhong

    2012-03-01

    Robotic partial nephrectomy is presently the fastest-growing robotic surgical procedure, and in comparison to traditional techniques it offers reduced tissue trauma and likelihood of post-operative infection, while hastening recovery time and improving cosmesis. It is also an ideal candidate for image guidance technology since soft tissue deformation, while still present, is localised and less problematic compared to other surgical procedures. This work describes the implementation and ongoing development of an effective image guidance system that aims to address some of the remaining challenges in this area. Specific innovations include the introduction of an intuitive, partially automated registration interface, and the use of a hardware platform that makes sophisticated augmented reality overlays practical in real time. Results and examples of image augmentation are presented from both retrospective and live cases. Quantitative analysis of registration error verifies that the proposed registration technique is appropriate for the chosen image guidance targets.

  13. Robot-Assisted Partial Nephrectomy for T1b Tumors: Strict Trifecta Outcomes

    PubMed Central

    Tufek, Ilter; Doganca, Tunkut; Obek, Can; Argun, Omer Burak; Tuna, Mustafa Bilal; Keskin, Mehmet Selcuk; Kural, Ali Rıza

    2017-01-01

    Background and Objectives: “Trifecta” in partial nephrectomy consists of negative surgical margins, minimal renal function decrease and absence of complications. In the present article, our single-center robot-assisted partial nephrectomy (RAPN) experience in T1b renal masses is reported in terms of strict Trifecta outcomes. Methods: This is a retrospective analysis of patients with a tumor diameter between 4 and 7 cm (stage T1b), who underwent RAPN by a single surgeon. Preoperative, intraoperative, and postoperative data were recorded and analyzed to evaluate short-term functional and oncologic outcomes. Patients with absence of grade ≥ 2 Clavien-Dindo complications, warm ischemia time (WIT) ≤25 minutes, ≤15% postoperative estimated glomerular filtration rate (eGFR) decrease and negative surgical margins were reported to achieve strict Trifecta outcomes. P < .05 was indicated statistically significant. Results: A total of 150 patients underwent RAPN, and 50 patients were identified with tumor size between 4 and 7 cm. Mean WIT was 20.8 ± 6.2 minutes and mean estimated blood loss (EBL) was 269 ± 191 mL. Surgical margins were negative in all patients. Eleven patients (22%) had a >15% eGFR decrease after surgery. Nine patients (18%) had WIT longer than 25 minutes. Four patients (8%) had grade ≥2 Clavien-Dindo complications. Twenty-nine (58%) patients had strict Trifecta outcomes. Mean follow-up was 44.2 ± 27.2 months. Tumor recurrence was not observed in any patient. Conclusions: Robot-assisted laparoscopic partial nephrectomy for T1b renal masses can be safely performed in experienced hands. Optimal strict Trifecta outcomes and recurrence rates can be achieved. PMID:28352149

  14. Robotic assisted laparoscopic partial nephrectomy using contrast‐enhanced ultrasound scan to map renal blood flow

    PubMed Central

    Motiwala, Aamir; Eves, Susannah; Gray, Rob; Thomas, Asha; Meiers, Isabelle; Sharif, Haytham; Motiwala, Hanif; Laniado, Marc; Karim, Omer

    2016-01-01

    Abstract Objective The paper describes novel real‐time ‘in situ mapping’ and ‘sequential occlusion angiography’ to facilitate selective ischaemia robotic partial nephrectomy (RPN) using intraoperative contrast enhanced ultrasound scan (CEUS). Materials and methods Data were collected and assessed for 60 patients (61 tumours) between 2009 and 2013. 31 (50.8%) tumours underwent ‘Global Ischaemia’, 27 (44.3%) underwent ‘Selective Ischaemia’ and 3 (4.9%) were removed ‘Off Clamp Zero Ischaemia’. Demographics, operative variables, complications, renal pathology and outcomes were assessed. Results Median PADUA score was 9 (range 7–10). The mean warm ischaemia time in selective ischaemia was less and statistically significant than in global ischaemia (17.1 and 21.4, respectively). Mean operative time was 163 min. Postoperative complications (n = 10) included three (5%) Clavien grade 3 or above. Malignancy was demonstrated in 47 (77%) with negative margin in 43 (91.5%) and positive margin in four (8.5%). Long‐term decrease in eGFR post selective ischaemia robotic partial nephrectomy was less compared with global ischaemia (four and eight, respectively) but not statistically significant. Conclusions This technique is safe, feasible and cost‐effective with comparable perioperative outcomes. The technical aspects elucidate the role of intraoperative CEUS to facilitate and ascertain selective ischaemia. Further work is required to demonstrate long‐term oncological outcomes. © 2016 The Authors. The International Journal of Medical Robotics and Computer Assisted Surgery published by John Wiley & Sons, Ltd. PMID:26948671

  15. A multimodal imaging framework for enhanced robot-assisted partial nephrectomy guidance

    NASA Astrophysics Data System (ADS)

    Halter, Ryan J.; Wu, Xiaotian; Hartov, Alex; Seigne, John; Khan, Shadab

    2015-03-01

    Robot-assisted laparoscopic partial nephrectomies (RALPN) are performed to treat patients with locally confined renal carcinoma. There are well-documented benefits to performing partial (opposed to radical) kidney resections and to using robot-assisted laparoscopic (opposed to open) approaches. However, there are challenges in identifying tumor margins and critical benign structures including blood vessels and collecting systems during current RALPN procedures. The primary objective of this effort is to couple multiple image and data streams together to augment visual information currently provided to surgeons performing RALPN and ultimately ensure complete tumor resection and minimal damage to functional structures (i.e. renal vasculature and collecting systems). To meet this challenge we have developed a framework and performed initial feasibility experiments to couple pre-operative high-resolution anatomic images with intraoperative MRI, ultrasound (US) and optical-based surface mapping and kidney tracking. With these registered images and data streams, we aim to overlay the high-resolution contrast-enhanced anatomic (CT or MR) images onto the surgeon's view screen for enhanced guidance. To date we have integrated the following components of our framework: 1) a method for tracking an intraoperative US probe to extract the kidney surface and a set of embedded kidney markers, 2) a method for co-registering intraoperative US scans with pre-operative MR scans, and 3) a method for deforming pre-op scans to match intraoperative scans. These components have been evaluated through phantom studies to demonstrate protocol feasibility.

  16. Early Experience in Da Vinci Robot-Assisted Partial Nephrectomy: An Australian Single Centre Series

    PubMed Central

    Ting, Francis; Savdie, Richard; Chopra, Sam; Yuen, Carlo; Brenner, Phillip

    2015-01-01

    Introduction and Objectives. To demonstrate the safety and efficacy of the robot-assisted partial nephrectomy (RAPN) technique in an Australian setting. Methods. Between November 2010 and July 2014, a total of 76 patients underwent 77 RAPN procedures using the Da Vinci Surgical System© at our institution. 58 of these procedures were performed primarily by the senior author (PB) and are described in this case series. Results. Median operative time was 4 hours (range 1.5–6) and median warm ischaemic time (WIT) was 8 minutes (range 0–30) including 11 cases with zero ischaemic time. All surgical margins were clear with the exception of one patient who had egress of intravascular microscopic tumour outside the capsule to the point of the resection margin. Complications were identified in 9 patients (15.8%). Major complications included conversion to open surgery due to significant venous bleeding (n = 1), reperfusion injury (n = 1), gluteal compartment syndrome (n = 1), DVT/PE (n = 1), and readmission for haematuria (n = 1). Conclusion. This series demonstrates the safety and efficacy of the RAPN technique in an Australian setting when performed by experienced laparoscopic surgeons in a dedicated high volume robotic centre. PMID:26167299

  17. Intraoperative presentation of Bochdalek's hernia in an adult during robotic-assisted partial nephrectomy: An uncommon situation and literature review.

    PubMed

    Cindolo, Luca; Berardinelli, Francesco; Manzi, Arianna; Spagnuolo, Francesca; Fabbri, Elisa; Castellan, Pietro; Petrini, Flavia; Schips, Luigi

    2016-01-14

    Bochdalek's diaphragmatic hernia (BDH) is a congenital defect of the diaphragm that usually present during the neonatal period and rarely remain silent until adulthood. We present a 45-year-old-female case with diagnosis of double left kidney tumor prepared for robot-assisted partial nephrectomy (RPN). During the preoperative procedure she had a reduction of inspiratory volumes and increased pulmonary pressures: the robotic camera revealed the incidental presence of the left diaphragmatic defect. We report a simultaneous nephron sparing surgery (NSS) and left posterolateral BDH correction done by the da Vinci Surgical Robot (Intuitive Surgical, Sunnyvale, CA).

  18. Robotic-assisted partial nephrectomy without using ureteral stent: a single center experience

    PubMed Central

    Özkan, Burak; Coşkuner, Enis Rauf; Yalçın, Veli

    2016-01-01

    Objective To share our results of robotic assisted partial nephrectomy (RAPN) we performed without using ureteral stent in a single center from Turkey. Material and methods Medical records of consecutive 45 patients (34 men and 11 women) who underwent RAPN for kidney lesions between March 2011 and December 2014 were retrieved, and evaluated. All the procedures were performed by a transperitoneal approach without using ureteral stent prior to surgery. Renal artery clamping was used in all cases and intraoperative ultrasonography was used in 2 cases. Results Patients undergoing RAPN had a mean tumor size of 4.42 cm (2–8) and a mean renal nephrometry score of 5.82 (4–11). The mean estimated blood loss was 250 mL (150–450 ml) and the mean operative time was 195 minutes (150–300). There was no statistical difference between the preoperative and postoperative serum creatinine levels at the first follow-up visit (0.9 vs. 0.95, p=0.087). Surgical margin positivity was not detected in any patient, and the mean surgical margin distance was calculated as 0.4 mm (0.2–10). In only 1 patient disease recurrence was detected at the 21st month of the the follow-up period, and no distant metastases was reported in our patients at a mean follow-up of 10 months (3–36 mos). Our complication rate was 11.1% and according to the Clavien system complications were as; grade 2 (3 patients), grade 3a (1 patient) and grade 3b (1 patient). Conclusion With appropriately selected patients and adequate surgical experience, RAPN performed without using ureteral stent is a safe and feasible method for localized renal tumors. PMID:27011873

  19. Margin and complication rates in clampless partial nephrectomy: a comparison of open, laparoscopic and robotic surgeries.

    PubMed

    Mearini, Luigi; Nunzi, Elisabetta; Vianello, Alberto; Di Biase, Manuel; Porena, Massimo

    2016-06-01

    In performing partial nephrectomy (PN), surgeons focus on complete removal of tumor, preservation of renal function, the absence of major perioperative complications, expressed by the formula margin, ischemia and complication (MIC). The aim of current study was to perform a single-institution comparison of clampless open (OPN), laparoscopic (LPN) or robot-assisted (RAPN) PN as well as to evaluate pre-, intra- and postoperative factors that may influence achievement of ideal MIC. All consecutive clampless OPN, LPN or RAPN performed by experienced surgeons between 2006 and 2015 were included in the analysis. MIC was defined as negative surgical margin plus zero-ischemia plus absence of any grade ≥3 complications according to Clavien-Dindo classification. Bivariate and multivariate logistic regression models were fitted to predict the MIC. Odds ratios with 95 % confidence intervals were calculated. 80 patients underwent OPN, 66 LPN and 31 RAPN, and both groups had similar characteristics. The MIC rate was 67.5, 86.3 and 83.3 % in the OPN, LPN and RAPN groups, respectively (p = 0.016). At logistic regression analysis, surgical approach (p = 0.03) and operative time (p = 0.008) were independent predictors of the MIC rate. When stratified according to the surgical approach, preoperative aspects and dimensions used for an anatomical classification (PADUA) score, LPN, RAPN and operative time were independent predictors of MIC rate (p = 0.0488, p = 0.0494, p = 0.0479 and p = 0.0108, respectively). Clampless LPN and RAPN have an efficacy and safety profile that is on par with OPN, offering the additional benefits of a reduced operative time, blood loss, on demand ischemia and rate of high-grade complications.

  20. Simultaneous Retroperitoneal Robotic Partial Nephrectomy and Hepatectomy for Synchronous Renal-Cell Carcinoma and Hepatocellular Carcinoma in a Cirrhotic Patient

    PubMed Central

    Ong, Khaa Hoo; Huang, Steven Kuan-Hua; Yen, Chia-Sheng; Tian, Yu-Feng

    2016-01-01

    Abstract Background: The development of laparoscopic and robotic surgeries represents the modern era with the objective of improving patient outcomes; this surgical method is widespread in urology and general surgery. Retroperitoneal laparoscopic/robotic surgery is common in urologic surgery, but not in liver surgery. Tumors located in the posterosuperior aspect of the liver are difficult to access using a transperitoneal approach, and control of bleeding can also be difficult, especially in patients with cirrhosis. Case Presentation: Herein, we present a 66-year-old man who had a cirrhotic liver with concurrent renal and hepatic tumors. The renal tumor was located at the upper pole of the right kidney and the liver tumor was located at the liver dome (segment VII); the patient underwent simultaneous robotic hepatectomy and partial nephrectomy with a retroperitoneal approach. Conclusion: To our knowledge, this is the first case involving a retroperitoneal approach for a simultaneous robotic hepatectomy and partial nephrectomy; this method was feasible and safe. We hope this approach serves as an alternative surgical method for patients with synchronous renal and posterior segment liver tumors. PMID:27868101

  1. Robotic sequential right adrenalectomy and zero ischemia left partial nephrectomy in a patient with synchronous pheochromocytoma and renal cell carcinoma.

    PubMed

    Canda, Abdullah Erdem; Çakıcı, Özer Ural; Ener, Kemal; Atmaca, Ali Fuat

    2015-09-01

    Currently, most renal masses are detected incidentally while still small in size because of the widespread use of radiological imaging, and most pheochromocytomas are localized in the adrenal glands as unilateral lesions. A 5 × 4-cm right adrenal mass and a 19 × 13-mm exophytic left renal mass were synchronously detected by contrast enhancement on computed tomography and magnetic resonance imaging in a 47-year-old male with hypertension. The patient's preoperative serum and 24-h urine catecholamine levels were elevated. Initially, robotic transperitoneal right adrenalectomy was performed, and histopathology confirmed a 4 cm pheochromocytoma. After 3 months, transperitoneal zero ischemia robotic left partial nephrectomy was performed, and histopathology demonstrated clear cell renal cell carcinoma, Fuhrman grade II, 17 mm in size with clear surgical margins. This case indicates that sequential robotic surgery is feasible and safe as a minimally invasive approach to remove bilateral renal and adrenal masses. Zero ischemia robotic partial nephrectomy is also feasible and safe for selected small renal masses.

  2. Renal cavernous hemangioma: robot-assisted partial nephrectomy with selective warm ischemia. Case report and review of the literature.

    PubMed

    Ceccarelli, G; Codacci Pisanelli, M; Patriti, A; Biancafarina, A

    2015-01-01

    Renal hemangioma is a relatively rare benign tumor with a wide range of clinical and radiological presentation, not easy to differentiate preoperatively from a renal cancer. Due to its benign nature complete surgical resection is the recommended therapy and is considered curative. A 73-year old male patient followed-up for a lung carcinoma and a chronic renal failure underwent a CT scan showing a 35-mm mass of the inferior pole of the left kidney. The patient underwent robot-assisted partial nephrectomy with left inferior pole selective warm ischemia. The outcome was favorable and no repercussions on the renal reserve were observed postoperatively. Histopathological characteristics of the surgical specimen were consistent with renal cavernous hemangioma. A robot-assisted operation allows the fine dissection required to carry out a bloodless nephron-sparing surgery without a complete warm ischemia. The use of robot could be noteworthy for nephron-sparing surgery in cases of concomitant chronic renal failure.

  3. The future of partial nephrectomy.

    PubMed

    Malthouse, Theo; Kasivisvanathan, Veeru; Raison, Nicholas; Lam, Wayne; Challacombe, Ben

    2016-12-01

    Innovation in recent times has accelerated due to factors such as the globalization of communication; but there are also more barriers/safeguards in place than ever before as we strive to streamline this process. From the first planned partial nephrectomy completed in 1887, it took over a century to become recommended practice for small renal tumours. At present, identified areas for improvement/innovation are 1) to preserve renal parenchyma, 2) to optimise pre-operative eGFR and 3) to reduce global warm ischaemia time. All 3 of these, are statistically significant predictors of post-operative renal function. Urologists, have a proud history of embracing innovation & have experimented with different clamping techniques of the renal vasculature, image guidance in robotics, renal hypothermia, lasers and new robots under development. The DaVinci model may soon no longer have a monopoly on this market, as it loses its stranglehold with novel technology emerging including added features, such as haptic feedback with reduced costs. As ever, our predictions of the future may well fall wide of the mark, but in order to progress, one must open the mind to the possibilities that already exist, as evolution of existing technology often appears to be a revolution in hindsight.

  4. Comparison of Renal Function between Robot-Assisted and Open Partial Nephrectomy as Determined by Tc 99m-DTPA Renal Scintigraphy

    PubMed Central

    2016-01-01

    We compared postoperative renal function impairment between patients undergoing robot-assisted partial nephrectomy (RAPN) and those undergoing open partial nephrectomy (OPN) by using Tc-99m diethylenetriaminepentaacetic acid (DTPA) renal scintigraphy. Patients who underwent partial nephrectomy by a single surgeon between 2007 and 2013 were eligible and were matched by propensity score, based on age, tumor size, exophytic properties of tumor, and location relative to the polar lines. Of the 403 patients who underwent partial nephrectomy, 114 (28%) underwent RAPN and 289 (72%) underwent OPN. Mean follow-up duration was 35.2 months. Following propensity matching, there were no significant differences between the two groups in tumor exophytic properties (P = 0.818) or nephrometry score (P = 0.527). Renal ischemic time (24.4 minutes vs. 17.8 minutes, P < 0.001) was significantly longer in the RAPN group than in the OPN group, while the other characteristics were similar. Multivariate analysis showed that greater preoperative renal unit function (P = 0.011) and nephrometry score (P = 0.041) were independently correlated with a reduction in glomerular filtration rate. The operative method did not correlate with renal function impairment (P = 0.704). Postoperative renal function impairment was similar between patients who underwent OPN and those who underwent RAPN, despite RAPN having a longer ischemic time. PMID:27134496

  5. Comparison of Renal Function between Robot-Assisted and Open Partial Nephrectomy as Determined by Tc 99m-DTPA Renal Scintigraphy.

    PubMed

    Lee, Chanwoo; Kwon, Taekmin; Yoo, Sangjun; Jung, Jaeyoon; Lee, Chunwoo; You, Dalsan; Jeong, In Gab; Kim, Choung-Soo

    2016-05-01

    We compared postoperative renal function impairment between patients undergoing robot-assisted partial nephrectomy (RAPN) and those undergoing open partial nephrectomy (OPN) by using Tc-99m diethylenetriaminepentaacetic acid (DTPA) renal scintigraphy. Patients who underwent partial nephrectomy by a single surgeon between 2007 and 2013 were eligible and were matched by propensity score, based on age, tumor size, exophytic properties of tumor, and location relative to the polar lines. Of the 403 patients who underwent partial nephrectomy, 114 (28%) underwent RAPN and 289 (72%) underwent OPN. Mean follow-up duration was 35.2 months. Following propensity matching, there were no significant differences between the two groups in tumor exophytic properties (P = 0.818) or nephrometry score (P = 0.527). Renal ischemic time (24.4 minutes vs. 17.8 minutes, P < 0.001) was significantly longer in the RAPN group than in the OPN group, while the other characteristics were similar. Multivariate analysis showed that greater preoperative renal unit function (P = 0.011) and nephrometry score (P = 0.041) were independently correlated with a reduction in glomerular filtration rate. The operative method did not correlate with renal function impairment (P = 0.704). Postoperative renal function impairment was similar between patients who underwent OPN and those who underwent RAPN, despite RAPN having a longer ischemic time.

  6. Image-Guided Embolization Coil Placement for Identification of an Endophytic, Isoechoic Renal Mass During Robotic Partial Nephrectomy

    PubMed Central

    Forauer, Andrew; Seigne, John D.; Hyams, Elias S.

    2015-01-01

    Abstract Background: Intraoperative ultrasonography has proven to be a useful tool for tumor identification during robot-assisted laparoscopic partial nephrectomy (RALPN). However, its utility is limited in renal tumors that are completely endophytic and isoechoic in nature. We present a novel approach to intraoperative tumor identification using preoperative percutaneous intratumoral embolization coil placement that may be utilized in the management of such cases. Case Presentation: A 42-year-old Caucasian male was referred with an incidentally discovered right renal mass that was posterior and completely endophytic. He desired a RALPN; however, preoperative renal ultrasound demonstrated an isoechoic lesion. Thus, the patient underwent preoperative image-guided placement of an embolization coil within the tumor. This facilitated identification of the tumor intraoperatively using intracorporeal ultrasound centered on the coil and enabled resection with negative margins. Conclusion: Utilizing a novel approach analogous to preoperative localization of other solid malignancies, such as breast cancer, we were able to effectively identify and resect an isoechoic renal mass during RALPN. PMID:27579392

  7. Da Vinci Xi and Si platforms have equivalent perioperative outcomes during robot-assisted partial nephrectomy: preliminary experience.

    PubMed

    Abdel Raheem, Ali; Sheikh, Abulhasan; Kim, Dae Keun; Alatawi, Atalla; Alabdulaali, Ibrahim; Han, Woong Kyu; Choi, Young Deuk; Rha, Koon Ho

    2017-03-01

    The aims of this study were to compare the perioperative outcomes of da Vinci Xi to Si during robotic-assisted partial nephrectomy (RAPN) and to discuss the feasibility of our novel port placement scheme for the da Vinci Xi platform, to overcome the existing kinetic and technical difficulties we faced with the linear port placement in patients with a small body habitus. A retrospective data analysis of patients who underwent RPN using da Vinci Xi (n = 18) was carried out. The outcomes of the Xi group were compared with the Si group (n = 18) selected using a case-matched methodology. For da Vinci Xi, we applied the universal linear port placement in 12 patients and our modified port placement in the remaining 6 patients. The Xi group had a shorter mean docking time of 17.8 ± 2.6 min compared to the Si group of 20.5 ± 2.1 min (p = 0.002); otherwise, no significant difference was present with regard to the remaining perioperative variables (p > 0.05). The modified Xi port placement had a shorter mean console time of 70.8 ± 9.7 min compared to the universal linear port placement of 89.3 ± 17.2 min (p = 0.03). Moreover, it provided a broader field of vision with excellent robotic arms movement, minimizing collisions and allowing an easier and comfortable surgical assist. Da Vinci Xi appears to be feasible and safe during RPN with similar outcomes to Si. The novel Xi port placement makes surgery easier in patients with low BMI.

  8. Robotic partial nephrectomy for renal tumours in obese patients: Perioperative outcomes in a multi-institutional analysis

    PubMed Central

    Abdullah, Newaj; Dalela, Deepansh; Barod, Ravi; Larson, Jeff; Johnson, Michael; Mass, Alon; Zargar, Homayoun; Allaf, Mohamad; Bhayani, Sam; Stifelman, Michael; Kaouk, Jihad; Rogers, Craig

    2015-01-01

    Introduction: We sought to evaluate the association of obesity with surgical outcomes of robotic partial nephrectomy (RPN) using a large, multicentre database. Methods: We identified 1836 patients who underwent RPN from five academic centres from 2006–2014. A total of 806 patients were obese (body mass index [BMI] ≥30 kg/m2). Patient characteristics and outcomes were compared between obese and non-obese patients. Multivariable analysis was used to assess the association of obesity on RPN outcomes. Results: A total of 806 (44%) patients were obese with median BMI of 33.8kg/m2. Compared to non-obese patients, obese patients had greater median tumour size (2.9 vs. 2.5cm, p<0.001), mean RENAL nephrometry score (7.3 vs. 7.1, p=0.04), median operating time (176 vs. 165 min, p=0.002), and median estimated blood loss (EBL, 150 vs. 100 ml, p=0.002), but no difference in complications. Obesity was not an independent predictor of operative time or EBL on regression analysis. Among obese patients, males had a greater EBL (150 vs. 100 ml, p<0.001), operative time (180 vs. 166 min, p<0.001) and warm ischemia time (WIT, 20 vs. 18, p=0.001), and male sex was an independent predictor of these outcomes on regression analysis. Conclusions: In this large, multicentre study on RPN, obesity was not associated with increased complications and was not an independent predictor of operating time or blood loss. However, in obese patients, male gender was an independent predictor of greater EBL, operative time, and WIT. Our results indicate that obesity alone should not preclude consideration for RPN. PMID:26788235

  9. [Laparoscopic partial nephrectomy: technique and outcomes].

    PubMed

    Colombo, J R; Gill, I S

    2006-05-01

    The indication of laparoscopic partial nephrectomy (LPN) has evolved considerably, and the technique is approaching established status at our institution. Over the past 5 years, the senior author has performed more than 450 laparoscopic partial nephrectomies at the Cleveland Clinic. Herein we present our current technique, review contemporary data and oncological outcomes of LPN.

  10. Outlining the limits of partial nephrectomy

    PubMed Central

    Chopra, Sameer; Satkunasivam, Raj; Kundavaram, Chandan; Liang, Gangning

    2015-01-01

    Amongst nephron-sparing modalities, partial nephrectomy (PN) is the standard of care in the treatment of renal cell carcinoma (RCC). Despite the increasing utilization of PN, particularly propagated by robot-assisted, minimally invasive approaches for small renal masses (SRMs), the limits of PN appear to be also evolving. In this review, we sought to address the tumour stage beyond which PN may be oncologically perilous. While the evidence supports PN in the treatment of tumours < pT2a, PN may have a role in advanced or metastatic RCC. Other scenarios wherein PN has limited utility are also explored, including anatomical or surgical factors that dictate the difficulty of the case, such as prior renal surgery. Lastly, we discuss the emerging role of molecular biomarkers, specifically epigenetics, to aid in the risk stratification of SRMs and to select tumours optimally suited for PN. PMID:26236649

  11. Using a Harmonic Scalpel "Drilling and Clamping" Method to Implement Zero Ischemic Robotic-assisted Partial Nephrectomy: An Observation Case Report Study.

    PubMed

    Hou, Chen-Pang; Lin, Yu-Hsiang; Hsu, Yu-Chao; Chen, Chien-Lun; Chang, Phei-Lang; Tsui, Ke-Hung

    2016-01-01

    Robot-assisted partial nephrectomy (RAPN) has gradually become a popular minimally invasive nephron-sparing surgical option for small renal tumors. Ischemic injury should be minimized because it impacts renal function outcomes following partial nephrectomy. Herein, the authors detail the technique and present initial perioperative outcomes of our novel harmonic scalpel "drilling and clamping" method to implement zero-ischemic RAPN. The authors prospectively collected baseline and perioperative data of patients who underwent zero ischemic RAPN performed by our harmonic scalpel "drilling and clamping" method. From April 2012 to December 2014, a total of 19 consecutive zero ischemic RAPN procedures were performed by a single surgeon. For 18 of the 19 patients, RAPN using our harmonic scalpel "Drilling and Clamping" method was successfully completed without the need for hilar clamping. The median tumor size was 3.4 cm (range: 1.8-6.2); operative time was 3.2 hours (range: 1.9-4.5); blood loss was 100 mL (range: 30-950); and postoperative hospital stay was 4 days (3-26). One patient required intraoperative blood transfusion. Two patients had intra or postoperative complications: 1 was converted to traditional laparotomy because of massive bleeding, whereas another had postoperative stress ulcer. Pathology confirmed renal cell carcinoma in 13 patients (63.2%), angiomyolipoma in 6 patients: (31.5%), and oncocytoma in 1 patient (5.3%). Mean pre- and postoperative serum creatinine (0.82 mg/dL and 0.85 mg/dL, respectively), estimated glomerular filtration rate (84.12 and 82.18, respectively), and hemoglobin (13.27 g/dL and 12.71 g/dL, respectively) were comparable. The authors present a novel zero-ischemic technique for RAPN. They believe that this technique is feasible and reproducible.

  12. The clinical application of the sliding loop technique for renorrhaphy during robot-assisted laparoscopic partial nephrectomy: Surgical technique and outcomes

    PubMed Central

    Kim, Hyung Suk; Lee, Young Ju; Ku, Ja Hyeon; Kwak, Cheol; Kim, Hyeon Hoe

    2015-01-01

    Purpose To report the initial clinical outcomes of the newly devised sliding loop technique (SLT) used for renorrhaphy in patients who underwent robot-assisted laparoscopic partial nephrectomy (RALPN) for small renal mass. Materials and Methods We reviewed the surgical videos and medical charts of 31 patients who had undergone RALPN with the SLT renorrhaphy performed by two surgeons (CWJ and CK) between January 2014 and October 2014. SLT renorrhaphy was performed after tumor excision and renal parenchymal defect repair. Assessed outcomes included renorrhaphy time (RT), warm ischemic time, perioperative complications, and perioperative renal function change. RT was defined as interval from the end of bed suture to the renal artery declamping. Results In all patients, sliding loop renorrhaphy was successfully conducted without conversions to radical nephrectomy or open approaches. Mean renorrhaphy and warm ischemic time were 9.0 and 22.6 minutes, respectively. After completing renorrhaphy, there were no adverse events such as dehiscence of approximated renal parenchyma, renal parenchymal tearing, or significant bleeding. Furthermore, no postoperative complications or significant renal function decline were observed as of the last follow-up for all patients. The limitations of this study include the small volume case series, the retrospective nature of the study, and the heterogeneity of surgeons. Conclusions From our initial clinical experience, SLT may be an efficient and safe renorrhaphy method in real clinical practice. Further large scale, prospective, long-term follow-up, and direct comparative studies with other techniques are required to confirm the clinical applicability of SLT. PMID:26568794

  13. Are we ready for day-case partial nephrectomy?

    PubMed

    Bernhard, Jean-Christophe; Payan, Anne; Bensadoun, Henri; Cornelis, François; Pierquet, Grégory; Pasticier, Gilles; Robert, Grégoire; Capon, Grégoire; Ravaud, Alain; Ferriere, Jean-Marie

    2016-06-01

    Fast-track and day-case surgeries are gaining more and more importance. Their development was eased by the diffusion of minimal invasive surgical strategies and the consequential morbidity reduction. In the field of kidney cancer, seven cases of ambulatory radical nephrectomy were previously reported in the international literature. Regarding robotic partial nephrectomy (PN), short postoperative pathways resulting in patients' discharge on postoperative day 1 were shown to be safe and feasible. We report our initial experience of robot-assisted PN discharged on postoperative day zero and discuss the criteria for adequate patient selection. Indeed, outpatient PN will obviously not be suitable for all patients, and careful selection will be mandatory. Both specific baseline patient's factors and postoperative events will have to be recognized for the first ones and prevented for the second ones. Safety, patient satisfaction, cost efficiency, and reproducibility will be the key factors to assess and promote day-case PN.

  14. Open partial nephrectomy: ancient art or currently available technique?

    PubMed

    Seveso, Mauro; Grizzi, Fabio; Bozzini, Giorgio; Mandressi, Alberto; Guazzoni, Giorgio; Taverna, Gianluigi

    2015-12-01

    Renal cell carcinoma (RCC) accounts for 3 % of adult solid tumors, with the highest incidence between 50 and 70 years of age. Nephron-sparing surgery was initially reserved to patients with small renal masses detected in anatomically or functionally solitary kidney or in the presence of multiple bilateral tumors or hereditary forms of RCC, which posed a high risk of developing a tumor in the contralateral kidney. Nowadays, partial nephrectomy (PN) has grown up to an established approach for the treatment of small renal masses. In patients with T1a-staged RCCs, PN has proven to be associated with better survival, long-term renal function preservation with lower dialysis need or renal transplantation. Currently, most of the kidney masses are incidentally detected, up to 40 %, with smaller size due to the widespread use of imaging modalities such as ultrasound, computed tomography and magnetic resonance. Here we review the role of open PN in the management of small renal masses particularly focusing on indications, oncological outcomes and comparison with laparoscopic and robotic PN. Recent studies demonstrate that PN confers better survival, oncologic equivalence and lower risk of severe chronic kidney disease compared to radical nephrectomy becoming then the gold-standard surgical technique, even if increasingly challenged by laparoscopic and/or robot-assisted partial nephrectomy which in the hands of experts seems to achieve comparable outcome results albeit with slightly higher complication rate.

  15. An Ultrasonic Clamp for Bloodless Partial Nephrectomy

    NASA Astrophysics Data System (ADS)

    Lafon, Cyril; Bouchoux, Guillaume; Murat, François Joseph; Birer, Alain; Theillère, Yves; Chapelon, Jean Yves; Cathignol, Dominique

    2007-05-01

    Maximum conservation of the kidney is preferable through partial nephrectomy for patients at risk of disease recurrence of renal cancers. Haemostatic tools are needed in order to achieve bloodless surgery and reduce post surgery morbidity. Two piezo-ceramic transducers operating at a frequency of 4 MHz were mounted on each arm of a clamp. When used for coagulation purposes, two transducers situated on opposite arms of the clamp were driven simultaneously. Heat delivery was optimized as each transducers mirrored back to targeted tissues the wave generated by the opposite transducer. Real-time treatment monitoring with an echo-based technique was also envisaged with this clamp. Therapy was periodically interrupted so one transducer could generate a pulse. The echo returning from the opposite transducer was treated. Coagulation necroses were obtained in vitro on substantial thicknesses (23-38mm) of pig liver over exposure durations ranging from 30s to 130s, and with acoustic intensities of less than 15W/cm2 per transducer. Both kidneys of two pigs were treated in vivo with the clamp (14.5W/cm2 for 90s), and the partial nephrectomies performed proved to be bloodless. In vitro and in vivo, wide transfixing lesions corresponded to an echo energy decrease superior to -10dB and parabolic form of the time of flight versus treatment time. In conclusion, this ultrasound clamp has proven to be an excellent mean for achieving monitored haemostasis in kidney.

  16. Survival benefit of partial nephrectomy: Reconciling experimental and observational data.

    PubMed

    Tan, Hung-Jui

    2015-12-01

    Given recent epidemiological and practice trends, small kidney cancers are poised to become a focus of modern-day surgical care provided by urologists and urologic oncologists. For the past decade, partial nephrectomy has been viewed as preferable to radical nephrectomy for the treatment of many patients with early-stage kidney cancer, partly because observational studies suggest a survival benefit with nephron sparing. More recently, European Organisation for Research and Treatment of Cancer 30904--a phase 3 randomized control trial--demonstrated better survival for patients treated with radical vs. partial nephrectomy. Shortly thereafter, an instrumental variable analysis reported a survival advantage with partial nephrectomy. Although seemingly contradictory, these studies are potentially reconcilable when considering methodological differences and other empiric work.

  17. Interventional Management of Renal Bleeding after Partial Nephrectomy

    SciTech Connect

    Baumann, Clemens Westphalen, Kerstin; Fuchs, Heiko; Oesterwitz, Helmut; Hierholzer, Johannes

    2007-09-15

    Objective. Partial nephrectomy (PN) has emerged as a serious alternative to nephrectomy in oncologic therapy of renal tumours. While complications are rare in general, renal hemorrhage may occur und necessitate angiographic embolization. In this retrospective study, we evaluate the clinical, imaging and procedural findings of seven interventions in five patients with renal hemorrhage after PN. In four out of five patients (80%) the bleeding could be treated successfully by embolotherapy. Conclusion. Angiographic embolization in patients with renal hemorrhage after PN is feasible and has a high success rate. The procedure might facilitate avoidance of nephrectomy.

  18. Ex-vivo partial nephrectomy after living donor nephrectomy: Surgical technique for expanding kidney donor pool

    PubMed Central

    Nyame, Yaw A.; Babbar, Paurush; Aboumohamed, Ahmed A.; Mori, Ryan L.; Flechner, Stuart M.; Modlin, Charles S.

    2017-01-01

    Renal transplantation has profound improvements in mortality, morbidity, and overall quality of life compared to renal replacement therapy. This report aims to illustrate the use of ex-vivo partial nephrectomy in a patient with a renal angiomyolipoma prior to living donor transplantation. The surgical outcomes of the donor nephrectomy and recipient transplantation are reported with 2 years of follow-up. Both the donor and recipient are healthy and without any significant comorbidities. In conclusion, urologic techniques such as partial nephrectomy can be used to expand the living donor pool in carefully selected and well informed transplant recipients. Our experience demonstrated a safe and positive outcome for both the recipient and donor, and is consistent with other reported outcomes in the literature. PMID:28216945

  19. Open partial nephrectomy in renal cell cancer - Essential or obsolete?

    PubMed

    Anastasiadis, Eleni; O'Brien, Timothy; Fernando, Archana

    2016-12-01

    Since the first partial nephrectomy was first conducted 131 years ago, the procedure has evolved into the gold standard treatment for small renal masses. Over the past decade, with the introduction of minimally invasive surgery, open partial nephrectomy still retains a valuable role in the treatment of complex tumours in challenging clinical situations (e.g. hereditary renal cancer or single kidneys), and enables surgeons to push the boundaries of nephron-sparing surgery. In this article, we consider the origin of the procedure and how it has evolved over the past century, the surgical techniques involved, and the oncological and functional outcomes.

  20. Prospective study on laser-assisted laparascopic partial nephrectomy

    NASA Astrophysics Data System (ADS)

    Sroka, Ronald; Hennig, Georg; Zilinberg, Katja; Khoder, Wael Y.

    2012-02-01

    Introduction: Developments in laparoscopic partial nephrectomy (LPN) opened a demand for surgical tools compatible with laparoscopic manipulations to make laser assisted technique safe, feasible and reproducible. Warm ischemia and bleeding during laparoscopic partial nephrectomy place technical constraints on surgeons. Therefore it was the aim to develop a safe and effective laser assisted partial nephrectomy technique without need for ischemia. Patients and methods: A diode laser emitting light at 1318nm in cw mode was coupled into a bare fibre (core diameter 600 μm) thus able to transfer up to 100W to the tissue. After dry lab experience, a total of 10 patients suffering from kidney malformations underwent laparoscopic/retroperitoneoscopic partial nephrectomy. Clinically, postoperative renal function and serum c-reactive protein (CRP) were monitored. Laser induced coagulation depth and effects on resection margins were evaluated. Demographic, clinical and follow-up data are presented. Using a commercial available fibre guidance instrument for lanringeal intervention, the demands on an innovative laser fibre guidance instrument for the laser assisted laparoscopic partial nephrectomy (LLPN) are summarized. Results: Overall, all laparascopic intervention were succesfull and could be performed without conversion to open surgery. Mean operative time and mean blood loss were comparable to conventional open and laparascopic approaches. Laser assisted resection of the kidney tissue took max 15min. After extirpation of the tumours all patients showed clinical favourable outcome during follow up period. Tumour sizes were measured to be up 5cm in diameter. The depth of the coagulation on the removed tissue ranged between <1 to 2mm without effect on histopathological evaluation of tumours or resection margin. As the surface of the remaining kidney surface was laser assisted coagulated after removal. The sealing of the surface was induced by a slightly larger coagulation

  1. Open surgical partial nephrectomy for upper tract urothelial carcinoma.

    PubMed

    Macari, David; Faerber, Gary J; Hafez, Khaled S; Hollenbeck, Brent K; Montie, James E; Wood, David P; Wolf, J Stuart

    2014-04-01

    We aimed to determine the ability of partial nephrectomy to prevent end-stage renal disease and tumor recurrence or progression in patients with upper tract urothelial carcinoma. Retrospectively, eight patients undergoing partial nephrectomy for upper tract urothelial carcinoma were identified and their medical records reviewed. All patients had imperative indications for nephron sparing, and diagnosis of upper tract urothelial carcinoma not adequately amenable to endoscopic management. Although three patients suffered acute tubular necrosis, only one required postoperative hemodialysis. During the follow-up period 25% (2/8) developed end-stage renal disease, including the one patient who had received postoperative hemodialysis. Recurrences occurred in five of seven patients with adequate oncological surveillance. Recurrences were successfully treated endoscopically in 80% (4/5) patients, and one patient had metastases. Of the eight patients, four have died. Death occurred 4 months, 1 year, 1.2 years and 3.5 years after partial nephrectomy. Of these patients, one succumbed to metastatic disease; the exact cause of death is unknown in the other three, but there was no documentation of metastatic cancer. The mean duration of follow up in the remaining four patients, all without evidence of metastatic urothelial cancer, is 71 months (range 22-108 months). In summary, partial nephrectomy for upper tract urothelial carcinoma in patients with imperative indications averts end-stage renal disease in most patients, and appears to be associated with acceptable disease-specific survival. Partial nephrectomy is a sparingly used option in patients with upper tract urothelial carcinoma refractory to endoscopic management who have imperative indications for nephron sparing.

  2. Adaptive functional change of the contralateral kidney after partial nephrectomy.

    PubMed

    Choi, Se Young; Yoo, Sangjun; You, Dalsan; Jeong, In Gab; Song, Cheryn; Hong, Bumsik; Hong, Jun Hyuk; Ahn, Hanjong; Kim, Choung-Soo

    2017-04-12

    Partial nephrectomy aims to maintain renal function by nephron sparing; however, functional changes in the contralateral kidney remain unknown. We evaluate the functional change in the contralateral kidney using a diethylene triamine penta-acetic acid (DTPA) renal scan and determine factors predicting contralateral kidney function after partial nephrectomy. A total of 699 patients underwent partial nephrectomy, with a DTPA scan before and after surgery to assess the separate function of each kidney. Patients were divided into three groups according to initial contralateral glomerular filtration rate (GFR; group 1: <30 ml/min/1.73 m2, group 2: 30-45 ml/min/1.73 m2, and group 3: ≧45 ml/min/1.73 m2). Multiple regression analysis was used to identify the factors associated with increased GFR of the contralateral kidney over a 4 year postoperative period. Patients in group 1 had a higher mean age and hypertension history, worse American Society of Anesthesiologists score, and larger tumor size than in the other two groups. The ipsilateral GFR changes at 4 years after partial nephrectomy were -18.9%, -3.6%, and 3.9% in groups 1, 2, and 3, respectively, while the contralateral GFR changes were 10.8%, 25.7%, and 38.8%. Age (Beta: -0.105, 95% confidence interval [CI]: -0.213; -0.011 p<0.05) and preoperative contralateral GFR (Beta: -0.256, 95% CI: -0.332; -0.050 p<0.01) were significant predictive factors for increased GFR of the contralateral kidney after 4 years. The contralateral kidney compensated for the functional loss of the ipsilateral kidney. The increase of GFR in contralateral kidney is more prominent in younger patients with decreased contralateral renal function.

  3. Laser laparoscopic partial nephrectomy in clinical cases (N=17)

    NASA Astrophysics Data System (ADS)

    Teodorovich, Oleg; Zabrodina, Natalia; Galljamov, Eduard; Yankovskaya, Inna; Kochiev, David; Lukashev, Alexei

    2011-03-01

    A pulsed Nd:YAG laser approved for clinical use in Russian Federation was used for laparoscopic partial nephrectomy(LPN). Patients with T1N0M0 (N=17) cancer underwent laser LPN during 2006-2009 for removal tumor sized from 2.0 to 3.9 cm. Successful laser LPN was performed without ischemia in all cases. Bleeding during laser LPN was substantially reduced due to laser coagulation of tissue. Currently all patients are under medical supervision with no recurrence of tumor. A pulsed Nd:YAG laser showed safety and efficacy of LPN in humans.

  4. Diode laser supported partial nephrectomy in laparoscopic surgery: preliminary results

    NASA Astrophysics Data System (ADS)

    Sroka, Ronald; Hennig, Georg; Zillinberg, Katja; Khoder, Wael Y.

    2011-07-01

    Introduction: Warm ischemia and bleeding during laparoscopic partial nephrectomy place technical constraints on surgeons. Therefore it was the aim to develop a safe and effective laser assisted partial nephrectomy technique without need for ischemia. Patients and methods: A diode laser emitting light at 1318nm in cw mode was coupled into a bare fibre (core diameter 600 μm) thus able to transfer up to 100W to the tissue. After dry lab experience, a total of 8 patients suffering from kidney malformations underwent laparoscopic/retroperitoneoscopic partial nephrectomy. Clinically, postoperative renal function and serum c-reactive protein (CRP) were monitored. Laser induced coagulation depth and effects on resection margins were evaluated. Demographic, clinical and follow-up data are presented. Results: Overall interventions, the mean operative time was 116,5 minutes (range 60-175min) with mean blood loss of 238ml (range 50-600ml) while laser assisted resection of the kidney tissue took max 15min. After extirpation of the tumours all patients showed clinical favourable outcome during follow up period. The tumour size was measured to be 1.8 to 5cm. With respect to clinical safety and due to blood loos, two warm ischemia (19 and 24min) must be performed. Immediate postoperative serum creatinine and CRP were elevated within 0.1 to 0.6 mg/dl (mean 0.18 mg/dl) and 2.1-10 mg/dl (mean 6.24 mg/dl), respectively. The depth of the coagulation on the removed tissue ranged between <1 to 2mm without effect on histopathological evaluation of tumours or resection margin. As the surface of the remaining kidney surface was laser assisted coagulated after removal. The sealing of the surface was induced by a slightly larger coagulation margin, but could not measured so far. Conclusion: This prospective in-vivo feasibility study shows that 1318nm-diode laser assisted partial nephrectomy seems to be a safe and promising medical technique which could be provided either during open surgery

  5. Laparoscopic Partial Nephrectomy Using a Flexible CO2 Laser Fiber

    PubMed Central

    Khalaileh, Abed; Ponomarenko, Oleg; Abu-Gazala, Mahmoud; Lewinsky, Reuven M.; Elazary, Ram; Shussman, Noam; Shalhav, Arieh; Mintz, Yoav

    2012-01-01

    Background and Objectives: Laparoscopic partial nephrectomy (LPN) is a challenging surgery that requires precise tissue cutting and meticulous hemostasis under warm ischemia conditions. In this study, we tested the feasibility of performing LPN using CO2 laser energy transmitted through a specialized flexible mirror optical fiber. Methods: General anesthesia and pneumoperitoneum were induced in 7 farm pigs. Various portions of a kidney, either a pole or a midportion of the kidney, were removed using a novel flexible fiber to transmit CO2 laser energy set at a power of 45W and energy per pulse of 100mJ. The collecting system was approximated with a suture or 2, but no hemostatic measures were taken besides applying a few pulses of the laser to bleeding points. The pigs were sacrificed 3 wk later. Results: Average renal mass removed was 18% of the total kidney weight. All pigs tolerated surgery well. Sharp renal cutting was accomplished in a single continuous incision, with minimal tissue charring and minimal blood loss (<10cc) in all animals. Necropsy revealed no peritoneal or retroperitoneal abnormalities. Histologic examination of the cut surface showed a thin sector of up to 100 μm of coagulation necrosis. Conclusions: We report on the first LPN done using a CO2 laser transmitted through a flexible fiber in an animal model. This novel application of the CO2 laser produced excellent parenchymal incision and hemostasis along with minimal damage to adjacent renal tissue, thus, potentially shortening ischemia time and kidney function loss. Further studies comparing this laser to standard technique are necessary to verify its usefulness for partial nephrectomy. PMID:23484569

  6. Prediction of complications after partial nephrectomy by RENAL nephrometry score

    PubMed Central

    Pillai, R; Parker, RA; Weston, J; Burgess, NA; Ho, ETS; Mills, RD; Rochester, MA

    2014-01-01

    Introduction Discussing and planning the appropriate management for suspicious renal masses can be challenging. With the development of nephrometry scoring methods, we aimed to evaluate the ability of the RENAL nephrometry score to predict both the incidence of postoperative complications and the change in renal function after a partial nephrectomy. Methods This was a retrospective study including 128 consecutive patients who underwent a partial nephrectomy (open and laparoscopic) for renal lesions in a tertiary UK referral centre. Univariate and multivariate ordinal regression models were used to identify associations between Clavien–Dindo classification and explanatory variables. The Kendall rank correlation coefficient was used to examine an association between RENAL nephrometry score and a drop in estimated glomerular filtration rate (eGFR) following surgery. Results An increase in the RENAL nephrometry score of one point resulted in greater odds of being in a higher Clavien–Dindo classification after controlling for RENAL suffix and type of surgical procedure (odds ratio [OR]: 1.29, 95% confidence interval [CI]: 1.04–1.64, p=0.043). Furthermore, a patient with the RENAL suffix ‘p’ (ie posterior location of tumour) had increased odds of developing more serious complications (OR: 2.60, 95% CI: 1.07–6.30, p=0.042). A correlation was shown between RENAL nephrometry score and postoperative drop in eGFR (Kendall’s tau coefficient -0.24, p=0.004). Conclusions To our knowledge, this is the first study that has shown the predictive ability of the RENAL nephrometry scoring system in a UK cohort both in terms of postoperative complications and change in renal function. PMID:25198982

  7. Intraoperative ultrasound control of surgical margins during partial nephrectomy

    PubMed Central

    Alharbi, Feras M.; Chahwan, Charles K.; Le Gal, Sophie G.; Guleryuz, Kerem M.; Tillou, Xavier P.; Doerfler, Arnaud P.

    2016-01-01

    Aims: To evaluate a simple and fast technique to ensure negative surgical margins on partial nephrectomies, while correlating margin statuses with the final pathology report. Subjects and Methods: This study was conducted for patients undergoing partial nephrectomy (PN) with T1–T2 renal tumors from January 2010 to the end of December 2015. Before tumor removal, intraoperative ultrasound (US) localization was performed. After tumor removal and before performing hemostasis of the kidney, the specimens were placed in a saline solution and a US was performed to evaluate if the tumor's capsule were intact, and then compared to the final pathology results. Results: In 177 PN(s) (147 open procedures and 30 laparoscopic procedures) were performed on 147 patients. Arterial clamping was done for 32 patients and the mean warm ischemia time was 19 ± 6 min. The mean US examination time was 41 ± 7 s. The US analysis of surgical margins was negative in 172 cases, positive in four, and in only one case it was not possible to conclude. The final pathology results revealed one false positive surgical margin and one false negative surgical margin, while all other margins were in concert with US results. The mean tumor size was 3.53 ± 1.43 cm, and the mean surgical margin was 2.8 ± 1.5 mm. Conclusions: The intraoperative US control of resection margins in PN is a simple, efficient, and effective method for ensuring negative surgical margins with a small increase in warm ischemia time and can be conducted by the operating urologist. PMID:28057986

  8. Role of partial nephrectomy as cytoreduction in the management of metastatic renal cell carcinoma.

    PubMed

    Karam, J A; Babaian, K N; Tannir, N M; Matin, S F; Wood, C G

    2015-06-01

    In this review, we describe the role, feasibility and safety of partial nephrectomy in the setting of metastatic renal cell carcinoma. Partial nephrectomy is currently the preferred therapeutic modality in patients with localized renal tumors, while radical cytoreductive nephrectomy is the standard of care for appropriately selected patients with metastatic disease. Several studies have shown the prognostic value of percentage tumor removed when cytoreductive nephrectomy is done. This concept of percentage tumor removal and the associated benefit should also be applied when considering patients for cytoreductive partial nephrectomy; however, the potential adverse events after partial nephrectomy should be kept in mind, as these, when they occur, could delay time to starting systemic therapy. Several small retrospective studies have shown the feasibility of this approach in carefully selected patient groups. In well-selected patients with metastatic disease and primary tumors that are amenable to nephron sparing approaches, partial nephrectomy could offer an alternative to radical nephrectomy, with manageable adverse events, and good renal functional outcomes. Preserving renal function in this population could allow these patients to participate in clinical trial that they otherwise might not qualify for.

  9. Survival after partial and radical nephrectomy for high-risk disease: A propensity-matched comparison

    PubMed Central

    Maurice, Matthew J.; Zhu, Hui; Kim, Simon; Abouassaly, Robert

    2016-01-01

    Introduction: Increasingly, partial nephrectomy has been applied to high-risk disease without evidence that its survival benefits can be extrapolated to this entity. We aimed to compare overall survival after partial vs. radical nephrectomy in patients with high-risk renal cell carcinoma. Methods: Using the National Cancer Data Base, we identified patients who underwent partial or radical nephrectomy for high-risk disease between 2003 and 2006. High-risk disease was defined as the presence of adverse pathological features within the primary tumour, namely high-grade or unfavourable histology, T3 stage, or both. After matching the partial and radical nephrectomy groups based on propensity scores, 1680, 276, and 76 patients with high-grade or unfavourable histology, T3 stage, or both adverse pathologic features, respectively, were available for analysis. Five-year overall survival was compared after partial vs. radical nephrectomy for each high-risk cohort using the Kaplan-Meier and log rank tests. Results: Partial nephrectomy was associated with a statistically significant improvement in five-year overall survival compared to radical nephrectomy for small tumours (median size 3.0 cm; interquartile range 2.1–4.5 cm) with high-grade or unfavourable histology (87% vs. 81%; p<0.01) or with pT3a stage (82% vs. 71%; p<0.01). For patients concomitantly harbouring both adverse pathologic features, no difference in survival was detected (p=0.21). Conclusions: Partial nephrectomy is associated with survival benefits in patients with adverse pathologic features, suggesting that renal preservation is not only safe, but also potentially beneficial for high-risk disease. Due to inherent selection bias associated with partial nephrectomy use, prospective validation of these findings is needed. PMID:27695581

  10. Robotic-Assisted Laparoscopic Donor Nephrectomy of Patient With Nutcracker Phenomenon.

    PubMed

    Barman, Naman; Palese, Michael

    2016-05-17

    We report the case of a 30-year-old male patient undergoing a robotic-assisted laparoscopic left donor nephrectomy, where compression of the left renal vein between the superior mesenteric artery and aorta was noted on magnetic resonance angiography before the operation. The patient was diagnosed with nutcracker phenomenon and was noted to be asymptomatic at that time. This is the first reported case to date of a patient with nutcracker phenomenon who underwent a robotic-assisted laparoscopic donor nephrectomy. This article also reviews the current literature on nutcracker phenomenon and nutcracker syndrome.

  11. First case report of chylous ascites after robot-assisted donor nephrectomy

    PubMed Central

    Janki, Shiromani; Terkivatan, Türkan; Kimenai, Hendrikus J.A.N.; IJzermans, Jan N.M.; Tran, T.C. Khé

    2016-01-01

    We present the first case report of chylous ascites following total robot-assisted donor nephrectomy. A 39-year-old female underwent a transperitoneal left-sided total robot-assisted donor nephrectomy. The procedure was uneventful and the patient was discharged without any symptoms. At postoperative Day 29, the patient presented with abdominal pain, nausea and a distended, painful abdomen with shifting dullness. She was diagnosed with chylous ascites by ultrasonography and puncture analysis, and treated with therapeutic drainage and dietary restriction. After 4 weeks, she was free of symptoms. The occurrence of this complication is rare after donor nephrectomy. Fortunately, the complication can be successfully treated within a few weeks with minimal discomfort for the patient as demonstrated in this case. It is of utmost importance to minimize the risks and limit discomfort for live kidney donors who willingly undergo major surgery to improve the well-being of another individual. PMID:27381018

  12. Radiofrequency Ablation Versus Partial Nephrectomy in Treating Small Renal Tumors

    PubMed Central

    Yin, Xiaotao; Cui, Liang; Li, Fanglong; Qi, Siyong; Yin, Zhaoyang; Gao, Jiangping

    2015-01-01

    Abstract Radiofrequency ablation (RFA) has emerged as an alternative treatment to surgical partial nephrectomy (PN) in the treatment of small renal tumors (SRTs). But its safety and oncological efficacy are still controversial. We conducted this systematic review and meta-analysis to compare the peritoperative and oncological outcomes of RFA and PN in the treatment of SRTs. Pubmed, EMBASE, Cochrane CENTRAL, and Web of Science were searched to identify eligible studies that compared the RFA and PN in the treatment of SRTs. Twelve retrospective studies that compared RFA with PN in the treatment of SRTs met our selection criterion and were included in this meta-analysis. The pooled results indicated that the local recurrence rate (4.14% vs 4.10%, RR: 1.18, 95% CI: 0.68, 2.07, P = 0.550) and distant metastases rate (2.76% vs 1.89%, RR: 1.31, 95% CI: 0.70, 2.46, P = 0.686) were not significantly different between the RFA group and the PN group. In terms of perioperative outcomes, RFA was associated with shorter length of stay (LOS) (WMD: −2.02 days, 95% CI: −2.77, −1.27, P < 0.001), lower eGFR decline after treatment (WMD: −3.90, 95% CI: −6.660, −1.140, P = 0.006). However, the overall perioperative complication rate (7.5% vs 6.2%, RR:1.10, 95% CI: 0.64, 1.87, P = 0.740) and the major complication rate (3.7% vs 4.4%, RR: 0.83, 95% CI: 0.43, 1.60, P = 0.579) were both similar between RFA and PN groups. Compared with PN, RFA achieves an equal oncological outcome for SRTs with similar local recurrence rate and distant metastases rate. Additionally, RFA is associated with a similar perioperative complication rate, lower decline of eGFR, and shorter LOS. Therefore, RFA is an effective option in the treatment of SRTs for selected patients. PMID:26683944

  13. Laparoscopic wedge resection and partial nephrectomy--the Washington University experience and review of the literature.

    PubMed

    McDougall, E M; Elbahnasy, A M; Clayman, R V

    1998-01-01

    Open partial nephrectomy is an accepted form of treatment for a variety of benign conditions and for localized renal cell carcinoma. To date, there is limited experience with the clinical application of laparoscopic partial nephrectomy and wedge resection for benign and malignant disease of the kidney. Herein, we report our clinical experience with laparoscopic partial nephrectomy and a review of the current literature. Twelve patients (27-81 years) have undergone laparoscopic wedge resection (3) or attempted polar partial nephrectomy (9) since 1993. In the group of 12 patients, 5 had a mass suspicious for a malignancy, 4 patients had symptomatic polar calyceal dilation with or without stone disease, and 3 patients had an atrophic or hydronephrotic upper pole moiety. Among the patients in the polar nephrectomy group, a third were converted to an open procedure. The remaining 6 patients had a mean operative time of 6.5 hours (5.7-8.3 hours). These patients resumed their oral intake on average 0.8 days postoperatively. In the 2 patients with a mass, the final pathology was oncocytoma (1), and xanthogranulomatous reaction in a renal cyst (1). Postoperative complications included a nephrocutaneous fistula which was endoscopically fulgurated, a retroperitoneal urinoma which was percutaneously drained, and a two-day bout of ileus. The mean hospital stay was 5.3 days (2-9). Their full convalescence was completed in a mean of 4.2 weeks (2-8). Three patients underwent a wedge resection for a superficial < 2 cm mass. The average operative time in this group was 3.5 hours (2-5.4). The mean time to resuming oral intake was 0.7 days (0.3-0.7). The final pathology was oncocytoma (1), oncocytic renal cell cancer (1), and old infarction (1); none of the patients had any complications. The mean hospital stay was 2.7 days (2-4). Convalescence was completed in 4 weeks (range 1-8). Laparoscopic wedge resection and polar partial nephrectomy are feasible, albeit currently tedious

  14. Laparoscopic Wedge Resection and Partial Nephrectomy - The Washington University Experience and Review of the Literature

    PubMed Central

    Elbahnasy, Abdelhamid M.; Clayman, Ralph V.

    1998-01-01

    Open partial nephrectomy is an accepted form of treatment for a variety of benign conditions and for localized renal cell carcinoma. To date, there is limited experience with the clinical application of laparoscopic partial nephrectomy and wedge resection for benign and malignant disease of the kidney. Herein, we report our clinical experience with laparoscopic partial nephrectomy and a review of the current literature. Twelve patients (27 - 81 years) have undergone laparoscopic wedge resection (3) or attempted polar partial nephrectomy (9) since 1993. In the group of 12 patients, 5 had a mass suspicious for a malignancy, 4 patients had symptomatic polar calyceal dilation with or without stone disease, and 3 patients had an atrophic or hydronephrotic upper pole moiety. Among the patients in the polar nephrectomy group, a third were converted to an open procedure. The remaining 6 patients had a mean operative time of 6.5 hours (5.7 - 8.3 hours). These patients resumed their oral intake on average 0.8 days postoperatively. In the 2 patients with a mass, the final pathology was oncocytoma (1), and xanthogranulomatous reaction in a renal cyst (1). Postoperative complications included a nephrocutaneous fistula which was endoscopically fulgurated, a retroperitoneal urinoma which was percutaneously drained, and a two-day bout of ileus. The mean hospital stay was 5.3 days (2-9). Their full convalescence was completed in a mean of 4.2 weeks (2 - 8). Three patients underwent a wedge resection for a superficial < 2 cm mass. The average operative time in this group was 3.5 hours (2 - 5.4). The mean time to resuming oral intake was 0.7 days (0.3 - 0.7). The final pathology was oncocytoma (1), oncocytic renal cell cancer (1), and old infarction (1); none of the patients had any complications. The mean hospital stay was 2.7 days (2- 4). Convalescence was completed in 4 weeks (range 1-8). Laparoscopic wedge resection and polar partial nephrectomy are feasible, albeit currently

  15. Percutaneous injection of fibrin glue for persistent nephrocutaneous fistula after partial nephrectomy.

    PubMed

    Bradford, Timothy J; Wolf, J Stuart

    2005-04-01

    We report a case of persistent urinary leak of nearly 4 months' duration after open surgical partial nephrectomy. The urinary leak was refractory to ureteral stenting, urethral catheter placement, and ureteroscopic fulguration. Fibrin glue was injected percutaneously under fluoroscopic guidance into the nephrocutaneous fistula tract, which resulted in its prompt and complete resolution.

  16. Mannitol has no impact on renal function after open partial nephrectomy in solitary kidneys.

    PubMed

    Omae, Kenji; Kondo, Tsunenori; Takagi, Toshio; Iizuka, Junpei; Kobayashi, Hirohito; Hashimoto, Yasunobu; Tanabe, Kazunari

    2014-02-01

    Mannitol has been administered during partial nephrectomy as a renal protective agent for ischemic damage. However, we do not have any high-level clinical evidence of its effectiveness. The aim of the present study was to evaluate the effect of mannitol during open partial nephrectomy by comparing the postoperative renal function of patients who received it and those who did not. We retrospectively reviewed the records of 55 patients who underwent open partial nephrectomy for renal cancer in a solitary kidney from January 1990 to December 2012, and who were followed up postoperatively for at least 6 months. Of the 55 patients, mannitol was given to 20 patients (group M+) and not to the other 35 patients (group M-). We compared not only the postoperative estimated glomerular filtration rate, but also its decrease rate and the incidence of acute kidney injury requiring dialysis in the two groups. There were no significant differences in perioperative patient characteristics between the two groups. Mannitol made no significant difference in both the postoperative estimated glomerular filtration rate and its decrease rate at any point within 6 months of the postoperative period. The incidence of acute kidney injury requiring dialysis was one (5.0%) in group M+ and two (5.7%) in group M-. These findings suggest that there might be no advantage from the administration of mannitol during open partial nephrectomy.

  17. Prevalence and outcomes of peritumor fat involvement following partial nephrectomy for radiologic T1 renal cancer

    PubMed Central

    Kamel, Mohamed; Elfaramawi, Mohamed; Jadhav, Supria; Davis, Rodney; Saafan, Ahmed; Sher, Annashia

    2015-01-01

    Context: Partial nephrectomy is becoming the standard of care in management of small renal tumors and excision of the peritumor fat is recommended for accurate staging. During the surgery, the overlying fat may be excised for accurate visualization of margins or maybe inadvertently left behind when performing a partial nephrectomy in an obese patient. We investigated the prevalence of fat involvement in these patients. Aims: The aim was to document the prevalence of peritumor fat involvement discovered after partial nephrectomy performed for radiologic T1 renal cancer. Settings and Design: Between 2005 and 2011, 107 partial nephrectomy procedures were performed for radiologic T1 disease. Statistical Analysis: All analyses were performed using SAS 9.2. Subjects and Methods: Patients were classified as: Group A (n = 88 patients), patients with stage T1a (tumor size ≤4 cm) and Group B (n = 24 patients) patients with stage T1b (tumor size 4-7 cm). Results: The overall prevalence of peritumor fat involvement was 1.86% (n = 2). The two patients had tumor ≤4 cm in size of the papillary subtype and were followed for 61 and 57 months, respectively. Both were living and without recurrence. Patient demographics and tumor characteristics did not differ between the two groups except, Fuhrman Grades 3 and 4 were statistically more prevalent in Group B (<0.01). Tumor grade, clear cell type cancer and stage T1b did not correlate with peritumor fat involvement in the study population. Conclusions: Our study revealed a low prevalence of peritumor fat involvement in radiologic pT1 renal cancer; however, peritumor fat removal is still recommended. PMID:26692661

  18. Robotic trans-abdominal transplant nephrectomy for a failed renal allograft.

    PubMed

    Mulloy, M R; Tan, M; Wolf, J H; D'Annunzio, S H; Pollinger, H S

    2014-12-01

    Minimally invasive surgery for removal of a failed renal allograft has not previously been reported. Herein, we report the first robotic trans-abdominal transplant nephrectomy (TN). A 34-year-old male with Alport's syndrome lost function of his deceased donor allograft after 12 years and presented with fever, pain over his allograft and hematuria. The operation was performed intra-abdominally using the Da Vinci Robotic Surgical System with four trocars. The total operative time was 235 min and the estimated blood loss was less than 25 cm(3). There were no peri-operative complications observed and the patient was discharged to home less than 24 h postoperatively. The utilization of robotic technology facilitated the successful performance of a minimally invasive, trans-abdominal TN.

  19. Partial Nephrectomy for a Massive Sporadic Renal Angiomyolipoma: Case Report and Review of the Literature

    PubMed Central

    Klein, Molly; Murugan, Paari; Weight, Christopher J.

    2016-01-01

    Introduction. Angiomyolipomas are the most common benign tumor of the kidney, associated with Tuberous Sclerosis in 20% of cases and arising sporadically in 80% of cases. Renal angiomyolipomas are neoplasms of mesenchymal origin with varying proportions of vasculature, smooth muscle spindle cells, and adipocytes, making management of such neoplasms a challenging endeavor. Possible management options include partial or radical nephrectomy and segmental renal artery embolization. Case Presentation. A 61-year-old woman admitted for a large retroperitoneal hemorrhage was discovered to have a giant, sporadic, 3818.3 g, 30.0 × 26.5 × 18.0 cm left perinephric angiomyolipoma. Given her hemodynamic instability upon presentation, she underwent segmental arterial embolization, followed by an open left partial nephrectomy. Ten-month follow-up revealed no noticeable loss of renal function. Discussion. Literature review revealed occasional renal angiomyolipomas of comparable size, with all angiomyolipomas larger than this requiring treatment with radical nephrectomy. Conclusion. We show that nephron-sparing surgery may be considered in the treatment of even the largest of renal angiomyolipomas. PMID:28070443

  20. Preserved Nephrogenesis Following Partial Nephrectomy in Early Neonates

    PubMed Central

    Kirita, Yuhei; Kami, Daisuke; Ishida, Ryo; Adachi, Takaomi; Tamagaki, Keiichi; Matoba, Satoaki; Kusaba, Tetsuro; Gojo, Satoshi

    2016-01-01

    Reconstitution of total nephron segments after resection in the adult kidney has not been achieved; however, whether the neonatal kidney can maintain the capacity for neo-nephrogenesis after resection is unknown. We performed partial resection of the kidney in neonatal rats on postnatal days 1 (P1x kidney) and 4 (P4x kidney) and examined morphological changes and relevant factors. The P1x kidney bulged into the newly formed cortex from the wound edge, while nephrogenesis failure was prominent in the P4x kidney. Twenty-eight days post-resection, the glomerular number, cortex area, and collecting duct were preserved in the P1x kidney, whereas these parameters were markedly decreased in the P4x kidney. During normal development, Six2 expression and Six2+ nephron progenitor cells in the cap mesenchyme both rapidly disappear after birth. However, time course analysis for the P1x kidney showed that Six2 expression and Six2+ cells were well preserved in the tissue surrounding the resected area even 2 days after resection. In conclusion, our results indicate that kidneys in early neonate rats retain the capability for neo-nephrogenesis after resection; however, this ability is lost soon after birth, which may be attributed to a declining amount of Six2+ cells. PMID:27244673

  1. Bloodless Partial Nephrectomy Through Application of Non-Focused High-Intensity Ultrasound

    NASA Astrophysics Data System (ADS)

    Murat, François-Joseph; Lafon, Cyril; Gelet, Albert; Martin, Xavier; Cathignol, Dominique

    2005-03-01

    The goal of this study was to evaluate the hemostatic ability of a new interstitial applicator composed of a planar ultrasonic transducer with a reflector, during partial nephrectomy in a porcine model. The new applicator was designed to make effective use of all the acoustic energy to coagulate the renal tissue . Placement of the reflector opposite the transducer allows use of all the acoustic energy for coagulation. Despite the low transmission frequency, it is possible to work at a relatively weak intensity, with the aid of the reflector. As a result, intense cooling of the transducer is no longer needed. The transducer functions at a frequency of 3.78 MHz. A movable brass plate was mounted to the applicator, parallel to the transducer, to reflect energy that was not absorbed during ultrasound wave transmission. Additionally, the plate served to immobilize the kidney during the treatment. Our methodology was to expose the kidneys of 9 pigs through abdominal laparotomy. An initial series of experiments on 5 pigs allowed exposure conditions to be selected. Thermocouples were implanted in the kidneys after exposure at 15, 20, and 25 mm from the renal capsule surface. The remaining 4 pigs underwent ultrasound treatment with the applicator before a bilateral lower pole partial nephrectomy. The treatment consisted of juxtaposing elementary lesions (made at an intensity of 26 W/cm2 for 50 seconds) circumferentially in a subhilar location. The hemostatic efficacy was evaluated just after the shots and during the 30 minutes that followed the sectioning of the kidney's lower pole. In the event of persistent bleeding, an it was possible form an elementary lesion opposite the insufficiently treated zone. For an exposure duration of 50 seconds at 26 W/cm2, the lesions obtained covered the total thickness of the kidney, which varied between 22 and 36 mm. The temperatures observed within the treated tissues were 62°, 59°, and 58°C at 15, 20 and 25 mm respectively from the

  2. Partial and Radical Nephrectomy for Unilateral Synchronous Multifocal Renal Cortical Tumors

    PubMed Central

    Mano, Roy; Kent, Matthew; Larish, Yaniv; Winer, Andrew G.; Chevinsky, Michael S.; Hakimi, A. Ari; Sternberg, Itay A.; Sjoberg, Daniel D.; Russo, Paul

    2016-01-01

    Objective To evaluate clinicopathologic characteristics and treatment outcomes of patients undergoing partial (PN) or radical nephrectomy (RN) for unilateral synchronous multifocal renal tumors. Methods We retrospectively reviewed medical records for 128 patients with non-metastatic unilateral synchronous multifocal renal tumors who underwent surgical resection at our institution from 1995 to 2012. Five patients with hereditary renal cell carcinoma were excluded. Differences between patient and tumor characteristics from the two nephrectomy groups were evaluated. Outcomes in terms of recurrence-free survival, overall survival, and chronic kidney disease upstaging were estimated using Kaplan-Meier methods. The log-rank test was used for group comparisons. Results The study cohort included 78 PN patients (63%) and 45 RN patients (37%); 17/95 planned PN (18%) were converted to RN. Tumor diameter and R.E.N.A.L. nephrometry scores were greater in RN patients (p<0.0001 and p=0.0002, respectively). Pathological stage T3 was seen in 40% of RN patients and 10% of PN patients (p=0.0002). Histologic concordance was apparent in 60/123 patients (49%). Median follow-up for patients alive without a recurrence was 4 years. Five-year recurrence-free survival was 98% for PN and 85% for RN. Five-year overall survival was 96% for PN and 86% for RN (p=0.5). Five-year freedom from chronic kidney disease upstaging was 74% for PN, and 55% for RN (p=0.11). Conclusion Partial nephrectomy for the treatment of unilateral synchronous multifocal renal tumors with favorable characteristics was associated with a low recurrence rate. These findings suggest PN is an appropriate management strategy for this group of carefully selected patients. PMID:25872696

  3. Local tissue reaction after the application of topical hemostatic agents in a rat partial nephrectomy model.

    PubMed

    Chalupová, Marta; Suchý, Pavel; Pražanová, Gabriela; Bartošová, Ladislava; Sopuch, Tomáš; Havelka, Pavel

    2012-06-01

    Various hemostatics are used for renal surgical procedures. We investigated the hemostatic efficacy of cellulose derivatives on the model of partial nephrectomy in rats focusing on the local reaction of renal parenchyma. A total of 50 Wistar rats were divided into five groups of 10 animals each. Partial nephrectomy of the caudal pole without hilar vascular control was performed. Oxidized cellulose (OC), sodium salt of oxycellulose (OCN), carboxymethyl cellulose (CMC), dialdehyde cellulose (DAC), and gelatin-based hemostatic (C) were applied to the bleeding wounds. The time to hemostasis was monitored. Half of the animals were euthanized after 3 days, the second half 30 days from the experiment start date. The left kidney was excised and subjected to histopathological examination. The biochemical data was subjected to statistical analysis. The time to hemostasis in all groups was significantly less than in the C group (in OC p = 0.0057, OCN p = 0.0039, CMC and DAC p = 0.0001). In the C group, massive hemorrhages and necrosis did occur. In the OC and OCN groups, there were regenerative changes, a receding inflammatory reaction and hemorrhage. DAC caused an immune reaction and massive interstitial hemorrhages with biochemical signs of liver damage. Parenchyma in CMC revealed a reduction of necrosis and interstitial hemorrhages with regenerative processes. The most effective hemostatics were CMC and OC, achieving the best results both in the time to hemostasis, and for histopathological evaluation.

  4. Robotic Partial Nephrectomy: The Will Rogers Surgical Effect.

    PubMed

    George, Arvin K; Hartman, Christopher; Kavoussi, Louis R

    2016-01-01

    Comparison of surgical techniques must be critically and objectively evaluated, ideally in the context of prospective trials. Comprehensive surgical training ensures that patients are offered the most appropriate treatment and highest clinical care.

  5. Feasibility of quantitative diffuse reflectance spectroscopy for targeted measurement of renal ischemia during laparoscopic partial nephrectomy.

    PubMed

    Goel, Utsav O; Maddox, Michael M; Elfer, Katherine N; Dorsey, Philip J; Wang, Mei; McCaslin, Ian Ross; Brown, J Quincy; Lee, Benjamin R

    2014-01-01

    Reduction of warm ischemia time during partial nephrectomy (PN) is critical to minimizing ischemic damage and improving postoperative kidney function, while maintaining tumor resection efficacy. Recently, methods for localizing the effects of warm ischemia to the region of the tumor via selective clamping of higher-order segmental artery branches have been shown to have superior outcomes compared with clamping the main renal artery. However, artery identification can prolong operative time and increase the blood loss and reduce the positive effects of selective ischemia. Quantitative diffuse reflectance spectroscopy (DRS) can provide a convenient, real-time means to aid in artery identification during laparoscopic PN. The feasibility of quantitative DRS for real-time longitudinal measurement of tissue perfusion and vascular oxygenation in laparoscopic nephrectomy was investigated in vivo in six Yorkshire swine kidneys (n=three animals ). DRS allowed for rapid identification of ischemic areas after selective vessel occlusion. In addition, the rates of ischemia induction and recovery were compared for main renal artery versus tertiary segmental artery occlusion, and it was found that the tertiary segmental artery occlusion trends toward faster recovery after ischemia, which suggests a potential benefit of selective ischemia. Quantitative DRS could provide a convenient and fast tool for artery identification and evaluation of the depth, spatial extent, and duration of selective tissue ischemia in laparoscopic PN.

  6. Feasibility of quantitative diffuse reflectance spectroscopy for targeted measurement of renal ischemia during laparoscopic partial nephrectomy

    NASA Astrophysics Data System (ADS)

    Goel, Utsav O.; Maddox, Michael M.; Elfer, Katherine N.; Dorsey, Philip J.; Wang, Mei; McCaslin, Ian Ross; Brown, J. Quincy; Lee, Benjamin R.

    2014-10-01

    Reduction of warm ischemia time during partial nephrectomy (PN) is critical to minimizing ischemic damage and improving postoperative kidney function, while maintaining tumor resection efficacy. Recently, methods for localizing the effects of warm ischemia to the region of the tumor via selective clamping of higher-order segmental artery branches have been shown to have superior outcomes compared with clamping the main renal artery. However, artery identification can prolong operative time and increase the blood loss and reduce the positive effects of selective ischemia. Quantitative diffuse reflectance spectroscopy (DRS) can provide a convenient, real-time means to aid in artery identification during laparoscopic PN. The feasibility of quantitative DRS for real-time longitudinal measurement of tissue perfusion and vascular oxygenation in laparoscopic nephrectomy was investigated in vivo in six Yorkshire swine kidneys (n=three animals). DRS allowed for rapid identification of ischemic areas after selective vessel occlusion. In addition, the rates of ischemia induction and recovery were compared for main renal artery versus tertiary segmental artery occlusion, and it was found that the tertiary segmental artery occlusion trends toward faster recovery after ischemia, which suggests a potential benefit of selective ischemia. Quantitative DRS could provide a convenient and fast tool for artery identification and evaluation of the depth, spatial extent, and duration of selective tissue ischemia in laparoscopic PN.

  7. Ex vivo comparison of the tissue effects of six laser wavelengths for potential use in laser supported partial nephrectomy

    NASA Astrophysics Data System (ADS)

    Khoder, Wael Y.; Zilinberg, Katja; Waidelich, Raphaela; Stief, Christian G.; Becker, Armin J.; Pangratz, Thomas; Hennig, Georg; Sroka, Ronald

    2012-06-01

    Laparoscopic/robotic partial nephrectomy (LPN) is increasingly considered for small renal tumors (RT). This demands new compatible surgical tools for RT-resection, such as lasers, to optimize cutting and coagulation. This work aims to characterize ex vivo handling requirements for six medically approved laser devices emitting different light wavelengths (940, 1064, 1318, 1470, 1940, and 2010 nm) amenable for LPN. Incisions were made by laser fibers driven by a computer-controlled stepping motor allowing precise linear movement with a preset velocity at a fixed fiber-tip distance to tissue. Optical parameters were measured on 200 μm tissue slices. Cutting quality depended on power output, fiber velocity and fiber-tip distance to tissue. Contact manner is suitable for cutting while a noncontact manner (5 mm distance) induces coagulation. Ablation threshold differs for each wavelength. Ablation depth is proportional to power output (within limit) while axial and superficial coagulation remains mostly constant. Increased fiber velocity compromises the coagulation quality. Optical parameters of porcine kidney tissue demonstrate that renal absorption coefficient follows water absorption in the 2 μm region while for other spectral regions (900 to 1500 and 1 μm) the tissue effects are influenced by other chromophores and scattering. Tissue color changes demonstrate dependencies on irradiance, scan velocity, and wavelength. Current results clearly demonstrate that surgeons considering laser-assisted RT excisions should be aware of the mentioned technical parameters (power output, fiber velocity and fiber-tip tissue-distance) rather than wavelength only.

  8. Ex vivo comparison of the tissue effects of six laser wavelengths for potential use in laser supported partial nephrectomy.

    PubMed

    Khoder, Wael Y; Zilinberg, Katja; Waidelich, Raphaela; Stief, Christian G; Becker, Armin J; Pangratz, Thomas; Hennig, Georg; Sroka, Ronald

    2012-06-01

    Laparoscopic/robotic partial nephrectomy (LPN) is increasingly considered for small renal tumors (RT). This demands new compatible surgical tools for RT-resection, such as lasers, to optimize cutting and coagulation. This work aims to characterize ex vivo handling requirements for six medically approved laser devices emitting different light wavelengths (940, 1064, 1318, 1470, 1940, and 2010 nm) amenable for LPN. Incisions were made by laser fibers driven by a computer-controlled stepping motor allowing precise linear movement with a preset velocity at a fixed fiber-tip distance to tissue. Optical parameters were measured on 200 μm tissue slices. Cutting quality depended on power output, fiber velocity and fiber-tip distance to tissue. Contact manner is suitable for cutting while a noncontact manner (5 mm distance) induces coagulation. Ablation threshold differs for each wavelength. Ablation depth is proportional to power output (within limit) while axial and superficial coagulation remains mostly constant. Increased fiber velocity compromises the coagulation quality. Optical parameters of porcine kidney tissue demonstrate that renal absorption coefficient follows water absorption in the 2 μm region while for other spectral regions (900 to 1500 and 1 μm) the tissue effects are influenced by other chromophores and scattering. Tissue color changes demonstrate dependencies on irradiance, scan velocity, and wavelength. Current results clearly demonstrate that surgeons considering laser-assisted RT excisions should be aware of the mentioned technical parameters (power output, fiber velocity and fiber-tip tissue-distance) rather than wavelength only.

  9. Collecting Duct Renal Cell Carcinoma Found to Involve the Collecting System During Partial Nephrectomy: A Case Report

    PubMed Central

    Harbin, Andrew C; Styskel, Brett A; Patel, Viren; Wang, He; Eun, Daniel D

    2015-01-01

    Collecting duct carcinoma (CDC) is a rare and aggressive form of renal cell carcinoma (RCC) arising from the principal cells of the collecting duct. One third of cases present with metastatic disease, but many present in a manner similar to conventional RCC or urothelial carcinoma (UC). We discuss a case of CDC which presented as a small mass at the cortico-medullary junction, and was discovered at robotic partial nephrectomy (RPN) to be grossly involving the collecting system. A 62-year-old man presented with a small renal mass suspicious for RCC, which was found on computed tomography (CT) after an episode of gross hematuria. After thorough workup, RPN was attempted; however, intraoperatively the mass was found to be involving the collecting system. Radical nephroureterectomy was performed, and the pathology report revealed CDC. CDC is a rare and aggressive form of RCC. While many cases are metastatic at diagnosis, most patients present with the incidental finding of a small renal mass. There are no reports of a CDC involving the collecting system at RPN after negative ureteroscopy preoperatively. The adjuvant therapeutic options for CDC are limited, and long term survival is poor.

  10. Trends of partial and radical nephrectomy in managing small renal masses

    PubMed Central

    Al Saidi, Ibrahim Khalid; Alqasem, Kholoud Saleh; Gharaibeh, Saeda Turki; Qamhia, Naim Z.N.; Abukhiran, Ibrahim; Al-Daghmin, Ali Ahmad

    2017-01-01

    Objective Use of partial nephrectomy (PN) for renal tumors appears to have relatively lower incidence rates in Jordan. We sought to characterize its trend at King Hussein Cancer Center for the last 10 years. Material and methods A retrospective review of our renal cell cancer data was performed. We identified 169 patients who had undergone surgery for renal tumors measuring ≤7 cm between 2005 and 2015. We characterized tumor size, pathology, type of surgery and clinical outcomes. Factors associated with the use of PN were evaluated using univariable and multivariable logistic regression models. Results Of the 169 patients, 34 (20%) and 135 (80%) had undergone partial and radical nephrectomy (RN) respectively for tumors ≤7 cm in diameter. Total number of 48 patients with tumors of ≤4 cm in diameter had undergone either PN (n=19; 40%) or RN (n=29; 60%). The frequency of PN procedures steadily increased over the years from 6% in 2005–2008, to 32% in 2013–2015, contrary to RN which was less frequently applied 94% in 2005–2008, and 68% in 2013–2015. In multivariable analysis, delayed surgery (p=0.01) and smaller tumor size (p=0.0005) were significant independent predictors of PN. During follow-up period, incidence of metastasis was lower in PN versus RN (13% and 32%, respectively, p=0.043). Local recurrence rates were not significantly different between PN (6.9%) and RN (7.2%) (p=0.99). The mean tumor sizes for patients who had undergone PN and RN were 4.1 and 5.5 cm respectively, (p<0.0001). The mean follow-up period for PN was 20 months, and for RN 33 months, (p=0.0225). Conclusion Partial nephrectomy for small renal tumors is relatively less frequently applied in Jordan, however an increase in its use has been observed over the years. Our data showed lower rates of distant metastasis and similar rates of local recurrence in favor of PN. PMID:28270950

  11. Bolster material granuloma masquerading as recurrent renal cell carcinoma following partial nephrectomy

    PubMed Central

    Singh, Abhishek; Jai, Shrikant; Ganpule, Sanika; Ganpule, Arvind

    2016-01-01

    Nephron sparing surgery has seen a phenomenal rise in its application over the past few decades. The use of Surgicel and gel foam for closure of defect created after partial nephrectomy has become a routine practice at many centers. In this case report, we describe radiological artifact secondary to a surgical bolster mimicking a residual disease or an early recurrence in the kidney. This case highlights two facts; first, reapproximation of the renal tissue is best done without the use of Surgicel bolsters. Second, bolsteroma should always be kept in mind as a differential diagnosis in a case where computed tomography (CT) imaging is showing early recurrence. If the surgeon is sure about the surgical margins being negative and the CT image shows a bolsteroma, the patient should be observed and a repeat scan should be done at 3–6 months, which would show regression or disappearance of the lesion proving it to be an artifact rather than malignant lesion. PMID:27857461

  12. Microparticulate ICE slurry for renal hypothermia: laparoscopic partial nephrectomy in a porcine model.

    SciTech Connect

    Shikanov, S; Wille, M; Large, M; Razmaria, A; Lifshitz, D; Chang, A; Wu, Y; Kasza, K; Shalhav, A

    2010-10-01

    Previously, we described the feasibility of renal hypothermia using microparticulate ice slurry during laparoscopy. In the present study, we compared surface cooling with the ice slurry versus near-frozen saline or warm ischemia (WI) during laparoscopic partial nephrectomy (LPN) in a porcine model. We used a single-kidney porcine model. Animals in 5 equal groups (n = 6 each) underwent right laparoscopic complete nephrectomy. In Phase I, left LPN was performed under 90 minutes of ischemia and 90-minute renal cooling with either slurry (Slurry group 1) or saline (Saline group 1). No cooling was applied in the WI group. In Phase II, to simulate more extreme condition, ischemia time was extended to 120 minutes and cooling shortened to 10 minutes (Slurry group 2 and Saline group 2). The study endpoints were renal and core temperature during the surgery and serum creatinine at baseline and days 1, 3, 7, and 14 after the procedure. The ice slurry was easily produced and delivered. Nadir renal temperature (mean {+-} SD) was 8 {+-} 4 C in Slurry group 1 vs. 22.5 {+-} 3 C in Saline group 1 (P < .0001). Renal rewarming to 30 C occurred after 61 {+-} 7 minutes in Slurry group 2 vs. 24 {+-} 6 minutes in Saline group 2 (P < .0001). Core temperature decreased on average to 35 C in the Saline groups compared with 37 C in the Slurry groups (P < .0001). Serum creatinine did not differ between the Saline and Slurry groups in Phases I and II at any time point. Ice slurry provides superior renal cooling compared with near-frozen saline during LPN without associated core hypothermia.

  13. Preserving Renal Function through Partial Nephrectomy Depends on Tumor Complexity in T1b Renal Tumors

    PubMed Central

    2017-01-01

    This study aimed to determine patients with T1b renal cell carcinoma (RCC) who could benefit from partial nephrectomy (PN) and method to identify them preoperatively using nephrometry score (NS). From a total of 483 radical nephrectomy (RN)-treated patients and 40 PN-treated patients who received treatment for T1b RCC between 1995 and 2010, 120 patients identified through 1:2 propensity-score matching were included for analysis. Probability of chronic kidney disease (CKD) until postoperative 5-years was calculated and regressed with respect to the surgical method and NS. Median follow-up was 106 months. CKD-probability at 5-years was 40.7% and 13.5% after radical and PN, respectively (P = 0.005). While PN was associated with lower risk of CKD regardless of age, comorbidity, preoperative estimated renal function, the effect was observed only among patients with NS ≤ 8 (P < 0.001) but not in patients with NS ≥ 9 (P = 0.746). Percent operated-kidney volume reduction and ischemia time were similar between the patients with NS ≥ 9 and ≤ 8. In the stratified Cox regression accounting for the interaction observed between the surgical method and the NS, PN reduced CKD-risk only in patients with NS ≤ 8 (hazard ratio [HR], 0.054; P = 0.005) but not in ≥ 9 (HR, 0.996; P = 0.994). In T1b RCC with NS ≥ 9, the risk of postoperative CKD was not reduced following PN compared to RN. Considering the potential complications of PN, minimally invasive RN could be considered with priority in this subgroup of patients. PMID:28145654

  14. Robot-assisted adrenalectomy (total, partial, & metastasectomy).

    PubMed

    Ball, Mark W; Allaf, Mohamad E

    2014-11-01

    Robotic-assisted adrenalectomy is an increasingly used intervention for patients with a variety of surgical adrenal lesions, including adenomas, aldosteronomas, pheochromocytomas, and metastases to the adrenal gland. Compared with traditional laparoscopy, robotic adrenalectomy has comparable perioperative outcomes and is associated with improved hospital length of stay and blood loss, though it does come at a cost premium. Emerging literature also supports a role for robotics in partial adrenalectomy and metastasectomy. Ultimately, well-conducted prospective trials are needed to fully define the role of robotics in the surgical management of adrenal disease.

  15. Laparoendoscopic single-site (LESS) adrenalectomy and partial nephrectomy: current Italian experience with two challenging surgical procedures.

    PubMed

    Cindolo, Luca; Scoffone, Cesare; Salzano, Luigi; Autorino, Riccardo; Mirone, Vincenzo; Schips, Luigi

    2010-10-01

    Since its initial clinical use in urology, there has been an increasing enthusiasm and a growing interest for laparoendoscopic single-site surgery (LESS). Several clinical series have been reported with an estimated cumulative clinical experience of more than four hundred so far. Nowadays, virtually all extirpative and reconstructive urological procedures have been described and shown to be feasible and safe, including advanced reconstructive procedures and major extirpative ones. Among them, adrenalectomy and partial nephrectomy represent highly complex procedures. Initial clinical data have been recently reported to test the safety and efficacy of these interventions in selected patients. Herein, we describe our initial cases of unclamp LESS partial nephrectomy and adrenalectomy. In our opinion, LESS is an established technique within the field of minimally invasive surgery. Even if further studies are needed to demonstrate its actual benefits, early clinical outcomes are encouraging and LESS might represent the way to go in minimally invasive urological surgery.

  16. Integrated image monitoring system using head-mounted display for gasless single-port clampless partial nephrectomy.

    PubMed

    Kihara, Kazunori; Saito, Kazutaka; Komai, Yoshinobu; Fujii, Yasuhisa

    2014-12-01

    A novel head-mounted display (HMD) offers a higher quality of endoscopic imagery in front of the eyes regardless of head position. We present an application of the HMD system as a personal integrated multi-image monitoring system in gasless single-port clampless partial nephrectomy (PN). Our HMD system displayed multiple forms of information as integrated, sharp, high-contrast images both seamlessly and synchronously using a four-split screen. The surgeon wearing an HMD display could continuously and simultaneously monitor the endoscopic, three-dimensional (3D) video and intraoperative ultrasound images. In addition, the operator can rotate the 3D video image using fingertip movements on the finger tracking system. All two clampless partial nephrectomies were safely completed within the operative time, blood loss was within usual limits and there were no complications. The integrated image HMD system might facilitate maneuverability and safety in minimally invasive clampless PN.

  17. Comparing different treatment modalities for partial nephrectomies without ischemic period: laser, Hydro-Jet and RF

    NASA Astrophysics Data System (ADS)

    de Boorder, Tjeerd; Boeken Kruger, Arto; Klaessens, John; Grimbergen, Matthijs; Verdaasdonk, Rudolf

    2008-02-01

    The treatment of partial nefrectomies is usually performed under a warm ischemic period. Recently, various treatment modalities have become available to perform a partial nefrectomy without clamping off the blood circulation. We have studied three devices in laboratory setting, investigating the thermal and high speed imaging techniques in tissue models and consequently, applying the instruments in the clinic during open procedures especially looking at efficacy and blood loss. The continuous wave 2.0 micron laser of 70 W (Revolix, LISA laser) is used as a fiber delivered knife cutting through circulated tissue with controlled hemostasis for vessels up to 3 mm diameter. The 2 μm wavelength effectively vaporizes tissue water and coagulates the smaller vessels. The Hydro-Jet (ERBE, Germany) uses high pressure (20-80 bar) to ejects a water jet of 40 um diameter at high velocity (10-30 m/s). The parenchyma is resected while vessels are preserved. Consequently, the exposed vessels can be coagulated in a controlled way with minimal blood loss. The water jet showed to induce cavitation bubbles that resect the soft tissue from the matrix leaving the elastic microvessels intact. Various systems are based on bipolar RF technology. We are using the Habib device (Rita 1500X RF generator) to create a coagulation zone around the tumor. Subsequently, the tumor can be resected along the coagulation zone with minimal bleeding. The treatment modalities investigated, have their own advantages and, stand-alone or in combination, can facilitate laparoscopic partial nephrectomies without an ischemic period.

  18. Successful Embolization of a Renal Artery Pseudoaneurysm with Arteriovenous Fistula and Extravasations Using Onyx After Partial Nephrectomy for Renal Cell Carcinoma

    SciTech Connect

    Zelenak, Kamil; Sopilko, Igor; Svihra, Jan; Kliment, Jan

    2009-01-15

    Partial nephrectomy can be associated with vascular complications. Computed tomography (CT) with CT angiography is ideal for noninvasive imaging of this process. The treatment of choice is selective embolization. Successful transcatheter embolization of right renal subsegmental artery pseudoaneurysm with arteriovenous fistula and extravasations using Onyx was performed in a 66-year-old woman with macrohematuria 12 days after partial nephrectomy for renal cell carcinoma.

  19. Urology residents experience comparable workload profiles when performing live porcine nephrectomies and robotic surgery virtual reality training modules.

    PubMed

    Mouraviev, Vladimir; Klein, Martina; Schommer, Eric; Thiel, David D; Samavedi, Srinivas; Kumar, Anup; Leveillee, Raymond J; Thomas, Raju; Pow-Sang, Julio M; Su, Li-Ming; Mui, Engy; Smith, Roger; Patel, Vipul

    2016-03-01

    In pursuit of improving the quality of residents' education, the Southeastern Section of the American Urological Association (SES AUA) hosts an annual robotic training course for its residents. The workshop involves performing a robotic live porcine nephrectomy as well as virtual reality robotic training modules. The aim of this study was to evaluate workload levels of urology residents when performing a live porcine nephrectomy and the virtual reality robotic surgery training modules employed during this workshop. Twenty-one residents from 14 SES AUA programs participated in 2015. On the first-day residents were taught with didactic lectures by faculty. On the second day, trainees were divided into two groups. Half were asked to perform training modules of the Mimic da Vinci-Trainer (MdVT, Mimic Technologies, Inc., Seattle, WA, USA) for 4 h, while the other half performed nephrectomy procedures on a live porcine model using the da Vinci Si robot (Intuitive Surgical Inc., Sunnyvale, CA, USA). After the first 4 h the groups changed places for another 4-h session. All trainees were asked to complete the NASA-TLX 1-page questionnaire following both the MdVT simulation and live animal model sessions. A significant interface and TLX interaction was observed. The interface by TLX interaction was further analyzed to determine whether the scores of each of the six TLX scales varied across the two interfaces. The means of the TLX scores observed at the two interfaces were similar. The only significant difference was observed for frustration, which was significantly higher at the simulation than the animal model, t (20) = 4.12, p = 0.001. This could be due to trainees' familiarity with live anatomical structures over skill set simulations which remain a real challenge to novice surgeons. Another reason might be that the simulator provides performance metrics for specific performance traits as well as composite scores for entire exercises. Novice trainees experienced

  20. Fusion of stereoscopic video and laparoscopic ultrasound for minimally invasive partial nephrectomy

    NASA Astrophysics Data System (ADS)

    Cheung, Carling L.; Wedlake, Christopher; Moore, John; Pautler, Stephen E.; Ahmad, Anis; Peters, Terry M.

    2009-02-01

    The development of an augmented reality environment that combines laparoscopic video and ultrasound imaging for image-guided minimally invasive abdominal surgical procedures, such as partial nephrectomy and radical prostatectomy, is an ongoing project in our laboratory. Our system overlays magnetically tracked ultrasound images onto endoscopic video to create a more intuitive visualization for mapping lesions intraoperatively and to give the ultrasound image context in 3D space. By presenting data in a common environment, this system will allow surgeons to visualize the multimodality information without having to switch between different images. A stereoscopic laparoscope from Visionsense Limited enhances our current system by providing surgeons with additional visual information through improved depth perception. In this paper, we develop and validate a calibration method that determines the transformation between the images from the stereoscopic laparoscope and the 3D locations of structures represented by a tracked laparoscopic ultrasound probe. We first calibrate the laparoscope with a checkerboard pattern and measure how accurate the transformation from image space to tracking space is. We then perform a target localization task using our fused environment. Our initial experience has demonstrated an RMS registration accuracy in 3D of 2.21mm for the laparoscope and 1.16mm for the ultrasound in a working volume of 0.125m3, indicating that magnetically tracked stereoscopic laparoscope and ultrasound images may be appropriately combined using magnetic tracking as long as steps are taken to ensure that the magnetic field generated by the system is not distorted by surrounding objects close to the working volume.

  1. A Literature Review of Renal Surgical Anatomy and Surgical Strategies for Partial Nephrectomy

    PubMed Central

    Klatte, Tobias; Ficarra, Vincenzo; Gratzke, Christian; Kaouk, Jihad; Kutikov, Alexander; Macchi, Veronica; Mottrie, Alexandre; Porpiglia, Francesco; Porter, James; Rogers, Craig G.; Russo, Paul; Thompson, R. Houston; Uzzo, Robert G.; Wood, Christopher G.; Gill, Inderbir S.

    2016-01-01

    Context A detailed understanding of renal surgical anatomy is necessary to optimize preoperative planning and operative technique and provide a basis for improved outcomes. Objective To evaluate the literature regarding pertinent surgical anatomy of the kidney and related structures, nephrometry scoring systems, and current surgical strategies for partial nephrectomy (PN). Evidence acquisition A literature review was conducted. Evidence synthesis Surgical renal anatomy fundamentally impacts PN surgery. The renal artery divides into anterior and posterior divisions, from which approximately five segmental terminal arteries originate. The renal veins are not terminal. Variations in the vascular and lymphatic channels are common; thus, concurrent lymphadenectomy is not routinely indicated during PN for cT1 renal masses in the setting of clinically negative lymph nodes. Renal-protocol contrast-enhanced computed tomography or magnetic resonance imaging is used for standard imaging. Anatomy-based nephrometry scoring systems allow standardized academic reporting of tumor characteristics and predict PN outcomes (complications, remnant function, possibly histology). Anatomy-based novel surgical approaches may reduce ischemic time during PN; these include early unclamping, segmental clamping, tumor-specific clamping (zero ischemia), and unclamped PN. Cancer cure after PN relies on complete resection, which can be achieved by thin margins. Post-PN renal function is impacted by kidney quality, remnant quantity, and ischemia type and duration. Conclusions Surgical renal anatomy underpins imaging, nephrometry scoring systems, and vascular control techniques that reduce global renal ischemia and may impact post-PN function. A contemporary ideal PN excises the tumor with a thin negative margin, delicately secures the tumor bed to maximize vascularized remnant parenchyma, and minimizes global ischemia to the renal remnant with minimal complications. Patient summary In this report

  2. Mini-flank supra-12th rib incision for open partial nephrectomy for renal tumor with RENAL nephrometry score ≥10: an innovation of traditional open surgery.

    PubMed

    Wang, Hang; Sun, Li-an; Wang, Yiwei; Xiang, Zhuoyi; Zhou, Lin; Guo, Jianming; Wang, Guomin

    2015-04-01

    The skill of supra-12th rib mini-flank approach for open partial nephrectomy (MI-OPN) provides an advanced operative method for renal tumor. Compared with laparoscopic and robotic surgery, it may be a feasible selection for the complex renal tumors. We describe our techniques and results of MI-OPN in complex renal tumors with high RENAL nephrometry score (RENAL nephrometry score ≥10). Fifty-five patients diagnosed with renal tumors between January 2009 and July 2013 were included in this study. Eligibility criteria comprised of patients with complex renal tumor (RENAL score ≥10) being candidates for partial nephrectomy (PN). All patients received MI-OPN and all surgeries were performed by a single urologist. The preoperative workup comprised of medical history, physical examination, and routine laboratory tests. Serum creatinine was recorded preoperatively and 2 to 3 months after operation. Operative time, ischemia time, blood loss, operative and postoperative complications, renal function, and pathology parameters were recorded. MI-OPN was successfully performed in all cases. Mean tumor size was 4.7 cm (range: 2.5-8.1). Mean warm ischemia time was 28.1 minutes (range: 21-39), mean operative time was 105 minutes (range: 70-150) and mean estimated blood loss was 68 mL (range: 10-400). Mean postoperative hospital stay was 6.5 days (range: 5-12). Postoperative complications were found in 3 patients (5.5%). The mean pre- and postoperative serum creatinine levels were 76.2 μmol/L (range: 47-132) and 87.1 μmol/L (range: 61-189) with significant difference (P = 0.004). The mean pre- and postoperative estimated glomerular filtration rate (eGFR) were 91.5 (range: 34-133) and 82.5 (range: 22-126.5), respectively with significant difference (P = 0.024). In an average follow-up of 19.9 months (range: 8-50), no local recurrence or systemic progression occurred. In conclusion, MI-OPN can combine the benefits of both minimal invasive and traditional open

  3. Robot assisted "en bloc" radical nephrectomy, splenectomy and distal pancreatectomy for renal cell carcinoma: case report and illustration of technique.

    PubMed

    Abdul-Muhsin, Haidar Mohamed; Stern, Karen Lynn; Katariya, Nitin Nath; Castle, Erik Peter

    2016-12-01

    A 57-year-old female presented with recurrent gross hematuria and a large left renal mass with solitary pancreatic metastasis. After thorough evaluation, an en bloc robot assisted radical nephrectomy, distal pancreatectomy and splenectomy was performed using a team-based approach between urologists and the transplant/hepatobiliary teams. A standard robotic nephrectomy approach was used with intraoperative ultrasound to determine the extent of pancreatic involvement. Left kidney, left adrenal gland, spleen and pancreatic tail were resected en bloc. Total operative time was 194 min. Perioperative Hemoglobin change was 2.3 g/dL. The final pathology demonstrated a 12.5 cm, Fuhrman grade 3, clear cell RCC along with a 2.5 cm pancreatic metastasis consistent with pT3a, N0, M1 with negative surgical margins. The patient was discharged on post-operative day three and experienced no postoperative complications. This case report highlights the feasibility of this procedure and calls for evaluation of surgical outcomes in this disease category.

  4. Better recovery of kidney function in patients with de novo chronic kidney disease after partial nephrectomy compared with those with pre-existing chronic kidney disease.

    PubMed

    Takagi, Toshio; Kondo, Tsunenori; Iizuka, Junpei; Omae, Kenji; Kobayashi, Hirohito; Hashimoto, Yasunobu; Yoshida, Kazuhiko; Tanabe, Kazunari

    2014-06-01

    We compared kidney functional recovery between patients with pre-existing chronic kidney disease, those with de novo chronic kidney disease and those with normal kidney function, after partial nephrectomy. A total of 311 patients who underwent partial nephrectomy at Tokyo Women's Medical University Hospital, Tokyo, Japan, between January 2004 and July 2011 with sufficient kidney functional data participated in the study. Patients with pre-existing chronic kidney disease (group1: 78 patients) were defined as those with estimated glomerular filtration rate under 60 mL/min/m(2) before partial nephrectomy. Patients with de novo chronic kidney disease (group 2: 49) were defined as those with estimated glomerular filtration rate over 60 mL/min/m(2) before surgery and who developed estimated glomerular filtration rate under 60 mL/min/m(2) 3 months after partial nephrectomy. Normal patients (group 3: 184) were defined as those with estimated glomerular filtration rate over 60 mL/min/m(2) both before and after partial nephrectomy. Group 1 was associated with older age and higher comorbidity, including hypertension and diabetes mellitus, compared with other groups. R.E.N.A.L. score was not significantly different between the groups. Although the percent change of estimated glomerular filtration rate between the preoperative period and 3 months after partial nephrectomy in group 2 was significantly decreased compared with that in other groups (group 1: -6.8%, group 2: -18%, group 3: -7.3%), the renal functional recovery between 3 and 12 months after partial nephrectomy in group 2 was better than that in other groups (group 1: -0.5%, group 2: 5.6%, group 3: -0.4%). Patients with de novo chronic kidney disease had better kidney functional recovery than the other two groups, which might suggest that they were surgically assaulted and developed chronic kidney disease in the early postoperative period, and were essentially different from those with pre-existing chronic kidney

  5. The Physiologic and Anesthetic Considerations in Elderly Patients Undergoing Robotic Renal Surgery

    PubMed Central

    Vasdev, Nikhil; Poon, Anna Sau Kuk; Gowrie-Mohan, S; Lane, Tim; Boustead, Gregory; Hanbury, Damian; Adshead, James M

    2014-01-01

    A number of patients are diagnosed with renal malignancies incidentally worldwide. Once a diagnosis of a renal malignancy is established, after a careful evaluation, patients can be offered a robotic nephrectomy or partial nephrectomy. We present a review of the physiologic and anesthetic considerations in elderly patients who are being considered for robotic renal surgery. PMID:24791150

  6. [Renal Cell Carcinoma: When is a Partial, Organ-preserving Nephrectomy Possible and Reasonable?].

    PubMed

    Padevit, Christian; Sauck, Anja; John, Hubert

    2016-06-22

    In Switzerland about 900 people a year are newly diagnosed with a kidney tumour. This is about 3 % of all cancer cases in this country. Because of the abundent diagnostic examinations carried out (MR, CT, US), kidney tumours are often coincidentally found. In recent years the organ-sparing therapy has moved to the foreground for kidney tumours of <4 cm. This is increasingly true for larger lesions of 4–7 cm diameter. Organ-sparing kidney surgery has replaced the radical nephrectomy for tumours up to 7 cm because of the superior post-op quality of Life and the total survival rate. In addition, the control of oncological parameters, maintenance of kidney function, low morbidity and reproducibility of the method are existant and can be achieved using this organ-sparing therapy.

  7. Optimising renal cancer patients for nephron-sparing surgery: a review of pre-operative considerations and peri-operative techniques for partial nephrectomy.

    PubMed

    Ertemi, Hani; Khetrapal, Pramit; Pavithran, Nevil M; Mumtaz, Faiz

    2017-02-03

    Nonmodifiable factors including pre-operative renal function and amount of healthy renal tissue preserved are the most important predictive factors that determine renal function after partial nephrectomy. Ischaemia time is an important modifiable risk factor and cold ischaemia time should be used if longer ischaemia time is anticipated. New techniques may have a role in maximising postoperative kidney function, but more robust studies are required to understand their potential benefits and risks.

  8. Multicenter Experience with Nonischemic Multiport Laparoscopic and Laparoendoscopic Single-Site Partial Nephrectomy Utilizing Bipolar Radiofrequency Ablation Coagulator

    PubMed Central

    Bazzi, Wassim M.; Allaf, Mohamad E.; Berkowitz, Jared; Atalah, Hany N.; Parekattil, Sijo; Derweesh, Ithaar H.

    2011-01-01

    Objective. To investigate feasibility of multiport and laparoendoscopic single-site (LESS) nonischemic laparoscopic partial nephrectomy (NI-LPN) utilizing bipolar radiofrequency coagulator. Methods. Multicenter retrospective review of 60 patients (46 multiport/14 LESS) undergoing NI-LPN between 4/2006 and 9/2009. Multiport and LESS NI-LPN utilized Habib 4X bipolar radiofrequency coagulator to form a hemostatic zone followed by nonischemic tumor excision and renorrhaphy. Demographics, tumor/perioperative characteristics, and outcomes were analyzed. Results. 59/60 (98.3%) successfully underwent NI-LPN. Mean tumor size was 2.35 cm. Mean operative time was 160.0 minutes. Mean estimated blood loss was 131.4 mL. Preoperative/postoperative creatinine (mg/dL) was 1.02/1.07 (P = .471). All had negative margins. 12 (20%) patients developed complications. 3 (5%) developed urine leaks. No differences between multiport and LESS-PN were noted as regards demographics, tumor size, outcomes, and complications. Conclusion. Initial experience demonstrates that nonischemic multiport and LESS-PN is safe and efficacious, with excellent short-term preservation of renal function. Long-term data are needed to confirm oncological efficacy. PMID:21747654

  9. Targeted Endovascular Temporary Vessel Occlusion with a Reverse Thermosensitive Polymer for Near-Bloodless Partial Nephrectomy: Comparison to Standard Surgical Clamping Techniques

    SciTech Connect

    Flacke, Sebastian; Harty, Niall J.; Laskey, Daniel H.; Moinzadeh, Alireza; Benn, James A.; Villani, Rosanna; Kalra, Aarti; Libertino, John A.; Madras, Peter N.

    2012-10-15

    Purpose: To determine whether reversible blood flow interruption to a randomly chosen target region of the kidney may be achieved with the injection of a reverse thermoplastic polymer through an angiographic catheter, thereby facilitating partial nephrectomy without compromising blood flow to the remaining kidney or adding risks beyond those encountered by the use of hilar clamping. Methods: Fifteen pigs underwent partial nephrectomy after blood flow interruption by vascular cross-clamping or injection of polymer (Lumagel Trade-Mark-Sign ) into a segmental artery. Five animals were euthanized after surgery (three open and two laparoscopic resection, cross-clamping n = 2), and 10 (open resection, cross-clamping n = 4) were euthanized after 6 weeks' survival. Blood specimens were obtained periodically, and angiogram and necropsy were performed at 6 weeks. Results: Selective renal ischemia was achieved in all cases. Surgical resection time averaged 9 and 24.5 min in the open and laparoscopic groups, respectively. Estimated blood loss was negligible with the exception of one case where an accessory renal artery was originally overlooked. Reversal of the polymer to a liquid state was consistent angiographically and visually in all cases. Time to complete flow return averaged 7.4 and 2 min for polymer and clamping, respectively. Angiography at 6 weeks revealed no evidence of vascular injury. Laboratory data and necropsies revealed no differences between animals undergoing vascular clamping or polymer injection. Conclusion: Lumagel was as effective as vascular clamping in producing a near bloodless operative field for partial nephrectomy while maintaining flow to the uninvolved portion of the affected kidney.

  10. Robot-assisted partial adrenalectomy for isolated adrenal metastasis.

    PubMed

    Kumar, Angelish; Hyams, Elias S; Stifelman, Michael D

    2009-04-01

    Adrenal-sparing surgery is an effective and safe alternative to total adrenalectomy for small, benign adrenal lesions and may decrease the risk of the development of adrenal insufficiency. While series of laparoscopic partial adrenalectomy have demonstrated safety and excellent long-term outcomes, there have been no reports of a complete robot-assisted partial adrenalectomy. We believe that robotic techniques may be useful for this procedure, given the complex vascularity and small size of the adrenal gland. Furthermore, there have been no reports of minimally invasive partial adrenalectomy for management of small, isolated adrenal metastasis. We report a case of robot-assisted partial adrenalectomy in a patient with a history of renal-cell carcinoma who had previously undergone contralateral adrenalectomy for metastasis. We report our surgical technique and short-term follow-up for our patient. To our knowledge, this is the first report of a complete robot-assisted partial adrenalectomy and the first report of minimally invasive partial adrenalectomy for an isolated adrenal metastasis.

  11. Robotic-assisted laparoscopic partial cystectomy for symptomatic urachal hamartoma

    PubMed Central

    Shepler, Richard; Zuckerman, Jack M.; Troyer, Dean; Malcolm, John B.

    2016-01-01

    We report a case of an urachal hamartoma in a 30-year-old African American woman. The urachal lesion was excised with a robotic-assisted laparoscopic partial cystectomy. Pathologic analysis revealed cysts, smooth muscle, and ciliated epithelium consistent with a hamartoma. The patient recovered without complication. This case highlights an unusual pathology that is infrequently reported following urachal remnant excision. PMID:27011882

  12. Generation of Chimeric "ABS Nanohemostat" Complex and Comparing Its Histomorphological In Vivo Effects to the Traditional Ankaferd Hemostat in Controlled Experimental Partial Nephrectomy Model.

    PubMed

    Huri, Emre; Beyazit, Yavuz; Mammadov, Rashad; Toksoz, Sila; Tekinay, Ayse B; Guler, Mustafa O; Ustun, Huseyin; Kekilli, Murat; Dadali, Mumtaz; Celik, Tugrul; Astarci, Müzeyyen; Haznedaroglu, Ibrahim C

    2013-01-01

    Purpose. Using the classical Ankaferd Blood Stopper (ABS) solution to create active hemostasis during partial nephrectomy (PN) may not be so effective due to insufficient contact surface between the ABS hemostatic liquid agent and the bleeding area. In order to broaden the contact surface, we generated a chimeric hemostatic agent, ABS nanohemostat, via combining a self-assembling peptide amphiphile molecule with the traditional Ankaferd hemostat. Materials and Methods. In order to generate ABS nanohemostat, a positively charged Peptide Amphiphile (PA) molecule was synthesized by using solid phase peptide synthesis. For animal experiments, 24 Wistar rats were divided into the following 4 groups: Group 1: control; Group 2: conventional PN with only 0.5 ml Ankaferd hemostat; Group 3: conventional PN with ABS + peptide gel; Group 4: conventional PN with only 0.5 ml peptide solution. Results. Mean warm ischemia times (WITs) were 232.8  ±  56.3, 65.6 ± 11.4, 75.5 ± 17.2, and 58.1 ± 17.6 seconds in Group 1 to Group 4, respectively. Fibrosis was not different among the groups, while inflammation was detected to be significantly different in G3 and G4. Conclusions. ABS nanohemostat has comparable hemostatic efficacy to the traditional Ankaferd hemostat in the partial nephrectomy experimental model. Elucidation of the cellular and tissue effects of this chimeric compound may establish a catalytic spark and open new avenues for novel experimental and clinical studies in the battlefield of hemostasis.

  13. 76 FR 67716 - Notice of Intent To Grant Partially Exclusive Patent License; ReconRobotics, Inc.

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-02

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF DEFENSE Department of the Navy Notice of Intent To Grant Partially Exclusive Patent License; ReconRobotics, Inc... notice of its intent to grant to ReconRobotics, Inc., a revocable, nonassignable, partially...

  14. Partial nephrectomy using radiofrequency incremental bipolar generator with multi electrode probe: experimental study in bench pig kidneys

    PubMed Central

    2014-01-01

    Background The aim of this research project was the realization of an incremental bipolar radiofrequency generator with inline 4-electrode probe for partial renal resection without clamping of the vessels. Methods The experimentation was carried out across two phases: the preliminary realization of a specific generator and an inline multielectrode probe for open surgery (Phase 1); system testing on 27 bench kidneys for a total of 47 partial resection (Phase 2). The parameters evaluated were: power level, generator automatisms, parenchymal coagulation times, needle caliber, thickness of the coagulated tissue “slice”, charring, ergonomy, feasibility of the application of “bolster” stitches. Results The analysis of the results referred to the homogeneity and thickness of coagulation, energy supply times with reference to the power level and caliber of the needles. The optimal results were obtained by using needles of 1.5 mm caliber at power level 5, and with coagulation times of 54 seconds for the first insertion and 30 seconds for the second. Conclusions The experimentation demonstrated that the apparatus, consisting of a generator named “LaparoNewPro” and fitted with a dedicated probe for open surgery, is able to carry out a coagulation of the line of resection of the renal parenchyma in a homogeneous manner, in short times, without tissue charring, and with the possibility of stitching both on coagulated tissue and the caliceal system. The generator automatism based on the flow of the current supplied by each electrode is reliable, and the cessation of energy supply coincides with optimal coagulation. PMID:24410789

  15. The percentage of resected and ischemic volume determined by a geometric model is a significant predictor of renal functional change after partial nephrectomy

    PubMed Central

    Huang, Wei-Hsuan; Chang, Chao-Hsiang; Huang, Chi-Ping; Wu, Hsi-Chin; Hsieh, Po-Fan

    2017-01-01

    ABSTRACT Purpose The percentage of parenchyma preserved plays a predominant role in predicting renal function after partial nephrectomy (PN). Currently there is no standard method to estimate preserved renal parenchyma. In this study we propose a formula of the percentage of resected and ischemic volume (PRAIV) determined by a geometric model and evaluate the relationships between renal functional change and PRAIV as well as other clinical parameters. Materials and Methods We identified 71 patients who underwent open PN between January 2004 and April 2014. Assuming the kidney to be an ellipsoid with bilaterally equal volume and tumor to be a sphere, we calculated PRAIV by integral calculus. Nadir estimated glomerular filtration rate (eGFR) between postoperative 3 and 12 months were recorded. The correlation between percent eGFR reduction, PRAIV, and other clinical parameters were examined. Results On univariate analysis, age (p=0.03), depth of tumor invasion (p=0.004), C index (p=0.003), RAIV (p=0.04), and PRAIV (p<0.001) were correlated with percent reduction of eGFR. However, only age (p=0.007) and PRAIV (p<0.001) were significantly correlated with percent reduction of eGFR on multivariate analysis. Depicting these values along the regression line, we found R2 was 0.194 and 0.073 for PRAIV and age, respectively. Conclusions PRAIV determined by a geometric model is a significant predictor of renal functional change after PN. Using PRAIV, we can estimate percent eGFR reduction preoperatively for better patient consultation and surgical planning. PMID:28124529

  16. Preoperative Predictors of Malignancy and Unfavorable Pathology for Clinical T1a Tumors Treated with Partial Nephrectomy: A Multi-Institutional Analysis

    PubMed Central

    Ball, Mark W.; Gorin, Michael A.; Bhayani, Sam B.; Rogers, Craig G.; Stifelman, Michael D.; Kaouk, Jihad H.; Zargar, Homayoun; Marshall, Susan; Larson, Jeffrey A.; Rahbar, Haider M.; Trock, Bruce J.; Pierorazio, Phillip M.; Allaf, Mohamad E.

    2014-01-01

    Purpose To determine preoperative predictors associated with RCC and unfavorable pathology in small renal masses treated with partial nephrectomy (PN). Materials and Methods PN records from 5 centers were retrospectively queried for patients with a clinically localized, single tumor < 4 cm on imaging (cT1a). Between 2007 and 2013, 1009 patients met inclusion criteria. Unfavorable pathology was defined as any grade III or IV RCC or tumors upstaged to pathologic T3a disease. Logistic regression models were used to determine preoperative characteristics associated with RCC and with unfavorable pathology. Results A total of 771 (76.4%) patients were found to have RCC and 198 (19.6%) had unfavorable pathology. On multivariate, bootstrap-adjusted logistic regression analysis, factors associated with presence of malignancy were imaging tumor size > 3 cm (OR 1.46, p = 0.040), male sex (OR 1.88, p < 0.0001) and nephrometry score > 8 (OR 1.64, p = 0.005). These same factors were independently associated with risk of unfavorable pathology: size > 3 cm (OR 1.46, p=0.021), male sex (OR 2.35, p < 0.0001) and nephrometry score > 8 (OR 1.49, p =0.015). The c statistic was 0.62 for the predicting malignancy and 0.63 for unfavorable pathology. Conclusions In this multi-institutional cohort, male sex, imaging tumor size >3 cm, and nephrometry score >8 were predictors of RCC and adverse pathology following PN. These factors may assist in risk stratification and selective renal mass biopsy prior to decision making. Further studies are necessary to validate these findings. PMID:25499258

  17. What’s the best minimal invasive approach to pediatric nephrectomy and heminephrectomy: conventional laparoscopy (CL), single-site (LESS) or robotics (RAS)?

    PubMed Central

    Basharkhah, Ali; Hock, Andras

    2016-01-01

    Background Conventional laparoscopy (CL) using 3–5 mm ports has become the goldstandard for pediatric nephrectomy (N), heminephrectomy (HN) and heminephrecto-ureterectomy (HNU) for many years now. Recently the spectrum of minimal invasive surgery (MIS) has been extended by variants like laparoendoscopic single-site surgery (LESS) or robot-assisted surgery (RAS). However such technical developments tend to drive surgical euphoria and feasibility studies, but may miss adequate academic research about function and proven patients’ benefits. This article delivers a comprehensive analysis of present pediatric studies comparing at least two MIS approaches to N, HN and HNU. Methods A systematic literature-based search for studies published between 2011–2016 about CL versus LESS or RAS for pediatric N, HN, and HNU was performed using multiple electronic databases and sources. The level of evidence was determined using the Oxford Centre for Evidence-based Medicine (OCEBM) criteria. Single arm observational studies about N, HN or HNU using CL, LESS or RAS as well as publications including adult patients were excluded. Results A total of 11 studies met defined inclusion criteria, reporting on CL versus LESS or RAS. No studies of OCEBM Level 1 or 2 were identified. Performing CL for N and HN limited evidence indicated reduced analgesic requirements and shorter hospital stay over open surgery, but longer operating time. Preservation of renal function of the remaining moiety after CL-HN was 95%. Importantly, of patients losing their remaining moiety, median age at surgery was 9 months (range, 4–42 months), and all except 1 (6/7) had an upper pole HN. Several authors compared TNP versus RPN access for CL and confirmed a longer operating time for RPN versus TPN-NU. Moreover one study reported a longer ureteric stump in RPN versus TPN-HNU (range, 2–5 cm vs. 3–7 mm). Disadvantages of LESS or RAS over CL were longer operative time and higher total costs (RAS). There were

  18. Visual Enhancement of Laparoscopic Partial Nephrectomy With 3-Charge Coupled Device Camera: Assessing Intraoperative Tissue Perfusion and Vascular Anatomy by Visible Hemoglobin Spectral Response

    DTIC Science & Technology

    2010-10-01

    Surgeon observes compos· ite of 3 ceo responses on high definition monitor in operating room. computer and may potentially mdicate organ per- fusion ...and adaptation of sur- gical technique, and appropriate experience as well as improved instrumentation, hemostatic agents and video endoscopic...renal lunctio11 after lapa- roscoprc pa1 Ml nephrectomy BJU lnl 2005; 95: 377 23 Yossepow1tch 0 Eggener SE. Ser1o A et al Tem- porary renal 1schemra

  19. [Life without robots : What is left for the urologist?].

    PubMed

    Hakenberg, O

    2010-08-01

    The triumphal march of robots in urology seems to be unstoppable. In the meantime, a broadening of the scope for indications in urology can be observed: this applies to pyeloplasty and to a lesser degree also to partial nephrectomy and radical cystectomy. As yet no evidence has been provided that robot-assisted radical prostatectomy (RP) is superior to open surgery. Furthermore, data are available which suggest that the midterm functional results are possibly even worse than those achieved with open RP.

  20. What is next in robotic urology?

    PubMed

    Cathelineau, Xavier; Sanchez-Salas, Rafael; Sivaraman, Arjun

    2014-12-01

    The application of robotic technology in surgical practice was developed during the past three decades, but its clinical application has made a significant impact during the last 10 years. Urologists have embraced surgical robots throughout their evolution, and robot-assisted urologic surgeries have matured into everyday clinical practice in many parts of the world. Long-term data from robot-assisted radical prostatectomies (RARP), an early robotic urologic surgery, has shown that the results are comparable to contemporary open radical prostatectomy (ORP) cohorts. Robot-assisted partial nephrectomy (RAPN) is largely restricted to high-volume academic centers; comparative studies have demonstrated significant advantages in favor of RAPN over laparoscopic partial nephrectomy (LPN) to achieve adequate warm ischemia time, surgical margins free of cancer cells, and no peri-operative complications. Robot-assisted radical cystectomy shows results that are comparable to contemporary open radical cystectomy. Several authors have reported the feasibility of robotic intracorporeal urinary diversion. The available long-term outcomes of robot-assisted urological surgeries are comparable to conventional open surgical methods and are associated with fewer complications. Surgical robots continue to evolve, and robotic engineers alongside surgeons strive hard to synthesize and evaluate novel robotic platforms, downsize hardware, and develop flexible instruments and newer technologies. Robotic applications available at this point represent the infancy of this technology. Future developments in robotics are profoundly limited to human imagination and can potentially scale to unimaginable heights. We would expect robots coupled with imaging and energies, aiming to provide accurate and reliable treatments which will be finely targeted by biogenetic information.

  1. Robot-assisted laparoscopic partial adrenalectomy: a case report and review of the literature.

    PubMed

    Yates, Jennifer; Uberoi, Jayant; Munver, Ravi

    2010-09-01

    Adrenal-sparing surgery has recently been reported in the literature on minimally-invasive surgery. Originally described as a conventional laparoscopic procedure, encouraging outcomes in terms of preservation of adrenal function have been reported. Since the introduction of robotic surgery, surgeons have utilized robotic assistance for adrenal surgery and have recently described adrenal-sparing surgery using this platform. Certain patients that present with adrenal masses may benefit from minimally-invasive partial adrenalectomy, including those with a solitary adrenal gland, bilateral adrenal masses, and hereditary disease predisposing them to multiple adrenal masses. Patients without these conditions may also benefit from adrenal-sparing surgery in order to preserve normal adrenal function. We present the case of a patient with a 1.5-cm adrenal mass who elected to undergo adrenal-sparing surgery. The technique of transperitoneal laparoscopic partial adrenalectomy utilizing the da Vinci™ Surgical System is described. We also review the literature on minimally-invasive partial adrenalectomy in which robotic-assistance was utilized. In conclusion, while robot-assisted laparoscopic partial adrenalectomy remains in its infancy, it can be performed safely and with satisfactory surgical and functional outcomes.

  2. Urinary biomarkers after donor nephrectomy.

    PubMed

    Hoogendijk-van den Akker, Judith M; Warlé, Michiel C; van Zuilen, Arjan D; Kloke, Heinrich J; Wever, Kim E; d'Ancona, Frank C H; Ӧzdemir, Denise M D; Wetzels, Jack F M; Hoitsma, Andries J

    2015-05-01

    As the beginning of living-donor kidney transplantation, physicians have expressed concern about the possibility that unilateral nephrectomy can be harmful to a healthy individual. To investigate whether the elevated intra-abdominal pressure (IAP) during laparoscopic donor nephrectomy causes early damage to the remaining kidney, we evaluated urine biomarkers after laparoscopic donor nephrectomy. We measured albumin and alpha-1-microglobulin (α-1-MGB) in urine samples collected during and after open and laparoscopic donor nephrectomy and laparoscopic cholecystectomy and colectomy. Additionally, kidney injury molecule 1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) were measured in urine samples collected during and after laparoscopic donor nephrectomy and colectomy. The same biomarkers were studied in patients randomly assigned to standard or low IAP during laparoscopic donor nephrectomy. We observed a peak in urinary albumin excretion during all procedures. Urine α-1-MGB rose in the postoperative period with a peak on the third postoperative day after donor nephrectomy. Urine α-1-MGB did not increase after laparoscopic cholecystectomy and colectomy. After laparoscopic nephrectomy, we observed slight increases in urine KIM-1 during surgery and in urine NGAL at day 2-3 after the procedure. After laparoscopic colectomy, both KIM-1 and NGAL were increased in the postoperative period. There were no differences between the high- and low-pressure procedure. Elevated urinary α-1-MGB suggests kidney damage after donor nephrectomy, occurring irrespective of IAP during the laparoscopic procedure.

  3. Moving Horizon Estimation for Vehicle Robots using Partial Marker Information of Motion Capture System

    NASA Astrophysics Data System (ADS)

    Takahashi, Manami; Nonaka, Kenichiro; Sekiguchi, Kazuma

    2016-09-01

    The measurement using a motion capture camera is fluctuated by white noise and outliers. In addition, markers to be measured are frequently hidden from cameras by occlusion, then the position and heading angle of a vehicle cannot be uniquely determined because of failure to detect sufficient number of markers. Thus, robust estimation method is required which suppresses the influence of the white noise, the outlier and the occlusion. In this study, we introduce Moving Horizon Estimation (MHE) using partial marker information of motion capture system. It optimizes the objective function using both the marker information in the evaluation range and the constraints on the robot dynamics. By virtue of introduction of constraints, even if the cameras fail to measure the actual state of the robot, the estimated value is determined by MHE. It is the difference from our previous research which assumed that sufficient number of markers are available. In this paper, we estimate the position of the vehicle robot by MHE using the information of the measured markers on the robot, even if several markers are hidden. We will prove the effectiveness of the proposed method by comparing MHE with EKF.

  4. Concurrent robotic partial adrenalectomy and extra-adrenal pheochromocytoma resection in a pediatric patient with von Hippel-Lindau disease.

    PubMed

    Rogers, Craig G; Blatt, Adam M; Miles, George E; Linehan, W Marston; Pinto, Peter A

    2008-07-01

    Laparoscopic partial adrenalectomy is a surgical option for select patients with hereditary pheochromocytoma. We present a case of a pediatric patient with von Hippel-Lindau disease (VHL) and both an adrenal pheochromocytoma and an extra-adrenal pheochromocytoma, who underwent concurrent partial adrenalectomy and extra-adrenal pheochromocytoma resection utilizing robotic assistance. To the best of our knowledge, this is the first report of partial adrenalectomy with concurrent extra-adrenal pheochromocytoma resection.

  5. Laparoscopic donor nephrectomy.

    PubMed

    Deger, S; Giessing, M; Roigas, J; Wille, A H; Lein, M; Schönberger, B; Loening, S A

    2005-01-01

    Laparoscopic live donor nephrectomy (LDN) has removed disincentives of potential donors and may bear the potential to increase kidney donation. Multiple modifications have been made to abbreviate the learning curve while at the same time guarantee the highest possible level of medical quality for donor and recipient. We reviewed the literature for the evolution of the different LDN techniques and their impact on donor, graft and operating surgeon, including the subtleties of different surgical accesses, vessel handling and organ extraction. We performed a literature search (PubMed, DIMDI, medline) to evaluate the development of the LDN techniques from 1995 to 2003. Today more than 200 centres worldwide perform LDN. Hand-assistance has led to a spread of LDN. Studies comparing open and hand-assisted LDN show a reduction of operating and warm ischaemia times for the hand-assisted LDN. Different surgical access sites (trans- or retroperitoneal), different vessel dissection approaches, donor organ delivery techniques, delivery sites and variations of hand-assistance techniques reflect the evolution of LDN. Proper techniques and their combination for the consecutive surgical steps minimize both warm ischaemia time and operating time while offering the donor a safe minimally invasive laparoscopic procedure. LDN has breathed new life into the moribund field of living kidney donation. Within a few years LDN could become the standard approach in living kidney donation. Surgeons working in this field must be trained thoroughly and well acquainted with the subtleties of the different LDN techniques and their respective advantages and disadvantages.

  6. Robotics.

    ERIC Educational Resources Information Center

    Waddell, Steve; Doty, Keith L.

    1999-01-01

    "Why Teach Robotics?" (Waddell) suggests that the United States lags behind Europe and Japan in use of robotics in industry and teaching. "Creating a Course in Mobile Robotics" (Doty) outlines course elements of the Intelligent Machines Design Lab. (SK)

  7. Current status of robotic surgery in Japan

    PubMed Central

    2015-01-01

    The da Vinci S surgical system (Intuitive Surgical) was approved as a medical device in 2009 by the Japanese Ministry of Health, Labour and Welfare. Robotic surgery has since been used in gastrointestinal, thoracic, gynecological, and urological surgeries. In April 2012, robotic-assisted laparoscopic radical prostatectomy (RALP) was first approved for insurance coverage. Since then, RALP has been increasingly used, with more than 3,000 RALP procedures performed by March 2013. By July 2014, 183 institutions in Japan had installed the da Vinci surgical system. Other types of robotic surgeries are not widespread because they are not covered by public health insurance. Clinical trials using robotic partial nephrectomy and robotic gastrectomy for renal and gastric cancers, respectively, have recently begun as advanced medical treatments to evaluate health insurance coverage. These procedures must be evaluated for efficacy and safety before being covered by public health insurance. Other types of robotic surgery are being evaluated in clinical studies. There are several challenges in robotic surgery, including accreditation, training, efficacy, and cost. The largest issue is the cost-benefit balance. In this review, the current situation and a prospective view of robotic surgery in Japan are discussed. PMID:25763120

  8. Current status of robotic surgery in Japan.

    PubMed

    Nishimura, Kazuo

    2015-03-01

    The da Vinci S surgical system (Intuitive Surgical) was approved as a medical device in 2009 by the Japanese Ministry of Health, Labour and Welfare. Robotic surgery has since been used in gastrointestinal, thoracic, gynecological, and urological surgeries. In April 2012, robotic-assisted laparoscopic radical prostatectomy (RALP) was first approved for insurance coverage. Since then, RALP has been increasingly used, with more than 3,000 RALP procedures performed by March 2013. By July 2014, 183 institutions in Japan had installed the da Vinci surgical system. Other types of robotic surgeries are not widespread because they are not covered by public health insurance. Clinical trials using robotic partial nephrectomy and robotic gastrectomy for renal and gastric cancers, respectively, have recently begun as advanced medical treatments to evaluate health insurance coverage. These procedures must be evaluated for efficacy and safety before being covered by public health insurance. Other types of robotic surgery are being evaluated in clinical studies. There are several challenges in robotic surgery, including accreditation, training, efficacy, and cost. The largest issue is the cost-benefit balance. In this review, the current situation and a prospective view of robotic surgery in Japan are discussed.

  9. Robotics

    SciTech Connect

    Scheide, A.W.

    1983-11-01

    This article reviews some of the technical areas and history associated with robotics, provides information relative to the formation of a Robotics Industry Committee within the Industry Applications Society (IAS), and describes how all activities relating to robotics will be coordinated within the IEEE. Industrial robots are being used for material handling, processes such as coating and arc welding, and some mechanical and electronics assembly. An industrial robot is defined as a programmable, multifunctional manipulator designed to move material, parts, tools, or specialized devices through variable programmed motions for a variety of tasks. The initial focus of the Robotics Industry Committee will be on the application of robotics systems to the various industries that are represented within the IAS.

  10. Patient Positioning and Port Placement for Robot-Assisted Surgery

    PubMed Central

    Chang, Charles; Steinberg, Zoe; Shah, Anup

    2014-01-01

    Abstract The introduction of robotic surgical systems and their integration into minimally invasive procedures have changed the landscape of laparoscopic surgery dramatically. Intuitive Surgical's da Vinci Surgical System was first approved by the Food and Drug Administration for cardiothoracic procedures in the late 1990s. This trend quickly spread through other surgical specialties, with urologists as one of the frontrunners in adoption. Subsequently, pediatric urologists have adopted robot-assisted procedures in selected centers, performing procedures such as pyeloplasty for ureteropelvic junction obstruction, partial and complete nephrectomy, and both intravesical and extravesical ureteral reimplantation. In this article, we will discuss technical considerations related to patient positioning and port placement in pediatric robot-assisted surgery. PMID:24548088

  11. Robotics

    NASA Technical Reports Server (NTRS)

    1985-01-01

    An overview of research being done into the use of robotic devices in space by MSFC is discussed. The video includes footage and explanations of robots being used to blast layers of thermal coating from the Space Shuttle's external tanks, the Shuttle's Remote Manipulator Arm, and animations of an Orbiting Maneuvering Vehicle to retrieve and repair satellites.

  12. Intraureteral and intravenous indocyanine green to facilitate robotic partial nephroureterectomy in a patient with complete ureteral triplication

    PubMed Central

    Lee, Matthew; Lee, Ziho

    2015-01-01

    A patient with a complete right ureteral triplication presented with recurrent pyelonephritis and flank pain that was refractory to medical management. Evaluation showed that the atrophic upper-most renal moiety had been chronically obstructed and was associated with a dilated ureter. Intraureteral and intravenous indocyanine green (ICG) were used as real-time contrast agents intraoperatively to facilitate right robotic partial nephroureterectomy of the diseased system. Intraureteral ICG was used to accurately distinguish the pathologic ureter and associated renal pelvis from its normal counterparts. Intravenous ICG was used to assess perfusion in the right kidney and delineate the margins of diseased renal parenchyma. PMID:26078846

  13. Symplastic glomus tumor of the urinary bladder treated by robot-assisted partial cystectomy: a case report and literature review.

    PubMed

    Palmisano, Franco; Gadda, Franco; Spinelli, Matteo G; Maggioni, Marco; Rocco, Bernardo; Montanari, Emanuele

    2017-01-16

    Glomus tumors arising in the urinary bladder are extremely rare, and only two cases have been reported in the English Literature. We present a case of a 58-year-old man with an asymptomatic mass of the anterior wall of the bladder that measured 2.5 × 2.5 cm. Endoscopic excision was performed, and the tumor was diagnosed as symplastic glomus tumor. The patient finally underwent robotic-assisted partial cystectomy, and he remains healthy without any recurrence to date.After reviewing this case and previous reports, we analyzed the clinicopathologic features and treatment options for this rare neoplasm.

  14. Laparoscopic donor nephrectomy versus open donor nephrectomy: recipient's perspective.

    PubMed

    Jamale, Tukaram E; Hase, Niwrutti K; Iqbal, Anwar M

    2012-11-01

    Effects of laparoscopic donor nephrectomy (LDN) on graft function, especially early post-transplant, have been controversial. To assess and compare early and late graft function in kidneys procured by open and laparoscopic methods, a retrospective observational study was carried out on 37 recipients-donors who underwent LDN after introduction of this technique in February 2007 at our center, a tertiary care nephrology referral center. Demographic, immunological and intraoperative variables as well as immunosuppressive protocols and number of human leukocyte antigen (HLA) mismatches were noted. Early graft function was assessed by serum creatinine on Days two, five, seven, 14 and 28 and at the time of discharge. Serum creatinine values at three months and at one year post-transplant were considered as the surrogates of late graft function. Data obtained were compared with the data from 33 randomly selected kidney transplants performed after January 2000 by the same surgical team, in whom open donor nephrectomy was used. Pearson's chi square test, Student's t test and Mann-Whitney U test were used for statistical analysis. Early graft function (serum creatinine on Day five 2.15 mg/dL vs 1.49 mg/dL, P = 0.027) was poorer in the LDN group. Late graft function as assessed by serum creatinine at three months (1.45 mg/dL vs 1.31 mg/dL, P = 0.335) and one year (1.56 mg/dL vs 1.34 mg/dL, P = 0.275) was equivalent in the two groups. Episodes of early acute graft dysfunction due to acute tubular necrosis were significantly higher in the LDN group (37.8% vs 12.1%, Z score 2.457, P = 0.014). Warm ischemia time was significantly prolonged in the LDN group (255 s vs 132.5 s, P = 0.002). LDN is associated with slower recovery of graft function and higher incidence of early acute graft dysfunction due to acute tubular necrosis. Late graft function at one year is however comparable.

  15. Risk-adjusted outcomes in Medicare inpatient nephrectomy patients

    PubMed Central

    Fry, Donald E.; Pine, Michael; Nedza, Susan M.; Locke, David G.; Reband, Agnes M.; Pine, Gregory

    2016-01-01

    Abstract Without risk-adjusted outcomes of surgical care across both the inpatient and postacute period of time, hospitals and surgeons cannot evaluate the effectiveness of current performance in nephrectomy and other operations, and will not have objective metrics to gauge improvements from care redesign efforts. We compared risk-adjusted hospital outcomes following elective total and partial nephrectomy to demonstrate differences that can be used to improve care. We used the Medicare Limited Dataset for 2010 to 2012 for total and partial nephrectomy for benign and malignant neoplasms to create prediction models for the adverse outcomes (AOs) of inpatient deaths, prolonged length-of-stay outliers, 90-day postdischarge deaths without readmission, and 90-day relevant readmissions. From the 4 prediction models, total predicted adverse outcomes were determined for each hospital in the dataset that met a minimum of 25 evaluable cases for the study period. Standard deviations (SDs) for each hospital were used to identify specific z-scores. Risk-adjusted adverse outcomes rates were computed to permit benchmarking each hospital's performance against the national standard. Differences between best and suboptimal performing hospitals defined the potential margin of preventable adverse outcomes for this operation. A total of 449 hospitals with 23,477 patients were evaluated. Overall AO rate was 20.8%; 17 hospitals had risk-adjusted AO rates that were 2 SDs poorer than predicted and 8 were 2 SDs better. The top performing decile of hospitals had a risk-adjusted AO rate of 10.2% while the lowest performing decile had 32.1%. With a minimum of 25 cases for each study hospital, no statistically valid improvement in outcomes was seen with increased case volume. Inpatient and 90-day postdischarge risk-adjusted adverse outcomes demonstrated marked variability among study hospitals and illustrate the opportunities for care improvement. This analytic design is applicable for comparing

  16. Risk-adjusted outcomes in Medicare inpatient nephrectomy patients.

    PubMed

    Fry, Donald E; Pine, Michael; Nedza, Susan M; Locke, David G; Reband, Agnes M; Pine, Gregory

    2016-09-01

    Without risk-adjusted outcomes of surgical care across both the inpatient and postacute period of time, hospitals and surgeons cannot evaluate the effectiveness of current performance in nephrectomy and other operations, and will not have objective metrics to gauge improvements from care redesign efforts.We compared risk-adjusted hospital outcomes following elective total and partial nephrectomy to demonstrate differences that can be used to improve care. We used the Medicare Limited Dataset for 2010 to 2012 for total and partial nephrectomy for benign and malignant neoplasms to create prediction models for the adverse outcomes (AOs) of inpatient deaths, prolonged length-of-stay outliers, 90-day postdischarge deaths without readmission, and 90-day relevant readmissions. From the 4 prediction models, total predicted adverse outcomes were determined for each hospital in the dataset that met a minimum of 25 evaluable cases for the study period. Standard deviations (SDs) for each hospital were used to identify specific z-scores. Risk-adjusted adverse outcomes rates were computed to permit benchmarking each hospital's performance against the national standard. Differences between best and suboptimal performing hospitals defined the potential margin of preventable adverse outcomes for this operation.A total of 449 hospitals with 23,477 patients were evaluated. Overall AO rate was 20.8%; 17 hospitals had risk-adjusted AO rates that were 2 SDs poorer than predicted and 8 were 2 SDs better. The top performing decile of hospitals had a risk-adjusted AO rate of 10.2% while the lowest performing decile had 32.1%. With a minimum of 25 cases for each study hospital, no statistically valid improvement in outcomes was seen with increased case volume.Inpatient and 90-day postdischarge risk-adjusted adverse outcomes demonstrated marked variability among study hospitals and illustrate the opportunities for care improvement. This analytic design is applicable for comparing provider

  17. The morbidity of trauma nephrectomy.

    PubMed

    Edwards, Norma M; Claridge, Jeffrey A; Forsythe, Raquel M; Weinberg, Jordan A; Croce, Martin A; Fabian, Timothy C

    2009-11-01

    Mortality has been shown to be high in patients after trauma nephrectomy (TN). However, there are little data regarding morbidity in survivors. The objective of this study was to determine the morbidity rates associated with TN with attention directed to renal failure (RF) and formation of intra-abdominal abscess (IAA). Patients who underwent TN over a 9-year period (1996 to 2004) were identified from the trauma registry. Records were reviewed for all complications after TN in patients surviving at least 48 hours. Eighty-nine patients were identified with TN; 61 per cent resulted after penetrating trauma. Overall mortality was 34 per cent. Seventy-one patients survived greater than 48 hours; 51 (72%) experienced at least one morbidity. There was no difference in morbidity rates between patients undergoing blunt trauma and those undergoing penetrating trama. Patients with morbidities were significantly older, more severely injured, and had higher mortality rates and longer hospital courses. Infectious complications were seen in 52 per cent, respiratory in 48 per cent, gastrointestinal in 30 per cent, coagulopathy in 25 per cent, and RF and IAA were each seen in 14 per cent of patients. Patients undergoing TN are severely injured with significant morbidity. The results from this study allow us to establish benchmarks to assess complication rates for patients who undergo TN, which can provide prognostic information and goals to improve patient outcomes.

  18. Robotics

    NASA Technical Reports Server (NTRS)

    Ambrose, Robert O.

    2007-01-01

    Lunar robotic functions include: 1. Transport of crew and payloads on the surface of the moon; 2. Offloading payloads from a lunar lander; 3. Handling the deployment of surface systems; with 4. Human commanding of these functions from inside a lunar vehicle, habitat, or extravehicular (space walk), with Earth-based supervision. The systems that will perform these functions may not look like robots from science fiction. In fact, robotic functions may be automated trucks, cranes and winches. Use of this equipment prior to the crew s arrival or in the potentially long periods without crews on the surface, will require that these systems be computer controlled machines. The public release of NASA's Exploration plans at the 2nd Space Exploration Conference (Houston, December 2006) included a lunar outpost with as many as four unique mobility chassis designs. The sequence of lander offloading tasks involved as many as ten payloads, each with a unique set of geometry, mass and interface requirements. This plan was refined during a second phase study concluded in August 2007. Among the many improvements to the exploration plan were a reduction in the number of unique mobility chassis designs and a reduction in unique payload specifications. As the lunar surface system payloads have matured, so have the mobility and offloading functional requirements. While the architecture work continues, the community can expect to see functional requirements in the areas of surface mobility, surface handling, and human-systems interaction as follows: Surface Mobility 1. Transport crew on the lunar surface, accelerating construction tasks, expanding the crew s sphere of influence for scientific exploration, and providing a rapid return to an ascent module in an emergency. The crew transport can be with an un-pressurized rover, a small pressurized rover, or a larger mobile habitat. 2. Transport Extra-Vehicular Activity (EVA) equipment and construction payloads. 3. Transport habitats and

  19. Robotics

    NASA Technical Reports Server (NTRS)

    Rothschild, Lynn J.

    2012-01-01

    Earth's upper atmosphere is an extreme environment: dry, cold, and irradiated. It is unknown whether our aerobiosphere is limited to the transport of life, or there exist organisms that grow and reproduce while airborne (aerophiles); the microenvironments of suspended particles may harbor life at otherwise uninhabited altitudes[2]. The existence of aerophiles would significantly expand the range of planets considered candidates for life by, for example, including the cooler clouds of a hot Venus-like planet. The X project is an effort to engineer a robotic exploration and biosampling payload for a comprehensive survey of Earth's aerobiology. While many one-shot samples have been retrieved from above 15 km, their results are primarily qualitative; variations in method confound comparisons, leaving such major gaps in our knowledge of aerobiology as quantification of populations at different strata and relative species counts[1]. These challenges and X's preliminary solutions are explicated below. X's primary balloon payload is undergoing a series of calibrations before beginning flights in Spring 2012. A suborbital launch is currently planned for Summer 2012. A series of ground samples taken in Winter 2011 is being used to establish baseline counts and identify likely background contaminants.

  20. From Leonardo to da Vinci: the history of robot-assisted surgery in urology.

    PubMed

    Yates, David R; Vaessen, Christophe; Roupret, Morgan

    2011-12-01

    What's known on the subject? and What does the study add? Numerous urological procedures can now be performed with robotic assistance. Though not definitely proven to be superior to conventional laparoscopy or traditional open surgery in the setting of a randomised trial, in experienced centres robot-assisted surgery allows for excellent surgical outcomes and is a valuable tool to augment modern surgical practice. Our review highlights the depth of history that underpins the robotic surgical platform we utilise today, whilst also detailing the current place of robot-assisted surgery in urology in 2011. The evolution of robots in general and as platforms to augment surgical practice is an intriguing story that spans cultures, continents and centuries. A timeline from Yan Shi (1023-957 bc), Archytas of Tarentum (400 bc), Aristotle (322 bc), Heron of Alexandria (10-70 ad), Leonardo da Vinci (1495), the Industrial Revolution (1790), 'telepresence' (1950) and to the da Vinci(®) Surgical System (1999), shows the incredible depth of history and development that underpins the modern surgical robot we use to treat our patients. Robot-assisted surgery is now well-established in Urology and although not currently regarded as a 'gold standard' approach for any urological procedure, it is being increasingly used for index operations of the prostate, kidney and bladder. We perceive that robotic evolution will continue infinitely, securing the place of robots in the history of Urological surgery. Herein, we detail the history of robots in general, in surgery and in Urology, highlighting the current place of robot-assisted surgery in radical prostatectomy, partial nephrectomy, pyeloplasty and radical cystectomy.

  1. Robot-assisted partial cystectomy with intraoperative frozen section examination: Evolution and evaluation of a novel technique

    PubMed Central

    Klett, Dane E.; Abdollah, Firas; Sammon, Jesse D.; Pucheril, Dan; Menon, Mani; Jeong, Wooju; Peabody, James O.

    2016-01-01

    Purpose To describe a novel modification to robot-assisted partial cystectomy (RAPC) that allows for intraoperative surgical margin assessment by bimanual-examination and frozen-section analysis. Materials and Methods A total of 7 patients underwent RAPC at a single tertiary-care institution between 2008 and 2013. The technique evolved over the study-period and permitted real-time intraoperative surgical margin evaluation in the last 5 patients via bimanual-examination and frozen-section analysis, utilizing the GelPOINT platform (a hand-assist device). The GelPOINT platform was placed through a 4- to 5-cm vertical supraumbilical incision and allowed for rapid retrieval of the bladder specimen without compromising the pneumoperitoneum or prolonging the operative time. Perioperative, oncological and functional outcomes were evaluated; all patients had a minimum 12-month follow-up. At the time of last follow-up, a cross-sectional survey of patients was performed to evaluate regret/satisfaction utilizing validated questionnaires. Results The mean age was 72.5 years; 71.4% of the patients were men (n=5). All patients underwent RAPC for a malignant indication. The mean operative and console times were 291 and 217 minutes, respectively. No patient had a positive surgical margin. Mean length-of-stay was 1.7 days. At a median follow-up of 38.9 months, 1 patient experienced a local recurrence 6 months postsurgery. The only mortality was secondary to Lewy-body disease, in the same patient, 1 year postoperatively. Patient assessment of regret and satisfaction indicated 0% regret and 0% dissatisfaction. Conclusions The 'modified' technique of RAPC is technically feasible, safe, and reproducible; further, RAPC leads to favorable oncological, functional and quality-of-life outcomes in patients eligible for partial cystectomy. PMID:27195322

  2. Dosimetric Comparison Between 3-Dimensional Conformal and Robotic SBRT Treatment Plans for Accelerated Partial Breast Radiotherapy.

    PubMed

    Goggin, L M; Descovich, M; McGuinness, C; Shiao, S; Pouliot, J; Park, C

    2016-06-01

    Accelerated partial breast irradiation is an attractive alternative to conventional whole breast radiotherapy for selected patients. Recently, CyberKnife has emerged as a possible alternative to conventional techniques for accelerated partial breast irradiation. In this retrospective study, we present a dosimetric comparison between 3-dimensional conformal radiotherapy plans and CyberKnife plans using circular (Iris) and multi-leaf collimators. Nine patients who had undergone breast-conserving surgery followed by whole breast radiation were included in this retrospective study. The CyberKnife planning target volume (PTV) was defined as the lumpectomy cavity + 10 mm + 2 mm with prescription dose of 30 Gy in 5 fractions. Two sets of 3-dimensional conformal radiotherapy plans were created, one used the same definitions as described for CyberKnife and the second used the RTOG-0413 definition of the PTV: lumpectomy cavity + 15 mm + 10 mm with prescription dose of 38.5 Gy in 10 fractions. Using both PTV definitions allowed us to compare the dose delivery capabilities of each technology and to evaluate the advantage of CyberKnife tracking. For the dosimetric comparison using the same PTV margins, CyberKnife and 3-dimensional plans resulted in similar tumor coverage and dose to critical structures, with the exception of the lung V5%, which was significantly smaller for 3-dimensional conformal radiotherapy, 6.2% when compared to 39.4% for CyberKnife-Iris and 17.9% for CyberKnife-multi-leaf collimator. When the inability of 3-dimensional conformal radiotherapy to track motion is considered, the result increased to 25.6%. Both CyberKnife-Iris and CyberKnife-multi-leaf collimator plans demonstrated significantly lower average ipsilateral breast V50% (25.5% and 24.2%, respectively) than 3-dimensional conformal radiotherapy (56.2%). The CyberKnife plans were more conformal but less homogeneous than the 3-dimensional conformal radiotherapy plans. Approximately 50% shorter

  3. Commentary on "Laparoendoscopic single-site (LESS) partial nephrectomy short-term outcomes." Rais-Bahrami S, George AK, Montag S, Okhunov Z, Richstone L, The Arthur Smith Institute for Urology, Hofstra North Shore-LIJ School of Medicine, New Hyde Park, NY: BJU Int 2012 (Epub ahead of print).

    PubMed

    Meng, Maxwell V

    2013-01-01

    Study type-therapy (case series). Level of evidence 4. What's known on the subject and what does the study add? Laparoendoscopic single-site (LESS) surgery has been used by urologists for a broad-range of operations including LESS partial nephrectomy (LESS-PN). To date, experiences of LESS-PN have been presented as small series or as a subset of larger heterogeneous operative experiences, which have shown the overall feasibility and safety of this novel technique. We report our experience with LESS-PN with complete pathologic resection and excellent short-term oncologic and renal functional outcomes in the select patient-population who underwent this minimally invasive approach. To present our experience of transumbilical LESS-PN with pathologic and short-term oncologic and renal functional outcomes. In all, 15 LESS-PNs were performed for cT1a tumors between July 2008 and August 2011 by 1 surgeon. All patients underwent transumbilical LESS using a 5mm flexible-tip laparoscope and a combination of flexible and conventional laparoscopic instruments. The technique for transperitoneal LESS-PN otherwise replicated conventional laparoscopic PN. Demographic, perioperative, and postoperative variables were recorded and analyzed. Of the 14 patients (8 men), undergoing 15 distinct LESS-PN, the mean (sd) age was 57.9 (8.7) years and the mean (sd, range) tumor size resected was 2.4 (0.8; 1.2-4.0). There were 12 renal cell carcinomas, 2 angiomyolipomas, and 2 metanephric adenomas on final pathology, all with negative margins. The mean (sd) operative duration was 169 (47) minutes with a mean (sd, range) warm ischemia time of 14.7 (13.4; 0-37) minutes; bull-dog clamps were used for hilar-control in 9 cases with the remaining 6 cases done without hilar vascular clamping. The mean (sd) estimated blood loss in this series was 293 (325)ml (median 200ml) and no cases required intraoperative or postoperative blood transfusions. The mean (sd) hospital stay was 2.7 (0.8) days and mean

  4. Retroperitoneoscopic nephrectomy for benign nonfunctioning kidneys: Training and outcome

    PubMed Central

    Saifee, Yusuf; Nagarajan, Ramya; Qadri, Syed Javed; Sarmah, Amlan; Kumar, Suresh; Pal, Bipin Chandra; Modi, Pranjal

    2016-01-01

    Introduction: Between the two techniques of laparoscopic nephrectomy, retroperitoneoscopy has certain distinct advantages over transperitoneal access but may be a more difficult technique to learn. We present our experience of training novices in retroperitoneoscopic nephrectomy with a good outcome, making it a standard of care for nephrectomy at our institute. Methods: The aim of this study was to report the initial experience, learning curve, and outcome of retroperitoneoscopic nephrectomy by novices under a mentored approach. The series included four novice urologists. The data from the initial forty retroperitoneoscopic nephrectomies performed by each of them were reviewed. Results: Retroperitoneoscopic nephrectomies were successfully completed by novices in 88.1% (141/160) of the patients. Nine cases (5.6%) required the mentor's help because of nonprogression, and ten cases (6%) required conversion to open nephrectomy. The median operative time of all surgeons decreased with increased surgical experience. There was some intersurgeon variation in the learning curve ranging from 10 to 30 cases, but all surgeons showed a significant reduction in operative time across consecutive sets of ten cases. Seven cases required mentor help in the initial series (7/80) and only two in later half of cases (2/80). All minor complications were also significantly less in the later series. Conclusions: The present series represents the effectiveness of training in retroperitoneoscopic nephrectomy of novices by a responsible team and with the standard protocol and surgical steps. Through effective mentoring, the steep learning curve associated with retroperitoneoscopic nephrectomy has been overcome, making it standard of care for nephrectomy at our institute. PMID:27843214

  5. Preparedness in robotically assisted interventions.

    PubMed

    Coste-Manière, Eve; Adhami, Louaï; Antiphon, Patrick; Abbou, Clément-Claude

    2003-04-01

    For many years, robots have been used in manufacturing to perform a variety of delicate tasks. Their use is now being generalized to other fields, such as biology, domestic applications, and especially medicine, in which they are poised to make a significant contribution. This evolution comes from the progress made in the field of robotics and from recent changes in medical and surgical techniques, namely, developments in medical imaging and a new desire for minimally invasive interventions. This emerging combination of high-precision robotic manipulators, new medical diagnostic techniques, and efficient minimally invasive surgery has not yet been perfected. After a brief discussion of state-of-the-art robotic systems used in urology, this article discusses new challenges presented by robotic minimally invasive surgery. A computer-integrated approach aimed at increasing the efficiency of such interventions through better preparedness is presented. This approach is illustrated by a case study in human nephrectomy and a cardiac animal experiment.

  6. Nonfunctioning Renal Allograft Embolization as an Alternative to Graft Nephrectomy: Report on Seven Years' Experience

    SciTech Connect

    Atar, Eli; Belenky, Alexander; Neuman-Levin, Margalit; Yussim, A.; Bar-Nathan, Nathan; Bachar, Gil N.

    2003-02-15

    Purpose: Graft nephrectomy is the treatment of choice in patients with graft intolerance syndrome, but it is associated with high morbidity and mortality rates. Renal vascular embolization has been suggested as a possible alternative. The aim of this study was to evaluate the efficacy and safety of arterial embolization of these nonfunctioning transplanted kidneys. Methods: Twenty-six transplanted kidneys in 25 patients with irreversible renal graft rejection and graft intolerance who underwent arterial embolization at our center from August 1994 to April 2001 we reanalyzed for procedural success and long-term outcome. Embolization was performed with absolute alcohol or with polyvinyl alcohol (Ivalon) and coils. Results: Twenty-four of the 26 (92%) procedures were technically successful, but in one patient only partial occlusion of one of two renal arteries was achieved, and in another the renal artery was already completely occluded. There were two major complications: emphysematous pyelonephritis necessitating nephrectomy and groin abscess that was drained. Follow-up ranged from 8 to 84 months. Clinical success was achieved in 24 of the 26 procedures(92%), and only in one patient did embolization fail to relieve the symptoms, and nephrectomy was performed 3 months later. Conclusion: Renal vascular embolization is a simple, safe and effective technique for the treatment of nonfunctioning renal allografts associated with graft intolerance syndrome. We suggest that it be considered the treatment of choice.

  7. Visual enhancement of laparoscopic nephrectomies using the 3-CCD camera

    NASA Astrophysics Data System (ADS)

    Crane, Nicole J.; Kansal, Neil S.; Dhanani, Nadeem; Alemozaffar, Mehrdad; Kirk, Allan D.; Pinto, Peter A.; Elster, Eric A.; Huffman, Scott W.; Levin, Ira W.

    2006-02-01

    Many surgical techniques are currently shifting from the more conventional, open approach towards minimally invasive laparoscopic procedures. Laparoscopy results in smaller incisions, potentially leading to less postoperative pain and more rapid recoveries . One key disadvantage of laparoscopic surgery is the loss of three-dimensional assessment of organs and tissue perfusion. Advances in laparoscopic technology include high-definition monitors for improved visualization and upgraded single charge coupled device (CCD) detectors to 3-CCD cameras, to provide a larger, more sensitive color palette to increase the perception of detail. In this discussion, we further advance existing laparoscopic technology to create greater enhancement of images obtained during radical and partial nephrectomies in which the assessment of tissue perfusion is crucial but limited with current 3-CCD cameras. By separating the signals received by each CCD in the 3-CCD camera and by introducing a straight forward algorithm, rapid differentiation of renal vessels and perfusion is accomplished and could be performed real time. The newly acquired images are overlaid onto conventional images for reference and comparison. This affords the surgeon the ability to accurately detect changes in tissue oxygenation despite inherent limitations of the visible light image. Such additional capability should impact procedures in which visual assessment of organ vitality is critical.

  8. Robot-Assisted Laparoscopic Renal Schwannoma Excision.

    PubMed

    Kelley, Jeremy; Collins, Ryan; Allam, Christopher

    2016-01-01

    Background: To report the first case of a renal schwannoma excised with robot-assisted laparoscopy. Case Presentation: A 43-year-old Caucasian female patient with vague abdominal symptoms was noted to have incidental right renal mass. Physical examination and laboratory tests were within normal limits. CT revealed a 4.6 cm heterogeneous enhancing right renal mass arising near the hilum. RENAL nephrometry score was 11a. She was treated by right robot-assisted laparoscopic nephrectomy. She recovered well without complications. Pathology analysis revealed a benign renal schwannoma. Conclusion: Renal schwannoma is a rare kidney tumor. We report the first known case of this tumor excised by robot-assisted laparoscopic nephrectomy.

  9. Robot-Assisted Laparoscopic Renal Schwannoma Excision

    PubMed Central

    Kelley, Jeremy; Collins, Ryan

    2016-01-01

    Abstract Background: To report the first case of a renal schwannoma excised with robot-assisted laparoscopy. Case Presentation: A 43-year-old Caucasian female patient with vague abdominal symptoms was noted to have incidental right renal mass. Physical examination and laboratory tests were within normal limits. CT revealed a 4.6 cm heterogeneous enhancing right renal mass arising near the hilum. RENAL nephrometry score was 11a. She was treated by right robot-assisted laparoscopic nephrectomy. She recovered well without complications. Pathology analysis revealed a benign renal schwannoma. Conclusion: Renal schwannoma is a rare kidney tumor. We report the first known case of this tumor excised by robot-assisted laparoscopic nephrectomy. PMID:27872900

  10. Comparison of Acute and Chronic Pain after Open Nephrectomy versus Laparoscopic Nephrectomy: A Prospective Clinical Trial.

    PubMed

    Alper, Isik; Yüksel, Esra

    2016-04-01

    We evaluated postoperative pain intensity and the incidence of chronic pain in patients with renal cell carcinoma undergoing laparoscopic or open radical nephrectomy. In this prospective study, 27 laparoscopic nephrectomy (Group LN) and 25 open nephrectomy (Group ON) patients were included. All patients received paracetamol infusion and intramuscular morphine 30 minutes before the end of the operation and intravenous patient controlled analgesia with morphine postoperatively. Data including patients' demographics, visual analog scale (VAS) pain scores at postoperative 0.5, 1, 2, 4, 6, 12, and 24 hours, postoperative morphine consumption, analgesic demand, analgesic delivery, number of patients requiring rescue analgesics, side effects because of analgesic medications, and overall patient satisfaction were recorded and compared between the two groups. Two and 6 months after the operation, patients were evaluated for chronic postsurgical pain (CPSP). Postoperative average VAS pain scores were not different between the two groups. However, only at 2 hours postoperatively, pain score was significantly higher in Group ON than in Group LN. In both groups, the highest pain scores were recorded at 30 minutes and 1 hour after surgery. Ninety-six percent of group ON patients and 88% of group LN patients required additional analgesia in the early postoperative period (P = 0.33). Postoperative morphine consumption and analgesic demand were found to be similar between the two groups. CPSP at 2 months after surgery was observed in 4 out of 25 patients (16%) in the ON group and 3 out of 27 patients (11.1%) in the LN group (P = 0.6). Chronic pain at 6 months after surgery was observed in 1 ON patient (4%) and 1 LN patient (3.7%, P = 0.9). This study demonstrated that postoperative acute pain scores were not different after laparoscopic or open nephrectomy and patients undergoing laparoscopic or open nephrectomy were at equal risk of developing CPSP. Pain control

  11. Cost comparison of open approach, transoral laser microsurgery and transoral robotic surgery for partial and total laryngectomies.

    PubMed

    Dombrée, Manon; Crott, Ralph; Lawson, Georges; Janne, Pascal; Castiaux, Annick; Krug, Bruno

    2014-10-01

    Activity-based costing is used to give a better insight into the actual cost structure of open, transoral laser microsurgery (TLM) and transoral robotic surgery (TORS) supraglottic and total laryngectomies. Cost data were obtained from hospital administration, personnel and vendor structured interviews. A process map identified 17 activities, to which the detailed cost data are related. One-way sensitivity analyses on the patient throughput, the cost of the equipment or operative times were performed. The total cost for supraglottic open (135-203 min), TLM (110-210 min) and TORS (35-130 min) approaches were 3,349 euro (3,193-3,499 euro), 3,461 euro (3,207-3,664 euro) and 5,650 euro (4,297-5,974 euro), respectively. For total laryngectomy, the overall cost were 3,581 euro (3,215-3,846 euro) for open and 6,767 euro (6,418-7,389 euro) for TORS. TORS cost is mostly influenced by equipment (54%) where the other procedures are predominantly determined by personnel cost (about 45%). Even when we doubled the yearly case-load, used the shortest operative times or a calculation without robot equipment costs we did not reach cost equivalence. TORS is more expensive than standard approaches and mainly influenced by purchase and maintenance costs and the use of proprietary instruments. Further trials on long-term outcomes and costs following TORS are needed to evaluate its cost-effectiveness.

  12. Comparison of renal function after donor and radical nephrectomy.

    PubMed

    Gazel, Eymen; Biçer, Sait; Ölçücüoğlu, Erkan; Yığman, Metin; Taştemur, Sedat; Çamtosun, Ahmet; Ceylan, Cavit; Ateş, Can

    2015-04-01

    Glomerular filtration rate (GFR) is directly proportionate to nephron reserves. In this respect, it is known that the patients who underwent radical nephrectomy due to renal tumor are under high risk of chronic kidney disease (CKD) in the long term. In this study, it was aimed to compare post-operative renal functions of patients who underwent radical nephrectomy due to renal malignancy and who underwent donor nephrectomy as renal donors, to observe whether renal failure process develops or not, and to determine the factors that affect post-operative renal functions. 70 patients who underwent donor nephrectomy as renal donors and 130 patients who underwent radical nephrectomy due to renal tumor were studied. When we divided the groups as those with a GFR of below 60 mL/min/1.73 m(2) and those with a GFR of above 60 mL/min/1.73 m(2), we observed that GFR values of patients who underwent radical nephrectomy had a significantly stronger tendency to stay below 60 mL/min/1.73 m(2) compared to patients who underwent donor nephrectomy (p < 0.001). When we divided the groups as those with a GFR of below 30 mL/min/1.73 m(2) and those with a GFR of above 30 mL/min/1.73 m(2), we observed that there were no patients in donor nephrectomy group whose GFR values dropped below 30 mL/min/1.73 m(2) and there was not a statistically significant difference between the groups (p = 0.099). If possible, nephron sparing methods should be preferred for patients to undergo nephrectomy because of the tumor without ignoring oncologic results and it should be remembered that patient's age and pre-operative renal functions may affect post-operative results in donor selection.

  13. [RADICAL LAPAROSCOPIC NEPHRECTOMY WITH INFERIOR VENA CAVA THROMBECTOMY].

    PubMed

    Perlin, D V; Aleksandrov, I V; Zipunnikov, V P; Ljaljuev, A M

    2015-01-01

    Laparoscopic radical nephrectomy has proven itself as the "gold standard" treatment of renal cell carcinoma. Inferior vena cava (IVC) tumor thrombus is a complicating factor that occurs in 5% to 10% of patients with renal cell carcinoma. In world literature, there are only anecdotal reports on using laparoscopic approach for IVC thrombectomy in patients with renal cell carcinoma. Herein we report our experience of laparoscopic radical nephrectomy and thrombectomy of the level II tumor thrombus in the IVC. Two patients (79-year-old female and 48-year-old male) underwent radical nephrectomy with thrombectomy from IVC for renal cell carcinoma T3bNxM0 complicated by the formation of a tumor thrombus in the IVC. To do this, IVC was isolated, the right gonadal and lumbar veins were ligated and transected. The IVC and the left renal vein blood flow were controlled with a plastic clip and Satinski clamp. After thrombectomy and resection of the IVC, the wall the defect was sutured with continuous Prolene suture. Laparoscopic radical nephrectomy with thrombectomy without conversion to open surgery was successfully carried out in both patients. During 6-18 months follow-up no local recurrence or distant metastasis were observed. Laparoscopic radical nephrectomy with thrombectomy for renal cell carcinoma complicated with tumor thrombus level II is a safe and reproducible method, which can be applied to a specific population of patients.

  14. [Pneumothorax during right-sided nephrectomy in a heifer].

    PubMed

    Nuss, K; Muggli, E; Gerspach, C; Schramm, S; Dettwiler, M; Bach, F; Ringer, S

    2016-01-01

    A 250-kg heifer had signs of colic attributable to urolithiasis of the right kidney. Medical treatment did not result in resolution of clinical signs, and nephrectomy was carried out. The surgery was started with the heifer standing, and the 13th rib was resected. However, during blunt dissection of the kidney, air suddenly entered the pleural space and the heifer had acute severe dyspnoea. The hole in the pleural cavity was sutured and a chest drain was placed. Inhalation anaesthesia was then induced and nephrectomy could be completed without further complications. The heifer was discharged 11 days postoperatively, and was healthy and had been integrated into the herd 12 months after surgery. Pneumothorax must be considered a possible complication of rib resection in right-sided nephrectomy in cattle.

  15. Exploratorium: Robots.

    ERIC Educational Resources Information Center

    Brand, Judith, Ed.

    2002-01-01

    This issue of Exploratorium Magazine focuses on the topic robotics. It explains how to make a vibrating robotic bug and features articles on robots. Contents include: (1) "Where Robot Mice and Robot Men Run Round in Robot Towns" (Ray Bradbury); (2) "Robots at Work" (Jake Widman); (3) "Make a Vibrating Robotic Bug" (Modesto Tamez); (4) "The Robot…

  16. Training techniques in laparoscopic donor nephrectomy: a systematic review.

    PubMed

    Raque, Jessica; Billeter, Adrian T; Lucich, Elizabeth; Marvin, Michael M; Sutton, Erica

    2015-10-01

    The learning curve to achieve competency in laparoscopic donor nephrectomy (LDN) is poorly outlined. Online databases were searched for training in LDN. Abstracts and manuscripts were excluded if they did not address introduction of a laparoscopic technique for donor nephrectomy. Relevant manuscripts were reviewed for surgical technique, use of animal models, co-surgeons, surgeon specialty and training, institution type/volume, and assessment of training method. Forty-four met inclusion criteria, with 75% describing the evolution from open to LDN. Eighty-two percent were from academic centers, and 36% were from centers performing <25 donor nephrectomies each year. The learner was an attending surgeon 80% of the time, mostly urologists with prior laparoscopy or open nephrectomy experience. The learning curve, defined by decreased operating time, averaged 35 cases. Improved intra-operative, patient, and recipient outcomes were observed for centers performing ≥50 LDNs annually. The United Network of Organ Sharing requires 15 cases as surgeon or assistant to be certified as the primary LDN surgeon. This falls below the described learning curve for LDN. The assessment of training and competency for LDN is heterogeneous, and objective learner-based metrics could help surgeons and institutions reach a quality standard for performing this operation.

  17. [Right renal arteriovenous fistula after nephrectomy with streptococcal endarteritis].

    PubMed

    Natali, J; Emerit, J; Reynier, P; Maraval, M

    1975-01-18

    The authors add a new case, to the 41 already published, of arterio-venous fistula of the renal pedicle after nephrectomy, with the peculiarity of its presentation as a prolonged fever resulting from streptococcal bacterial endarteritis at the site of the fistula (3rd case in the literature). Surgical treatment in association with massive and prolonged antibiotic therapy resulted in recovery.

  18. Robotic surgery

    MedlinePlus

    Robot-assisted surgery; Robotic-assisted laparoscopic surgery; Laparoscopic surgery with robotic assistance ... computer station and directs the movements of a robot. Small surgical tools are attached to the robot's ...

  19. Hybrid Transureteral Nephrectomy in a Survival Porcine Model

    PubMed Central

    Anderson, Kirk M.; Alsyouf, Muhannad; Richards, Gideon; Agarwal, Gautum; Heldt, Jonathan P.; Schlaifer, Amy E.

    2014-01-01

    Background and Objectives: Natural-orifice approaches for nephrectomy have included access via the stomach, vagina, bladder, and rectum. Recently, the feasibility of using the ureter as a natural orifice for natural-orifice transluminal endoscopic surgery nephrectomy has been demonstrated in a nonsurvival porcine model. The purpose of this study was to assess the outcomes of transureteral laparoscopic natural-orifice transluminal endoscopic surgery nephrectomy in a survival porcine model. Methods: Three pigs underwent hybrid transureteral natural-orifice transluminal endoscopic surgery nephrectomy. An experimental balloon/dilating sheath was inserted over a wire to dilate the urethra, ureteral orifice, and ureter. Through a bariatric 12-mm laparoscopic port, the ureter was opened medially and the hilar dissection was performed. Next, 2 needlescopic ports were placed transabdominally to facilitate hilar transection. The kidney was morcellated using a bipolar sealing device and extracted via the ureter using the housing of a bariatric stapling device. The ureteral orifice was closed with a laparoscopic suturing device. The bladder was drained by a catheter for 10 to 14 days postoperatively. Pigs were euthanized on postoperative day 21. Results: All surgical procedures were successfully completed, with no intraoperative complications. One pig had an episode of postoperative clot retention that resolved with catheter irrigation. Each pig was healthy and eating a normal diet prior to euthanasia. Conclusions: This study demonstrates the feasibility of a hybrid transureteral approach to nephrectomy in a survival porcine model. This technique avoids the intentional violation of a second organ system and the risk for peritoneal contamination. Improved instrumentation is needed prior to implementation in the human population. PMID:25489210

  20. Hand-assisted laparoscopic donor nephrectomy: a single centre experience

    PubMed Central

    Macech, Michał; Alsharabi, Amro; Romanowski, Łukasz; Grochowiecki, Tadeusz; Lewandowska, Dorota; Kaliciński, Piotr; Durlik, Magdalena; Pączek, Leszek; Nazarewski, Sławomir

    2016-01-01

    Introduction The advantages of a minimally invasive nephrectomy are a faster recovery and better quality of life for the donors. Until recently, the majority of donor nephrectomies in Poland were done by open surgery. Aim To present a single centre experience in hand-assisted laparoscopic donor nephrectomy (HALDN). Material and methods The first videoscopic left donor nephrectomy in Poland was performed in our department in 2003 using a hand-assisted retroperitoneal approach. From 2011, we changed the method to a transperitoneal approach and started to harvest also right kidneys. Since then, it has become the method of choice for donor nephrectomy and has been performed in 59 cases. Preoperatively, kidneys were assessed by scintigraphy and by angio-computed tomography. We harvested 32 left and 27 right kidneys. There were double renal arteries in 2 cases and triple renal arteries in 1 case. The warm ischaemia time (WIT) was 80–420 s (average 176.13 s); operative time was 85–210 min (average 140 min). Results All procedures were uncomplicated, and all donors were discharged after 2–8 days with normal creatinine levels. The average follow-up period lasted 23 months (1–51 months). Out of all of the cases, 1 case had two minor complications, while all others were uneventful. None of the donors were lost to follow-up. All of the kidneys were transplanted. There were 2 cases of delayed graft function (DGF) and 2 cases of ureter necrosis. One of those kidneys was lost in the third postoperative week. Conclusions Our limited experience shows that HALDN is a safe method and should be used routinely instead of open surgery. PMID:28194249

  1. Nested hierarchical controller with partial autonomy

    NASA Technical Reports Server (NTRS)

    Meystel, A.

    1987-01-01

    The problem of computer architecture for intelligent robots with partial autonomy is addressed. A robot with partial autonomy is considered a degenerated case of a fully autonomous robot. Thus, the problem of man-machine communication is formulated, and the conditions are determined for generating a language for such a communication. The duties of the master are determined.

  2. The Role of Nephrectomy for Kidney Cancer in the Era of Targeted and Immune Therapies.

    PubMed

    Vaishampayan, Ulka N

    2016-01-01

    Although two phase III trials support the recommendation of nephrectomy followed by interferon alpha in metastatic renal cell carcinoma (RCC), this procedure cannot be applied to every patient with this condition. Systemic therapy has changed from interferon alpha to antiangiogenic-targeted therapy, and the clinical impact of nephrectomy in the era of targeted therapy has not been proven. The SEER database shows that only 35% of patients with advanced RCC undergo nephrectomy as their initial treatment. Retrospective studies showed improved overall survival (OS) outcomes with nephrectomy and interleukin-2 (IL-2) therapy; however, the inherent selection bias of younger and healthier patients receiving IL-2 likely accounts for this finding. Neoadjuvant therapy has demonstrated only modest efficacy in unresectable disease, and if remission is obtained with systemic therapy, it is unclear whether nephrectomy has any incremental benefit. In the absence of proven benefit of nephrectomy in the setting of targeted therapy, it seems advisable for patients with RCC with severely symptomatic disease, competing comorbidities, poor performance status, or unresectable disease to avoid nephrectomy and proceed directly to systemic therapy. The clinical implications of deferred cytoreductive nephrectomy for patients with metastatic RCC are poorly understood, and patient cohorts that do not undergo this procedure are likely to be comprised of patients with unfavorable disease characteristics. Unfortunately, the completed trials of targeted therapy were 90% comprised of patients with prior nephrectomy (the majority of trials incorporate prior nephrectomy as an eligibility requirement) and hence may not reflect the outcomes of the majority of the patients with advanced RCC who have not undergone nephrectomy. Newer therapies such as nivolumab and cabozantinib have also been evaluated for a population in which 90% of the patients underwent nephrectomy. Future clinical trials and registry

  3. New three-dimensional head-mounted display system, TMDU-S-3D system, for minimally invasive surgery application: procedures for gasless single-port radical nephrectomy.

    PubMed

    Kihara, Kazunori; Fujii, Yasuhisa; Masuda, Hitoshi; Saito, Kazutaka; Koga, Fumitaka; Matsuoka, Yoh; Numao, Noboru; Kojima, Kazuyuki

    2012-09-01

    We present an application of a new three-dimensional head-mounted display system that combines a high-definition three-dimensional organic electroluminescent head-mounted display with a high-definition three-dimensional endoscope to minimally invasive surgery, using gasless single-port radical nephrectomy procedures as a model. This system presents the surgeon with a higher quality of magnified three-dimensional imagery in front of the eyes regardless of head position, and simultaneously allows direct vision by moving the angle of sight downward. It is also significantly less expensive than the current robotic surgery system. While carrying out gasless single-port radical nephrectomy, the system provided the surgeon with excellent three-dimensional imagery of the operative field, direct vision of the outside and inside of the patient, and depth perception and tactile feedback through the devices. All four nephrectomies were safely completed within the operative time, blood loss was within usual limits and there were no complications. The display was light enough to comfortably be worn for a long operative time. Our experiences show that the three-dimensional head-mounted display system might facilitate maneuverability and safety in minimally invasive procedures, without prohibitive cost, and thus might mitigate the drawbacks of other three-dimensional vision systems. Because of the potential benefits that this system offers, it deserves further refinements of its role in various minimally invasive surgeries.

  4. [History of robotics: from archytas of tarentum until Da Vinci robot. (Part II)].

    PubMed

    Sánchez-Martín, F M; Jiménez Schlegl, P; Millán Rodríguez, F; Salvador-Bayarri, J; Monllau Font, V; Palou Redorta, J; Villavicencio Mavrich, H

    2007-03-01

    Robotic surgery is a reality. In order to to understand how new robots work is interesting to know the history of ancient (see part i) and modern robotics. The desire to design automatic machines imitating humans continued for more than 4000 years. Archytas of Tarentum (at around 400 a.C.), Heron of Alexandria, Hsieh-Fec, Al-Jazari, Bacon, Turriano, Leonardo da Vinci, Vaucanson o von Kempelen were robot inventors. At 1942 Asimov published the three robotics laws. Mechanics, electronics and informatics advances at XXth century developed robots to be able to do very complex self governing works. At 1985 the robot PUMA 560 was employed to introduce a needle inside the brain. Later on, they were designed surgical robots like World First, Robodoc, Gaspar o Acrobot, Zeus, AESOP, Probot o PAKI-RCP. At 2000 the FDA approved the da Vinci Surgical System (Intuitive Surgical Inc, Sunnyvale, CA, USA), a very sophisticated robot to assist surgeons. Currently urological procedures like prostatectomy, cystectomy and nephrectomy are performed with the da Vinci, so urology has become a very suitable speciality to robotic surgery.

  5. [Aspergillosis located on polycystic kidney treated with retroperitoneal nephrectomy].

    PubMed

    Rabii, R; Hoznek, A; Salomon, L; Bourg, S; Chopin, D K; Abbou, C C

    2001-03-01

    We reported an uncommon case of 40 years old man, cardiac transplant recipient with chronic renal faillure who consulted for infected left polycystic renal. The serum creatinine level was 750 mmol/L, and urine culture isolated a E. Ecol germe. The abdominopelvic computed tomography showed a bilateral large polycystic renal cortex and suspected the infected cyst in lower pole of left kidney. The retroperitoneal laparoscopic nephrectomy was performed confirming a renal invasive aspergillosa. About this case we should have a high index of suspicion for fungal aetiology in kidney infection in transplant patients and the management of non functioning infected polycystic kidney can use laparoscopic retroperitoneal nephrectomy. This approach can offers a minimal morbidity and alternative to open surgery.

  6. Experimental evaluation of Ethibloc for nonsurgical nephrectomy. [Dogs

    SciTech Connect

    Wright, K.C.; Bowers, T.; Chuang, V.P.; Tsai, C.C.

    1982-11-01

    Six adult dogs weighing 18-28 kg were used to evaluate a new embolic material, Ethibloc, for nonsurgical nephrectomy. Both acute and chronic studies were performed. Results indicated that Ethibloc is easily administered and neither toxic nor mutagenic (at 9 weeks). However, it exhibits inadequate radiopacity at the dosages used and may require a balloon catheter (which could cause some Ethibloc to be forced through the glomerular capillaries) or repeat embolization to achieve permanent and complete renal infarction.

  7. Malignant Hypertension Revisited: The Role of Bilateral Nephrectomy

    PubMed Central

    Cruz, Iluminado; Callender, Clive O.; Cummings, Yvonne; Dillard, Martin; Hosten, Adrian; Stevens, Joel

    1980-01-01

    Hypertension is the leading cause of renal failure in this dialysis and transplant center. When malignant hypertension is encountered, the symptom complex of cachexia and failure to thrive highlights its clinical presentation. The courses of 32 black renal hypertensive patients studied retrospectively demonstrated this symptom complex as well as prolongation of survival, when bilateral nephrectomy and renal transplantation were used as definitive treatment. PMID:6991710

  8. Death or dialysis? The risk of dialysis-dependent chronic renal failure after trauma nephrectomy.

    PubMed

    Dozier, Kristopher C; Yeung, Louise Y; Miranda, Marvin A; Miraflor, Emily J; Strumwasser, Aaron M; Victorino, Gregory P

    2013-01-01

    Although renal trauma is increasingly managed nonoperatively, severe renovascular injuries occasionally require nephrectomy. Long-term outcomes after trauma nephrectomy are unknown. We hypothesized that the risk of end-stage renal disease (ESRD) is minimal after trauma nephrectomy. We conducted a retrospective review of the following: 1) our university-based, urban trauma center database; 2) the National Trauma Data Bank (NTDB); 3) the National Inpatient Sample (NIS); and 4) the U.S. Renal Data System (USRDS). Data were compiled to estimate the risk of ESRD after trauma nephrectomy in the United States. Of the 232 patients who sustained traumatic renal injuries at our institution from 1998 to 2007, 36 (16%) underwent a nephrectomy an average of approximately four nephrectomies per year. The NTDB reported 1780 trauma nephrectomies from 2002 to 2006, an average of 356 per year. The 2005 NIS data estimated that in the United States, over 20,000 nephrectomies are performed annually for renal cell carcinoma. The USRDS annual incidence of ESRD requiring hemodialysis is over 90,000, of which 0.1 per cent (100 per year) of renal failure is the result of traumatic or surgical loss of a kidney. Considering the large number of nephrectomies performed for cancer, we estimated the risk of trauma nephrectomy causing renal failure that requires dialysis to be 0.5 per cent. National data regarding the etiology of renal failure among patients with ESRD reveal a very low incidence of trauma nephrectomy (0.5%) as a cause; therefore, nephrectomy for trauma can be performed with little concern for long-term dialysis dependence.

  9. [Robots in general surgery: present and future].

    PubMed

    Galvani, Carlos; Horgan, Santiago

    2005-09-01

    Robotic surgery is an emerging technology. We began to use this technique in 2000, after it was approved by the Food and Drug Administration. Our preliminary experience was satisfactory. We report 4 years' experience of using this technique in our institution. Between August 2000 and December 2004, 399 patients underwent robotic surgery using the Da Vinci system. We performed 110 gastric bypass procedures, 30 Lap band, 59 Heller myotomies, 12 Nissen fundoplications, 6 epiphrenic diverticula, 18 total esophagectomies, 3 esophageal leiomyoma resections, 1 pyloroplasty, 2 gastrojejunostomies, 2 transduodenal sphincteroplasties, 10 adrenalectomies and 145 living-related donor nephrectomies. Operating times for fundoplications and Lap band were longer. After the learning curve, the operating times and morbidity of the remaining procedures were considerably reduced. Robot-assisted surgery allows advanced laparoscopic procedures to be performed with enhanced results given that it reduces the learning curve as measured by operating time and morbidity.

  10. Robot and robot system

    NASA Technical Reports Server (NTRS)

    Behar, Alberto E. (Inventor); Marzwell, Neville I. (Inventor); Wall, Jonathan N. (Inventor); Poole, Michael D. (Inventor)

    2011-01-01

    A robot and robot system that are capable of functioning in a zero-gravity environment are provided. The robot can include a body having a longitudinal axis and having a control unit and a power source. The robot can include a first leg pair including a first leg and a second leg. Each leg of the first leg pair can be pivotally attached to the body and constrained to pivot in a first leg pair plane that is substantially perpendicular to the longitudinal axis of the body.

  11. Minimally invasive open nephrectomy on children with multicystic dysplastic kidney

    PubMed Central

    Feng, Dongchuan; Zhu, Xiaoyu; Sun, Fang; Ma, Tongsheng; Li, Yuan; Chen, Shujing

    2016-01-01

    The aim of the study was to summarize the preliminary experience of minimally invasive open nephrectomy operation on children with multicystic dysplastic kidney (MCDK). A retrospective review was performed on the clinical materials of the 15 children that had accepted consecutive minimally invasive open nephrectomies during the previous 2 years. The enrolled children were diagnosed with unilateral MCDK under computed tomography, emission computerized tomography and ultrasound and no anomaly in the contralateral functioning kidney was found. Of the 15 children, 12 were boys and 3 were girls, with 5 cases on the right and 10 cases on the left. Operations were completed at the retroperitoneal space in order to open an incision on the waists and ribs of the children, the length of which ranged from 1.5 to 2.0 cm (average 1.7 cm). The age of the children at operation ranged from 3 months to 5.6 years old, with an average of 2.4 years old. Surgery lasted for 30–50 min, with an average of 34.6 min. The estimated blood loss of each child was <5 ml. After operation, prophylactic intravenous antibiotics were administered for 2–4 days to prevent infection. All of the operations proved very successful. Following surgery the children were hospitalized for 2–4 days for observation, with an average of 2.8 days. No complications occurred during the follow-up period. In conclusion, minimally invasive open nephrectomy is effective for children with MCDK. The procedure is superior with regard to operative time, cosmesis, and length of stay. It is a safe and effective treatment choice for patietns with MCDK and can be easily performed on children. PMID:28101154

  12. Effects of maternal subtotal nephrectomy on the development of the fetal kidney: A morphometric study.

    PubMed

    Kondo, Tomohiro; Kitano-Amahori, Yoko; Nagai, Hiroaki; Mino, Masaki; Takeshita, Ai; Kusakabe, Ken Takeshi; Okada, Toshiya

    2015-11-01

    The present study was designed to explore if maternal subtotal (5/6) nephrectomy affects the development of fetal rat kidneys using morphometric methods and examining whether there are any apoptotic changes in the fetal kidney. To generate 5/6 nephrectomized model rats, animals underwent 2/3 left nephrectomy on gestation day (GD) 5 and total right nephrectomy on GD 12. The fetal kidneys were examined on GDs 16 and 22. A significant decrease in fetal body weight resulting from maternal 5/6 nephrectomy was observed on GD 16, and a significant decrease in fetal renal weight and fetal body weight caused by maternal nephrectomy was observed on GD 22. Maternal 5/6 nephrectomy induced a significant increase in glomerular number, proximal tubular length, and total proximal tubular volume of fetuses on GD 22. Maternal 5/6 nephrectomy resulted in an increase in the number of apoptotic cells in the metanephric mesenchyme of the kidney on GD 16, and in the collecting tubules on GD 22. These findings suggest that maternal 5/6 nephrectomy stimulates the development of the fetal kidney while suppressing fetal growth.

  13. Anesthetic management of nephrectomy in a chronic obstructive pulmonary disease patient with recurrent spontaneous pneumothorax.

    PubMed

    Santhosh, Mysore Chandramouli Basappaji; Bhat Pai, Rohini; Rao, Raghavendra P

    2016-01-01

    Nephrectomies are usually performed under general anesthesia alone or in combination with regional anesthesia and rarely under regional anesthesia alone. We report the management of a patient with chronic obstructive pulmonary disease with a history of recurrent spontaneous pneumothorax undergoing nephrectomy under regional anesthesia alone.

  14. [Anesthetic management of nephrectomy in a chronic obstructive pulmonary disease patient with recurrent spontaneous pneumothorax].

    PubMed

    Santhosh, Mysore Chandramouli Basappaji; Bhat Pai, Rohini; Rao, Raghavendra P

    2016-01-01

    Nephrectomies are usually performed under general anesthesia alone or in combination with regional anesthesia and rarely under regional anesthesia alone. We report the management of a patient with chronic obstructive pulmonary disease with a history of recurrent spontaneous pneumothorax undergoing nephrectomy under regional anesthesia alone.

  15. Comparison of three perioperative fluid regimes for laparoscopic donor nephrectomy

    PubMed Central

    Di Biase, Manuela; Verbrugge, Serge; IJzermans, Jan N. M.; Gommers, Diederik

    2007-01-01

    Background Pneumoperitoneum (PP), as used for laparoscopic procedures, impairs stroke volume, renal blood flow, glomerular filtration rate and urine output. This study investigated whether perioperative fluid management can abolish these negative effects of PP on hemodynamics. Methods Twenty-one patients undergoing laparoscopic donor nephrectomy (LDN) were randomized into three groups: group 1 received overnight infusion and received a bolus of colloid before induction of anesthesia, followed by a bolus just before PP; group 2 received overnight infusion and a colloid bolus before anesthesia; group 3 served as controls and received only infusion during operation. All three groups received the same total amount of crystalloids and colloids until nephrectomy. Data analysis of the donor included; mean arterial pressure (MAP), stroke volume (SV), left ventricular ejection time (LVETc), perioperative urine output and renal function measured as the creatinine clearance (CrCl) until one-year post-operative. Results SV was significantly higher in group 1 compared to controls for all measurements. In the control group SV significantly decreased after changing from the supine to lateral position whereas there was no change in SV in both pre-hydrated groups. In all groups, MAP decreased after induction of anesthesia, and restored to pre-anesthetic values during PP. CrCl decreased in the control group during PP, but not in the other groups. From two days postoperative, CrCl was comparable between the three study groups. Conclusion Overnight infusion and a bolus of colloid just before PP attenuate hemodynamic compromise from PP. PMID:17522928

  16. Percutaneously Assisted "Two-Ports" Transperitoneal Radical Nephrectomy: Initial Series.

    PubMed

    Porpiglia, Francesco; Bertolo, Riccardo; Morra, Ivano; Fiori, Cristian

    2016-06-01

    Looking for a virtually "scarless" surgery mini-laparoscopy (ML) could be a viable alternative to conventional laparoscopy. ML is a reproducible technique and allows for the preservation of the triangulation concept, the cornerstone of laparoscopic surgery. Drawback of ML could be the poor performance of miniaturized instruments that could affect the confidence of the surgeon and limit the indications. The recent availability of a novel mini-laparoscopic platform in our center expanded the indications of ML to radical nephrectomy even in cases of large renal tumors in kidneys with abundant perirenal fat. The platform is composed by mini-instruments with the peculiarity of a 2.9-mm shaft that is mounted on a handle and a jaw that are comparable in size and performance to those of conventional instruments, increasing the ergonomy and the confidence perceived by the surgeon. Allowing for inclusion criteria, nine consecutive patients were enrolled in our prospective study and underwent percutaneously assisted "two-ports" radical nephrectomy. Preliminary data showed that the novel platform allowed us to perform a safe and effective procedure with acceptable perioperative outcomes and apparent improvements in cosmesis. Larger sample size and comparative studies are needed to confirm these findings.

  17. Hand-Assisted Laparoscopic Donor Nephrectomy in Complete Situs Inversus

    PubMed Central

    Gahagan, John V.; Whealon, Matthew D.; Reddy, Uttam; Foster, Clarence E.

    2016-01-01

    Abstract Complete situs inversus is a rare congenital anomaly characterized by transposition of organs. We report a case of renal transplantation using a kidney from a living complete situs inversus donor. The recipient was a 59-year-old female with end-stage renal disease because of type 2 diabetes mellitus. The donor was the 56-year-old sister of the recipient with complete situs inversus. CT angiogram of the abdomen and pelvis showed complete situs inversus and an otherwise normal appearance of the bilateral kidneys with patent bilateral single renal arteries and longer renal vein in the right kidney. The patient was taken to the operating room for a hand-assisted laparoscopic right donor nephrectomy. The patient tolerated the procedure well and was discharged home in good condition on postoperative day 1. The recipient experienced no episodes of acute rejection or infection, with serum creatinine levels of 0.8–1.2 mg/dL. Laparoscopic donor nephrectomy in a patient with complete situs inversus remains a technically feasible operation and the presence of situs inversus should not preclude consideration for living kidney donation. PMID:27579434

  18. The Effects of Unilateral Nephrectomy on Blood Pressure and Its Circadian Rhythm.

    PubMed

    Ohashi, Naro; Isobe, Shinsuke; Ishigaki, Sayaka; Suzuki, Takahisa; Motoyama, Daisuke; Sugiyama, Takayuki; Nagata, Masao; Kato, Akihiko; Ozono, Seiichiro; Yasuda, Hideo

    Objective Hypertension and diurnal blood pressure (BP) variation are widely accepted as risk factors for renal damage. However, the effects of unilateral nephrectomy on BP and its circadian rhythm have not yet been clarified in patients with a compromised renal function, including dialysis patients. Methods We investigated 22 unilateral nephrectomized patients (16 men and 6 women, age: 64.5±14.3 years). The function of the circulating renin-angiotensin system (RAS) (plasma renin activity and plasma angiotensin II) and 24-h ambulatory BP monitoring (ABPM) were evaluated before and after nephrectomy. Daytime and nighttime 24-h ABPM values were determined based on sleep and waking times. Results In non-dialysis patients, the estimated glomerular filtration rate after nephrectomy was significantly lower than that before (before, 62.4±23.2 mL/min/1.73 m(2) vs. after, 43.7±16.8 mL/min/1.73 m(2); p<0.01). No significant differences were noted in the levels of BPs and circulating RAS before and after nephrectomy. However, the night-to-day (N/D) ratio of systolic BP (SBP) was significantly higher after nephrectomy than before (before, 93.3±6.5% vs. after, 98.4±6.9%; p<0.01), and the patterns of circadian BP rhythm also significantly differed before and after nephrectomy (p=0.022). Namely, the rates of dipper patterns decreased and nondipper and riser patterns increased after nephrectomy. In contrast, in dialysis patients, no significant differences were observed in the N/D ratio of SBP or the patterns of circadian BP rhythm before and after nephrectomy. Conclusion Unilateral nephrectomy affects the circadian rhythm of BP but not absolute values of BP.

  19. National nephrectomy registries: Reviewing the need for population-based data.

    PubMed

    Pearson, John; Williamson, Timothy; Ischia, Joseph; Bolton, Damien M; Frydenberg, Mark; Lawrentschuk, Nathan

    2015-09-01

    Nephrectomy is the cornerstone therapy for renal cell carcinoma (RCC) and continued refinement of the procedure through research may enhance patient outcomes. A national nephrectomy registry may provide the key information needed to assess the procedure at a national level. The aim of this study was to review nephrectomy data available at a population-based level in Australia and to benchmark these data against data from the rest of the world as an examination of the national nephrectomy registry model. A PubMed search identified records pertaining to RCC nephrectomy in Australia. A similar search identified records relating to established nephrectomy registries internationally and other surgical registries of clinical importance. These records were reviewed to address the stated aims of this article. Population-based data within Australia for nephrectomy were lacking. Key issues identified were the difficulty in benchmarking outcomes and no ongoing monitoring of trends. The care centralization debate, which questions whether small-volume centers provide comparable outcomes to high-volume centers, is ongoing. Patterns of adherence and the effectiveness of existing protocols are uncertain. A review of established international registries demonstrated that the registry model can effectively address issues comparable to those identified in the Australian literature. A national nephrectomy registry could address deficiencies identified in a given nation's nephrectomy field. The model is supported by evidence from international examples and will provide the population-based data needed for studies. Scope exists for possible integration with other registries to develop a more encompassing urological or surgical registry. Need remains for further exploration of the feasibility and practicalities of initiating such a registry including a minimum data set, outcome indicators, and auditing of data.

  20. The Effects of Unilateral Nephrectomy on Blood Pressure and Its Circadian Rhythm

    PubMed Central

    Ohashi, Naro; Isobe, Shinsuke; Ishigaki, Sayaka; Suzuki, Takahisa; Motoyama, Daisuke; Sugiyama, Takayuki; Nagata, Masao; Kato, Akihiko; Ozono, Seiichiro; Yasuda, Hideo

    2016-01-01

    Objective Hypertension and diurnal blood pressure (BP) variation are widely accepted as risk factors for renal damage. However, the effects of unilateral nephrectomy on BP and its circadian rhythm have not yet been clarified in patients with a compromised renal function, including dialysis patients. Methods We investigated 22 unilateral nephrectomized patients (16 men and 6 women, age: 64.5±14.3 years). The function of the circulating renin-angiotensin system (RAS) (plasma renin activity and plasma angiotensin II) and 24-h ambulatory BP monitoring (ABPM) were evaluated before and after nephrectomy. Daytime and nighttime 24-h ABPM values were determined based on sleep and waking times. Results In non-dialysis patients, the estimated glomerular filtration rate after nephrectomy was significantly lower than that before (before, 62.4±23.2 mL/min/1.73 m2 vs. after, 43.7±16.8 mL/min/1.73 m2; p<0.01). No significant differences were noted in the levels of BPs and circulating RAS before and after nephrectomy. However, the night-to-day (N/D) ratio of systolic BP (SBP) was significantly higher after nephrectomy than before (before, 93.3±6.5% vs. after, 98.4±6.9%; p<0.01), and the patterns of circadian BP rhythm also significantly differed before and after nephrectomy (p=0.022). Namely, the rates of dipper patterns decreased and nondipper and riser patterns increased after nephrectomy. In contrast, in dialysis patients, no significant differences were observed in the N/D ratio of SBP or the patterns of circadian BP rhythm before and after nephrectomy. Conclusion Unilateral nephrectomy affects the circadian rhythm of BP but not absolute values of BP. PMID:27904104

  1. Displacement of the Spleen Mimicking Renal Cell Cancer Recurrence Post-Nephrectomy: A Case Report

    PubMed Central

    Emanuels, Carolina S.; Timmerman, Krista D.; Aijaz, Tabish; Nguyen, Thu-Cuc; Jest, Nathaniel; Drane, Walter E.; Gilbert, Scott M.; Crispen, Paul L.; Su, Li-Ming; Deitte, Lori A.

    2015-01-01

    Local regional recurrence of renal cell cancer post-nephrectomy most often occurs within three years after surgery. Post-nephrectomy, many processes may mimic RCC recurrence. We present the case of a 75 year-old Caucasian male patient with a mass in his renal fossa post-nephrectomy for renal cell cancer, suggesting local recurrence. Use of the technetium-99m sulfur colloid scan showed that the mass was his spleen which had been displaced into the renal fossa. With high index of suspicion, characterization of these processes as splenic in origin would prevent subjecting patients to risks of biopsy or even surgery.

  2. Radiation response of the monkey kidney following contralateral nephrectomy

    SciTech Connect

    Robbins, M.E.C.; Stephens, L.C.; Gray, K.N.

    1994-09-30

    The long-term functional and morphologic responses of the hypertrophied monkey kidney after unilateral nephrectomy to fractionated irradiation were assessed. The right kidney of 13 adult female rhesus monkeys was removed. Twelve weeks after unilateral nephrectomy (UN) the remaining kidney received fractionated doses of {gamma}-rays ranging from 35.2 Gy/16 fractions (F) up to 44 Gy/20 F. Glomerular filtration rate, effective renal plasma flow, blood urea nitrogen, serum creatinine, and hematocrit values were measured up to 107 weeks postirradiation (PI). The monkeys were killed and the remaining kidneys were removed 107 weeks PI or earlier when end-stage renal failure was exhibited. Glomeruli were scored for the presence/absence of several pathologic features including increased intercapillary eosinophilic material (ICE), ecstatic capillaries, and thrombi. The relative proportion of renal cortex occupied by glomeruli, interstitium, normal tubules or abnormal tubules was determined using a Chalkley point grid. These quantal dose response data were analyzed using a logistic regression model. Irradiation of the remaining kidney in UN monkeys resulted in a dose-dependent reduction in renal function and anemia. Glomerular dysfunction preceded tubular dysfunction. Animals receiving 44 Gy all manifested progressive clinical renal failure. Conversely, those receiving {le} 39.6 Gy showed stable, albeit impaired, renal function for the duration of the observation period of 107 weeks. Morphologically, the incidence of ICE, ecstatic glomerular capillaries, thrombi, and periglomerular fibrosis was significantly dose-related (p < 0.005). A significant (p < 0.001) dose-related increase in the relative proportion of renal cortex occupied by abnormal tubules was indicative of tubular injury. A highly significant (p < 0.001) dose-dependent increase in the proportion of abnormal to normal tubules was also seen. 27 refs., 4 figs., 2 tabs.

  3. Robotic vehicle

    DOEpatents

    Box, W.D.

    1994-03-15

    A robotic vehicle is described for travel through an enclosed or partially enclosed conduit or pipe including vertical and/or horizontal conduit or pipe. The robotic vehicle comprises forward and rear housings each provided with a surface engaging mechanism for selectively engaging the walls of the conduit through which the vehicle is travelling, whereby the housings are selectively held in a stationary position within the conduit. The vehicle also includes at least three selectively extendable members, each of which defines a cavity therein. The forward end portion of each extendable member is secured to the forward housing and the rear end portion of each housing is secured to the rear housing. Each of the extendable members is independently extendable from a retracted position to an extended position upon the injection of a gas under pressure into the cavity of the extendable member such that the distance between the forward housing and the rear housing can be selectively increased. Further, each of the extendable members is independently retractable from the extended position to the retracted position upon the application of a vacuum to the cavity of the extendable member such that the distance between the forward housing and the rear housing can be selectively decreased. 11 figures.

  4. Robotic vehicle

    DOEpatents

    Box, W.D.

    1996-03-12

    A robotic vehicle is described for travel through an enclosed or partially enclosed conduit or pipe including vertical and/or horizontal conduit or pipe. The robotic vehicle comprises forward and rear housings each provided with a surface engaging mechanism for selectively engaging the walls of the conduit through which the vehicle is travelling, whereby the housings are selectively held in a stationary position within the conduit. The vehicle also includes at least three selectively extendable members, each of which defines a cavity therein. The forward end portion of each extendable member is secured to the forward housing and the rear end portion of each housing is secured to the rear housing. Each of the extendable members is independently extendable from a retracted position to an extended position upon the injection of a gas under pressure into the cavity of the extendable member such that the distance between the forward housing and the rear housing can be selectively increased. Further, each of the extendable members is independently retractable from the extended position to the retracted position upon the application of a vacuum to the cavity of the extendable member such that the distance between the forward housing and the rear housing can be selectively decreased. 14 figs.

  5. Robotic vehicle

    DOEpatents

    Box, W. Donald

    1996-01-01

    A robotic vehicle (10) for travel through an enclosed or partially enclosed conduit or pipe including vertical and/or horizontal conduit or pipe. The robotic vehicle (10) comprises forward and rear housings (32 and 12) each provided with a surface engaging mechanism for selectively engaging the walls of the conduit through which the vehicle is travelling, whereby the housings (32 and 12) are selectively held in a stationary position within the conduit. The vehicle (10) also includes at least three selectively extendable members (46), each of which defines a cavity (56) therein. The forward end portion (50) of each extendable member (46) is secured to the forward housing (32) and the rear end portion (48) of each housing is secured to the rear housing (12). Each of the extendable members (46) is independently extendable from a retracted position to an extended position upon the injection of a gas under pressure into the cavity (56) of the extendable member such that the distance between the forward housing (32 ) and the rear housing (12) can be selectively increased. Further, each of the extendable members (46) is independently retractable from the extended position to the retracted position upon the application of a vacuum to the cavity (56) of the extendable member (46) such that the distance between the forward housing (32) and the rear housing (12) can be selectively decreased.

  6. Robotic vehicle

    DOEpatents

    Box, W. Donald

    1994-01-01

    A robotic vehicle (10) for travel through an enclosed or partially enclosed conduit or pipe including vertical and/or horizontal conduit or pipe. The robotic vehicle (10) comprises forward and rear housings (32 and 12) each provided with a surface engaging mechanism for selectively engaging the walls of the conduit through which the vehicle is travelling, whereby the housings (32 and 12) are selectively held in a stationary position within the conduit. The vehicle (10) also includes at least three selectively extendable members (46), each of which defines a cavity (56) therein. The forward end portion (50) of each extendable member (46) is secured to the forward housing (32) and the rear end portion (48) of each housing is secured to the rear housing (12). Each of the extendable members (46) is independently extendable from a retracted position to an extended position upon the injection of a gas under pressure into the cavity (56) of the extendable member such that the distance between the forward housing (32 ) and the rear housing (12) can be selectively increased. Further, each of the extendable members (46) is independently retractable from the extended position to the retracted position upon the application of a vacuum to the cavity (56) of the extendable member (46) such that the distance between the forward housing (32) and the rear housing (12) can be selectively decreased.

  7. Kidney retransplantation for BK virus nephropathy with active viremia without allograft nephrectomy.

    PubMed

    Huang, Jingbo; Danovitch, Gabriel; Pham, Phuong-Thu; Bunnapradist, Suphamai; Huang, Edmund

    2015-12-01

    BK virus nephropathy is an important cause of kidney allograft failure. Retransplantation has been successfully performed for patients with previous allograft loss due to BK virus nephropathy; however, whether allograft nephrectomy and viral clearance are required prior to retransplantation is controversial. Some recent studies have suggested that retransplantion can be successfully achieved without allograft nephrectomy if viremia is cleared prior to retransplant. The only published experience of successful retransplantation in the presence of active viremia occurred in the presence of concomitant allograft nephrectomy of the failing kidney. In this report, we describe a case of successful repeat kidney transplant in a patient with high-grade BK viremia and fulminant hepatic failure without concomitant allograft nephrectomy performed under the setting of a simultaneous liver-kidney transplant.

  8. Hand-assisted laparoscopic nephrectomy for xanthogranulomatous pyelonephritis with nephrocutaneous fistula after failed flank exploration.

    PubMed

    Kijvikai, Kittinut; Dissaranan, Charuspong; Chalermsanyakorn, Panas; Matchariyakul, Chaiyasit; Kochakarn, Wachira

    2006-08-01

    Xanthogranulomatous pyelonephritis presenting with nephrocutaneous fistula is a rare condition, and its treatment of choice is nephrectomy. Laparoscopic management has been proved to be challenging in these inflammatory renal conditions. However, there was no previous report in the literature regarding laparoscopic treatment of nephrocutaneous fistula especially after previous operation. In this communication, we report the first case of hand-assisted laparoscopic nephrectomy for xanthogranulomatous pyelonephritis with nephrocutaneous fistula after previous failed flank exploration.

  9. Bilateral native nephrectomy for refractory hypertension in kidney transplant and kidney pancreas transplant patients

    PubMed Central

    Lerman, Mark J.; Hinton, Sandra; Aronoff, Ronald

    2015-01-01

    Hypertension is common in renal transplant patients and sometimes very difficult to control. Refractory hypertension can adversely affect renal graft and patient survival. Many antihypertensive medications are not well tolerated or can have important drug interactions with immunosuppressive medications. These drugs can cause significant side effects including fluid depletion, azotemia, electrolyte imbalance, and anemia. Bilateral native nephrectomy in renal transplant patients has been reported to be beneficial in controlling severe hypertension. We report five patients with severe hypertension despite as many as 9 different antihypertensive medications. All patients had previous kidney or simultaneous kidney pancreas transplantation. Each of our patients underwent laparoscopic bilateral native nephrectomy. Renal function varied from creatinine of 1.4–2.4, and the number of antihypertensive medications from 3 to 9 at the time of nephrectomy surgery. Mean arterial blood pressure improved in all five patients at 3–6 months post nephrectomy, the number of antihypertensive medications decreased in 4, but renal function remained stable at 3–6 months in only 3 patients. We found laparoscopic bilateral native nephrectomy to be beneficial in renal and simultaneous kidney pancreas transplant patients with severe and refractory hypertension. Our patients with better baseline renal allograft function at time of nephrectomy received the most benefit. No decrease in allograft function could be attributed to acute rejection. PMID:26348394

  10. Emerging role of robotics in urology

    PubMed Central

    Kumar, Rajeev; Hemal, Ashok K.

    2005-01-01

    Robotic assistance is one of the latest additions to the field of laparoscopic surgery. The most commonly used robotic device in Urology is the da Vinci® system of which over 200 devices are installed worldwide including 3 in India. This robot consists of three or four arms, one of which is used to hold and manipulate the laparoscopic camera while the others are used to manipulate specialized laparoscopic instruments with endowrist® technology that allows 7 degrees of freedom. The robot is currently used primarily for radical prostatectomies where complex dissection and reconstruction can be performed in less than 2 hours with excellent outcomes. There is a progressive increase in the number of surgeries being performed by this device which allows laparoscopy naïve surgeons to offer the benefits of minimally invasive surgery to their patients. The other surgeries where this device has been used to benefit are pyeloplasty, cystectomy with urinary diversion, nephrectomy and ureteric re-implant. The principal drawbacks of the device are the steep cost of machine and disposables. However, the benefits achieved in terms of improved surgical precision, magnified 3 dimensional vision, scaling of movements, remote surgery and as a teaching tools will help the robot establish a definitive place in the urologic armamentarium. PMID:21206664

  11. Assessment of renal oxygenation during partial nephrectomy using DLP hyperspectral imaging

    NASA Astrophysics Data System (ADS)

    Best, Sara L.; Thapa, Abhas; Holzer, Michael S.; Jackson, Neil; Mir, Saad A.; Donnally, Chester J.; Wehner, Eleanor; Raj, Ganesh V.; Livingston, Edward; Cadeddu, Jeffrey A.; Zuzak, Karel J.

    2011-03-01

    Digital Light Processing (DLP®) hyperspectral imaging (HsI) is a non-invasive method used to construct a highly sensitive, real-time tissue oxygenation map through the measurement of the percentage of oxyhemoglobin. We have demonstrated that this technology can detect the oxyhemoglobin in the blood vessels on the surface of the kidney and we have used this to monitor renal perfusion during kidney cancer operations, where the blood supply to the kidney is interrupted for a period of time. This technology may allow us to "personalize" surgery based on the oxygenation profile.

  12. [Extracorporeal partial nephrectomy under pharmaco-cold ischemia for renal cell carcinoma].

    PubMed

    Gritskevich, A A; Miroshkina, I V; Piyanikin, S S; Adyrkhayev, Z A; Stepanova, Yu A; Zotikov, A E; Teplov, A A; Kubyshkin, V A; Revishvili, A Sh

    2017-01-01

    В настоящее время приоритетным направлением является разработка мер по раннему выявлению рака и органосохраняющих методов лечения, особенно при почечно-клеточном раке (ПКР) с интрапаренхиматозной и центральной локализацией при единственной, единственно функционирующей почки, а также в сочетании с патологией контралатеральной почки. Цель исследования — разработка метода экстракорпоральной резекции почки в условиях фармакохолодовой ишемии без пересечения мочеточника с ортотопической реплантацией почечных сосудов при ПКР. Материал и методы. В исследование включены 37 больных с морфологически подтвержденным ПКР со стадией pT1a-Т3bN0M0—1G1—3 с интрапаренхиматозной и центральной локализацией опухоли при единственной, при наличии сопутствующей патологии, как контралатеральной почки, так и почки на стороне опухолевого поражения. Результаты. Средняя длительность операции составила 413,97±89,14 мин. Среднее время тепловой ишемии составило 8,39±4,75 мин, продолжительность холодовой ишемии в среднем 151,41±41,29 мин. Интраоперационные осложнения выявлены у 3 (8,1%) больных, послеоперационные — у 18 (48,6%) больных. Заключение. Экстракорпоральная резекция почки в условиях фармакохолодовой ишемии без пересечения мочеточника с ортотопической реплантацией почечных сосудов при ПКР является относительно безопасным методом органосохранного лечения, позволяющая выполнять резекции опухолей больших размеров, любой локализации, в условиях длительной холодовой ишемии, без пересечения мочеточников.

  13. Use of preoperative embolization prior to Transplant nephrectomy

    PubMed Central

    Yeast, Carrie; Riley, Julie M.; Holyoak, Joshua; Ross, Gilbert; Weinstein, Stephen; Wakefield, Mark

    2016-01-01

    ABSTRACT Introduction After a failed transplant, management of a non-functional graft with pain or recurrent infections can be challenging. Transplant nephrectomy (TN) can be a morbid procedure with the potential for significant blood loss. Embolization of the renal artery alone has been proposed as a method of reducing complications from an in vivo failed kidney transplant. While this does yield less morbidity, it may not address an infected graft or refractory hematuria or rejection. We elected to begin preoperative embolization to assess if this would help decrease the blood loss and transfusion rate associated with TN. Materials and Methods We performed a retrospective analysis of all patients who underwent non-emergent TN at our institution. Patients who had functioning grafts that later failed were included in analysis. TN was performed for recurrent infections, pain or hematuria. We evaluated for blood loss (EBL) during TN, transfusion rate and length of hospital stay. Results A total of 16 patients were identified. Nine had preoperative embolization or no blood flow to the graft prior to TN. The remaining 7 did not have preoperative embolization. The shortest time from transplant to TN was 8 months and the longest 18 years with an average of 6.3 years. Average EBL for the embolized patients (ETN) was 143.9cc compared to 621.4cc in the non-embolized (NETN) group (p=0.041). Average number of units of blood transfused was 0.44 in the ETN with only 3/9 patients requiring transfusion. The NETN patients had average of 1.29 units transfused with 5/7 requiring transfusion. The length of stay was longer for the ETN (5.4 days) compared to 3.9 in the NETN. No intraoperative complications were seen in either group and only one patient had a postoperative ileus in the NETN. Conclusion Embolization prior to TN significantly decreases the EBL but does not significantly decrease transfusion rate. However, patients do require a significantly longer hospitalization with

  14. CASSY Robot

    NASA Astrophysics Data System (ADS)

    Pittman, Anna; Wright, Ann; Rice, Aaron; Shyaka, Claude

    2014-03-01

    The CASSY Robot project involved two square robots coded in RobotC. The goal was to code a robot to do a certain set of tasks autonomously. To begin with, our task was to code the robot so that it would roam a certain area, marked off by black tape. When the robot hit the black tape, it knew to back up and turn around. It was able to do this thanks to the light sensor that was attached to the bottom of the robot. Also, whenever the robot hit an obstacle, it knew to stop, back up, and turn around. This was primarily to prevent the robot from hurting itself if it hit an obstacle. This was accomplished by using touch sensors set up as bumpers. Once that was accomplished, we attached sonar sensors and created code so that one robot was able to find and track the other robot in a sort of intruder/police scenario. The overall goal of this project was to code the robot so that we can test it against a robot coded exactly the same, but using Layered Mode Selection Logic. Professor.

  15. Renal parenchymal histopathology predicts life-threatening chronic kidney disease as a result of radical nephrectomy.

    PubMed

    Sejima, Takehiro; Honda, Masashi; Takenaka, Atsushi

    2015-01-01

    The preoperative prediction of post-radical nephrectomy renal insufficiency plays an important role in the decision-making process regarding renal surgery options. Furthermore, the prediction of both postoperative renal insufficiency and postoperative cardiovascular disease occurrence, which is suggested to be an adverse consequence caused by renal insufficiency, contributes to the preoperative policy decision as well as the precise informed consent for a renal cell carcinoma patient. Preoperative nomograms for the prediction of post-radical nephrectomy renal insufficiency, calculated using patient backgrounds, are advocated. The use of these nomograms together with other types of nomograms predicting oncological outcome is beneficial. Post-radical nephrectomy attending physicians can predict renal insufficiency based on the normal renal parenchymal pathology in addition to preoperative patient characteristics. It is suggested that a high level of global glomerulosclerosis in nephrectomized normal renal parenchyma is closely associated with severe renal insufficiency. Some studies showed that post-radical nephrectomy severe renal insufficiency might have an association with increased mortality as a result of cardiovascular disease. Therefore, such pathophysiology should be recognized as life-threatening, surgically-related chronic kidney disease. On the contrary, the investigation of the prediction of mild post-radical nephrectomy renal insufficiency, which is not related to adverse consequences in the postoperative long-term period, is also promising because the prediction of mild renal insufficiency might be the basis for the substitution of radical nephrectomy for nephron-sparing surgery in technically difficult or compromised cases. The deterioration of quality of life caused by post-radical nephrectomy renal insufficiency should be investigated in conjunction with life-threatening matters.

  16. Laparoscopic donor nephrectomy, complications and management: a single center experience

    PubMed Central

    Tuğcu, Volkan; Şahin, Selçuk; Yiğitbaşı, İsmail; Şener, Nevzat Can; Akbay, Fatih Gökhan; Taşçı, Ali İhsan

    2017-01-01

    Objective To present our experience with laparoscopic donor nephrectomy (LDN), our complications and management modalities. Material and methods: Fifty-one transperitoneal LDNs performed in our clinic between the years 2011, and 2015, were evaluated retrospectively. Demographic characteristics of the patients, operative and postoperative data and complications were evaluated. Results Nineteen female and 32 male patients with ages ranging from 24 to 65 years underwent left- (n=44), and right-sided (n=7) LDNs. Six patients had two, and one patient three renal arteries. Mean operation time was 115±11 (min–max: 90–150) minutes, and mean warm ischemia time 111±9 (min–max: 90–140 sec) seconds. Mean hospital stay was found to be 2.5±0.5 days. No patient needed to switch to open surgery. In one patient, lumbar vein was ruptured, and hemostatic control was achieved laparoscopically. Postoperative paralytic ileus developed in two patients. Three patients had postoperative atelectasis, and a febrile (38.1°C) episode. Conclusion LDN is a minimally invasive method with advantages of short hospital stay, less analgesic requirement, and better cosmetic results. However it should be performed by surgeons with advanced laparoscopic experience. PMID:28270958

  17. LESS living donor nephrectomy: Surgical technique and results

    PubMed Central

    Alessimi, Abdullah; Adam, Emilie; Haber, Georges-Pascal; Badet, Lionel; Codas, Ricardo; Fehri, Hakim Fassi; Martin, Xavier; Crouzet, Sébastien

    2015-01-01

    Purpose: We present the findings of 50 patients undergoing pure trans-umbilical laparo-endoscopic single-site surgery (LESS) living donor nephrectomy (LDN), between February 2010 and May 2014. Materials and Methods: Laparo-endoscopic single-site surgery LDN was performed through an umbilical incision. Different trocars were used, namely Gelpoint (Applied Mιdical, Rancho Santa Margarita, CA) SILS port (Covidien, Hamilton, Bermuda), R-port (Olympus Surgical, Orangeburg, NY) and standard trocars, inserted through the same skin incision but using separate fascial punctures. The standard laparoscopic technique was employed. The kidney was pre-entrapped in a retrieval bag and extracted trans-umbilically. Data were collected prospectively including questionnaires containing patient reported oral pain medication duration and time to recovery. Results: LESS LDN was successful in all patients. Mean warm ischemia time was 6.2 min (3–15), mean procedure time was 233.2 min (172–300), and hospitalization stay was 3.94 days (3–7) with a visual analogue pain score at discharge of 1.32 (0–3). No intraoperative complications occurred. The mean time of oral pain medication was 8.72 days (1–20) and final scar length was 4.06 cm (3–5). Each allograft was functional. Conclusion: Although challenging, trans-umbilical LESS LDN seems to be feasible and safe. Hence, LESS has the potential to improve cosmetic results and decrease morbidity. PMID:26229326

  18. Army Robotics

    DTIC Science & Technology

    2009-10-07

    Army Robotics 07 October 2009 Dr. Grant Gerhart, Senior Research Scientist Bernard Theisen, Joint Center for Robotics DISTRIBUTION STATEMENT A... Robots 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Grant Gerhart; Bernard Theisen 5d. PROJECT NUMBER 5e. TASK...CBRNE • IED Defeat Systems • Disarm / Disrupt • Reconnaissance • Investigation • Explosive Sniffer • Common Robotic Kit • EOD • Convoy • Log

  19. Space Robotics

    DTIC Science & Technology

    1982-08-01

    ACCESSION NO 3. RECIPIENTS CATALOG NUIA3.R CMU-RI-TR-82-10 I4 1 (. 4. ;,;-LL (and Sublitle) S. TYPE OF REPORT & PERIOD CovEREO SPACE ROBOTICS Interim... Robotics Institute Pittsburgh, PA. 15213 It. CONTROLLING OFFICE NAME AND ADDRESS 12. REPORT DATE Office of Naval Research -August 1982 Arlington, VA 22217...SXnet.eE . Space Robotics Richard E. Korf Department of Computer Science and The Robotics Institute Carnegie-Mellon University Pittsburgh, Oetusylvania

  20. TARDEC Robotics

    DTIC Science & Technology

    2010-01-12

    unclassified TARDEC Robotics Dr. James L. Overholt Director, Joint Center for Robotics US Army TARDEC Report Documentation Page Form ApprovedOMB No...COVERED - 4. TITLE AND SUBTITLE TARDEC Robotics 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) James L. Overholt... Robotics , Network and Control Components with a Focus on Customer Driven Requirements to Provide Full System Solutions to the War Fighter Technology

  1. (Robotic hands)

    SciTech Connect

    Mann, R.C.

    1988-09-23

    The traveler attended the International Workshop on Robot Hands at the Palace Hotel in Dubrovnik, Yugoslavia. The traveler presented a lecture on An integrated sensor system for the ORNL mobile robot.'' The traveler obtained important information on current R D efforts in multi-fingered robot hands and object recognition using touch sensing.

  2. Basic Robotics.

    ERIC Educational Resources Information Center

    Mullen, Frank

    This curriculum outline consists of instructional materials and information concerning resources for use in teaching a course in robotics. Addressed in the individual sections of the outline are the following topics: the nature of an industrial robot; the parts of an industrial robot (the manipulator, the power structure, and the control system);…

  3. Industrial Robots.

    ERIC Educational Resources Information Center

    Reed, Dean; Harden, Thomas K.

    Robots are mechanical devices that can be programmed to perform some task of manipulation or locomotion under automatic control. This paper discusses: (1) early developments of the robotics industry in the United States; (2) the present structure of the industry; (3) noneconomic factors related to the use of robots; (4) labor considerations…

  4. Subtotal nephrectomy inhibits the gastric emptying of liquid in awake rats

    PubMed Central

    da Graça, José Ronaldo Vasconcelos; Parente, Cynara Carvalho; Fiúza, Robério Ferreira; da Silva, Pedro Alberto Freitas; Mota, Bruno Teixeira; Salles, Luiz Derwal; Silva, Camila Meirelles de Souza; da Silva, Moisés Tolentino Bento; de Oliveira, Ricardo Brandt; dos Santos, Armenio Aguiar

    2015-01-01

    Homeostasis of blood volume (BV) is attained through a functional interaction between the cardiovascular and renal systems. The gastrointestinal tract also adjusts its permeability and motor behavior after acute BV imbalances. We evaluated the effect of progressive nephron loss on gut motility. Male Wistar rats were subjected or not (sham) to 5/6 partial nephrectomy (PNX) in two steps (0 and 7th day). After further 3, 7, or 14 days, PNX and sham operation (control) rats were instrumented to monitor mean arterial pressure (MAP), central venous pressure (CVP), heart rate (HR), and blood collection for biochemical analysis. The next day, they were gavage fed with a liquid test meal (phenol red in glucose solution), and fractional dye recovery determined 10, 20, or 30 min later. The effect of nonhypotensive hypovolemia and the role of neuroautonomic pathways on PNX-induced gastric emptying (GE) delay were also evaluated. Compared with the sham-operated group, PNX rats exhibited higher (P < 0.05) MAP and CVP values as well as increased values of gastric dye recovery, phenomenon proportional to the BV values. Gastric retention was prevented by prior hypovolemia, bilateral subdiaphragmatic vagotomy, coelic ganglionectomy + splanchnicectomy, guanethidine, or atropine pretreatment. PNX also inhibited (P < 0.05) the marker's progression through the small intestine. In anesthetized rats, PNX increased (P < 0.05) gastric volume, measured by a balloon catheter in a barostat system. In conclusion, the progressive loss of kidney function delayed the GE rate, which may contribute to gut dysmotility complaints associated with severe renal failure. PMID:25677547

  5. Clinicians’ Real World Perceptions of Pre-Nephrectomy Diagnostic Biopsy Performance as a Driver of Reduction in Unnecessary Surgeries in Renal Tumors

    PubMed Central

    Augustine, Lauren; Sanden, Mats O.; Wassman, E. Robert

    2015-01-01

    Operative removal of oncocytomas is generally unnecessary, but not infrequent in the context of renal masses. The infrequent use of pre-nephrectomy biopsies is a function of historical limitations of histopathological differential diagnosis in this setting. Assessment of clinicians’ receptiveness to a novel molecular diagnostic approach to this challenge was undertaken by means of a survey vehicle administered to 102 practicing urologists and pathologists who met inclusion criteria related to their actual clinical activity. Survey results supported the previously reported observations on misdiagnosis with urologists’ reported rates of 25% inconclusive results, and an additional 17% disagree with the final surgical diagnosis. The self-reported rate of 9% for pre-operative biopsies was comparable to prior reports, but 39% of urologists who are not currently performing pre-operative biopsies expressed interest in introducing them into their practice for this purpose with an improved diagnostic. Almost all urologists (94%) felt it important not to resect benign oncocytomas and 62% indicated they would use a test which improved the ability to sub-type renal tumors pre-operatively. The level of performance benchmark of the unidentified prototypic microRNA-based diagnostic as reported previously in the literature was deemed sufficient to change care in these cases by 73%. Overall they predicted a 38% rate of biopsies and resulting increases in decisions to forgo nephrectomy or to perform only partial nephrectomy. Pathologists also expressed support for the use of this technology in the context of inadequate specimens and for improved sub-typing of these tumors in inconclusive cases.

  6. Renal artery aneurysm in hand-assisted laparoscopic donor nephrectomy: case report.

    PubMed

    Maciel, R F; Branco, A J; Branco, A W; Guterres, J C; Silva, A E; Ramos, L B; Rost, C; Vieira, C A; Cicogna, P E S; Daudt, C A; Deboni, L M; Vieira, M A; Luz, H A; Vieira, J A

    2003-12-01

    We report a living donor who underwent laparoscopic nephrectomy using a hand-assisted device (HALD). At preoperative arteriography the donor showed a renal artery aneurysm. The patient was a 37-year-old female, 166 cm height, white, weighing 87 kg, HLA identical to the recipient. HALD was indicated due to the better visualization of renal pedicle and greater security in an obese patient. Renal artery aneurysm is a rare condition, with many possible complications. The method proved to be adequate and safe for donor nephrectomy, despite a renal artery aneurysm.

  7. Market-Driven Multi-Robot Exploration

    DTIC Science & Technology

    2002-01-01

    For many real-world applications, autonomous robots must execute complex tasks in unknown or partially known unstructured environments. This work...to communication interruptions and failures. Results showing the capabilities of our system on a team of exploring autonomous robots are also given.

  8. TARDEC Robotics

    DTIC Science & Technology

    2011-03-01

    TARDEC Robotics Dr. Greg Hudas Greg.hudas@us.army.mil UNCLASSIFIED: Dist A. Approved for public release Report Documentation Page Form ApprovedOMB...COVERED - 4. TITLE AND SUBTITLE TARDEC Robotics 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Dr. Greg Hudas...ANSI Std Z39-18 Excellence in Robotics Outreach & University Shaping Requirements Building Modeling & Simulation Component Development International

  9. ROBOT WRITING,

    DTIC Science & Technology

    Technical writers who are hypnotized by the mechanical metaphor inevitably produce robot writing - a separate language, distantly related to the...prose of Darwin, Huxley, Jeans, and Einstein. Where they were clear, fresh, and graceful, the robot writer is hard, dull, and clumsy. Where they were...merely human, the robot writer is infallible, prefabricated, impersonal, and irresponsible. These four characteristics are interlinked. An example of one usually illustrates the other three.

  10. Robot Programming.

    DTIC Science & Technology

    1982-12-01

    8217AD-A127 233 ROBOT PROGRRMMING(U) MASSACHUSETTS INST OFGTECHi/ CAMBRIDGE ARTIFICIAL INTELLIGENCE LAB T LOZANO-PEREZ UNCLASSIFIED DC8 AI-9 N884...CATALOG NUMBER * a ~AIM 698 R a is 4. TITLE (and Subtitle) S. TYPE OF REPORT & PERIOD COVERED Robot Programming Memorandum 6. PERFORMING ORG. REPORT...34R Distribution is Unlimted .. SUPPLEMENTARY NOTES None 1. KEY WORDS (Continue on r verea aide ii neeaortm and Identify by block number) *Q. Robotics

  11. Robotics research

    SciTech Connect

    Brady, M.; Paul, R.

    1984-01-01

    Organized around a view of robotics as ''the intelligent connection of perception to action,'' the fifty-three contributions collected in this book present leading current research in one of the fastest moving fields of artificial intelligence. Readings Include: Hand-Eye Coordination in Rope Handling; 3-D Balance Using 2-D algorithms. A Model Driven Visual Inspection Module: Stereo Vision: Complexity and Constraints; Interpretation of Contact Geometers from Force Measurement; The Utah MIT Dextrous Hand: Work in Progress; Hierarchical Nonlinear Control for Robots; VAL-11; A Robot Programming Language and Control System; Technological Barriers in Robotics: A Perspective from Industry.

  12. Hopping robot

    DOEpatents

    Spletzer, Barry L.; Fischer, Gary J.; Marron, Lisa C.; Martinez, Michael A.; Kuehl, Michael A.; Feddema, John T.

    2001-01-01

    The present invention provides a hopping robot that includes a misfire tolerant linear actuator suitable for long trips, low energy steering and control, reliable low energy righting, miniature low energy fuel control. The present invention provides a robot with hopping mobility, capable of traversing obstacles significant in size relative to the robot and capable of operation on unpredictable terrain over long range. The present invention further provides a hopping robot with misfire-tolerant combustion actuation, and with combustion actuation suitable for use in oxygen-poor environments.

  13. Can right-sided hand-assisted retroperitoneoscopic donor nephrectomy be advocated above standard laparoscopic donor nephrectomy: a randomized pilot study.

    PubMed

    Klop, Karel W J; Kok, Niels F M; Dols, Leonienke F C; Dor, Frank J M F; Tran, Khe T C; Terkivatan, Türkan; Weimar, Willem; Ijzermans, Jan N M

    2014-02-01

    Endoscopic techniques have contributed to early recovery and increased quality of life (QOL) of live kidney donors. However, laparoscopic donor nephrectomy (LDN) may have its limitations, and hand-assisted retroperitoneoscopic donor nephrectomy (HARP) has been introduced, mainly as a potentially safer alternative. In a randomized fashion, we explored the feasibility and potential benefits of HARP for right-sided donor nephrectomy in a referral center with longstanding expertise on the standard laparoscopic approach. Forty donors were randomly assigned to either LDN or HARP. Primary outcome was operating time, and secondary outcomes included QOL, complications, pain, morphine requirement, blood loss, warm ischemia time, and hospital stay. Follow-up time was 1 year. Skin-to-skin time did not significantly differ between both groups (162 vs. 158 min, P = 0.98). As compared to LDN, HARP resulted in a shorter warm ischemia time (2.8 vs. 3.9 min, P < 0.001) and increased blood loss (187 vs. 50 ml, P < 0.001). QOL, complication rate, pain, or hospital stay was not significantly different between the groups. Right-sided HARP is feasible but does not confer clear benefits over standard right-sided LDN yet. Further studies should explore the value of HARP in difficult cases such as the obese donor and the value of HARP for transplantation centers starting a live kidney donation program (Dutch Trial Register number: NTR3096). Nevertheless, HARP is a valuable addition to the surgical armamentarium in live donor surgery.

  14. Hypernephroma Presenting with Cutaneous Leukocytoclastic Vasculitis and Lupus Anticoagulant: Resolution after Nephrectomy

    PubMed Central

    Murray, Nigel P.; Ruíz, Amparo; Reyes, Eduardo

    2012-01-01

    Hypernephroma can present as a variety of paraneoplastic, nonmetastatic conditions, including vasculitis, and rarely a lupus-type anticoagulant. Nephrectomy leads to the resolution of the systemic complaints. Malignancy, in this case hypernephroma, can present as an immune-mediated paraneoplastic syndrome which resolves after removal of the underlying tumor. PMID:22919534

  15. Laparoscopic vs open donor nephrectomy: Lessons learnt from single academic center experience

    PubMed Central

    Tsoulfas, Georgios; Agorastou, Polyxeni; Ko, Dicken S C; Hertl, Martin; Elias, Nahel; Cosimi, AB; Kawai, Tatsuo

    2017-01-01

    AIM To compare laparoscopic and open living donor nephrectomy, based on the results from a single center during a decade. METHODS This is a retrospective review of all living donor nephrectomies performed at the Massachusetts General Hospital, Harvard Medical School, Boston, between 1/1998 - 12/2009. Overall there were 490 living donors, with 279 undergoing laparoscopic living donor nephrectomy (LLDN) and 211 undergoing open donor nephrectomy (OLDN). Demographic data, operating room time, the effect of the learning curve, the number of conversions from laparoscopic to open surgery, donor preoperative glomerular filtration rate and creatinine (Cr), donor and recipient postoperative Cr, delayed graft function and donor complications were analyzed. Statistical analysis was performed. RESULTS Overall there was no statistically significant difference between the LLDN and the OLDN groups regarding operating time, donor preoperative renal function, donor and recipient postoperative kidney function, delayed graft function or the incidence of major complications. When the last 100 laparoscopic cases were analyzed, there was a statistically significant difference regarding operating time in favor of the LLDN, pointing out the importance of the learning curve. Furthermore, another significant difference between the two groups was the decreased length of stay for the LLDN (2.87 d for LLDN vs 3.6 d for OLDN). CONCLUSION Recognizing the importance of the learning curve, this paper provides evidence that LLDN has a safety profile comparable to OLDN and decreased length of stay for the donor. PMID:28101451

  16. Robotics 101

    ERIC Educational Resources Information Center

    Sultan, Alan

    2011-01-01

    Robots are used in all kinds of industrial settings. They are used to rivet bolts to cars, to move items from one conveyor belt to another, to gather information from other planets, and even to perform some very delicate types of surgery. Anyone who has watched a robot perform its tasks cannot help but be impressed by how it works. This article…

  17. Robotic Surgery

    NASA Technical Reports Server (NTRS)

    2000-01-01

    The Automated Endoscopic System for Optimal Positioning, or AESOP, was developed by Computer Motion, Inc. under a SBIR contract from the Jet Propulsion Lab. AESOP is a robotic endoscopic positioning system used to control the motion of a camera during endoscopic surgery. The camera, which is mounted at the end of a robotic arm, previously had to be held in place by the surgical staff. With AESOP the robotic arm can make more precise and consistent movements. AESOP is also voice controlled by the surgeon. It is hoped that this technology can be used in space repair missions which require precision beyond human dexterity. A new generation of the same technology entitled the ZEUS Robotic Surgical System can make endoscopic procedures even more successful. ZEUS allows the surgeon control various instruments in its robotic arms, allowing for the precision the procedure requires.

  18. Robot Design

    NASA Technical Reports Server (NTRS)

    1988-01-01

    Martin Marietta Aero and Naval Systems has advanced the CAD art to a very high level at its Robotics Laboratory. One of the company's major projects is construction of a huge Field Material Handling Robot for the Army's Human Engineering Lab. Design of FMR, intended to move heavy and dangerous material such as ammunition, was a triumph in CAD Engineering. Separate computer problems modeled the robot's kinematics and dynamics, yielding such parameters as the strength of materials required for each component, the length of the arms, their degree of freedom and power of hydraulic system needed. The Robotics Lab went a step further and added data enabling computer simulation and animation of the robot's total operational capability under various loading and unloading conditions. NASA computer program (IAC), integrated Analysis Capability Engineering Database was used. Program contains a series of modules that can stand alone or be integrated with data from sensors or software tools.

  19. Robotic transportation.

    PubMed

    Lob, W S

    1990-09-01

    Mobile robots perform fetch-and-carry tasks autonomously. An intelligent, sensor-equipped mobile robot does not require dedicated pathways or extensive facility modification. In the hospital, mobile robots can be used to carry specimens, pharmaceuticals, meals, etc. between supply centers, patient areas, and laboratories. The HelpMate (Transitions Research Corp.) mobile robot was developed specifically for hospital environments. To reach a desired destination, Help-Mate navigates with an on-board computer that continuously polls a suite of sensors, matches the sensor data against a pre-programmed map of the environment, and issues drive commands and path corrections. A sender operates the robot with a user-friendly menu that prompts for payload insertion and desired destination(s). Upon arrival at its selected destination, the robot prompts the recipient for a security code or physical key and awaits acknowledgement of payload removal. In the future, the integration of HelpMate with robot manipulators, test equipment, and central institutional information systems will open new applications in more localized areas and should help overcome difficulties in filling transport staff positions.

  20. [Robotic surgery].

    PubMed

    Sándor, József; Haidegger, Tamás; Kormos, Katalin; Ferencz, Andrea; Csukás, Domokos; Bráth, Endre; Szabó, Györgyi; Wéber, György

    2013-10-01

    Due to the fast spread of laparoscopic cholecystectomy, surgical procedures have been changed essentially. The new techniques applied for both abdominal and thoracic procedures provided the possibility for minimally invasive access with all its advantages. Robots - originally developed for industrial applications - were retrofitted for laparoscopic procedures. The currently prevailing robot-assisted surgery is ergonomically more advantageous for the surgeon, as well as for the patient through the more precise preparative activity thanks to the regained 3D vision. The gradual decrease of costs of robotic surgical systems and development of new generations of minimally invasive devices may lead to substantial changes in routine surgical procedures.

  1. Subsumption Robotics

    DTIC Science & Technology

    1998-01-01

    Subsumption Robotics Christopher K. DeBolt Naval EOD Technology Division 2008 Stump Neck Road Indian Head, MD 20640-5070 phone: (301) 744-6850, Ext...eodmgate.navsea.navy.mil; nguyent.eodtc@eodmgate.navsea.navy.mil Helen Greiner and Polly K. Pook I.S. Robotics phone: (617) 629-0055 e-mail: helen@isr.com , pook...408) 656-3462 e-mail: healey@me.nps.navy.mil LONG-TERM GOALS Through the use of subsumption architectures, low cost, simple robots can be developed

  2. Ginger Essence Effect on Nausea and Vomiting After Open and Laparoscopic Nephrectomies

    PubMed Central

    Hosseini, Fatemeh Sadat; Adib-Hajbaghery, Mohsen

    2015-01-01

    Background: Some studies reported that ginger was effective in prevention or treatment of post-surgical nausea and vomiting; however, there are controversies. In addition, no study compared the effects of ginger on nausea and vomiting after open and laparoscopic nephrectomies. Objectives: The current study aimed to compare the effect of ginger essence on nausea and vomiting after open versus laparoscopic nephrectomies. Patients and Methods: A randomized, placebo trial was conducted on two groups of patients, 50 open and 50 laparoscopic nephrectomy. Half of the subjects in each group received ginger essence and the other half received placebo. Using a visual analogue scale the severity of nausea was assessed every 15 minutes for the first two post-operative hours and the sixth hour. Frequency of vomiting was counted until the sixth hour. The placebo subgroups were treated similarly. Descriptive statistics were employed. Chi-square and Fisher’s exact tests, paired and independent samples t-test and repeated measure analysis of variance were used to analyze the data. Results: Repeated measure analysis of variance showed that the type of surgery and the type of intervention as factors had significant effects on the nausea severity scores in the nine successive measurements (P < 0.001). In the first two post-operative hours, the mean vomiting episodes was 2.92 ± 0.70 in the subjects who underwent open surgery and received placebo while it was 0.16 ± 0.37 in patients with the same surgery but receiving ginger essence (P = 0.001). The mean vomiting episodes was 6.0 ± 1.33 in the subjects who underwent laparoscopic surgery and received placebo while it was 1.39 ± 0.78 in patients with the same surgery but receiving ginger essence (P = 0.001). Conclusions: Using ginger essence was effective in reducing nausea and vomiting not only in the subjects who underwent open nephrectomy but also in the subjects of laparoscopic nephrectomy. Using ginger essence is suggested as a

  3. Comparative effectiveness of adrenal sparing radical nephrectomy and non-adrenal sparing radical nephrectomy in clear cell renal cell carcinoma: Observational study of survival outcomes

    PubMed Central

    Nason, Gregory J.; Walsh, Leon G.; Redmond, Ciaran E.; Kelly, Niall P.; McGuire, Barry B.; Sharma, Vidit; Kelly, Michael E.; Galvin, David J.; Mulvin, David W.; Lennon, Gerald M.; Quinlan, David M.; Flood, Hugh D.; Giri, Subhasis K.

    2015-01-01

    Introduction: We compare the survival outcomes of patients with clear cell renal cell carcinoma (RCC) treated with adrenal sparing radical nephrectomy (ASRN) and non-adrenal sparing radical nephrectomy (NASRN). Methods: We conducted an observational study based on a composite patient population from two university teaching hospitals who underwent RN for RCC between January 2000 and December 2012. Only patients with pathologically confirmed RCC were included. We excluded patients undergoing cytoreductive nephrectomy, with loco-regional lymph node involvement. In total, 579 patients (ASRN = 380 and NASRN = 199) met our study criteria. Patients were categorized by risk groups (all stage, early stage and locally advanced RCC). Overall survival (OS) and cancer-specific survival (CSS) were analyzed for risk groups. Survival analysis was performed using Kaplan-Meier curves and Cox proportional hazards regression. Results: The median follow-up was 41 months (range: 12–157). There were significant benefits in OS (ASRN 79.5% vs. NASRN 63.3%; p = 0.001) and CSS (84.3% vs. 74.9%; p = 0.001), with any differences favouring ASRN in all stage. On multivariate analysis, there was a trend towards worse OS (hazard ratio [HR] 1.759, 95% confidence interval [CI] 0.943–2.309, p = 0.089) and CSS (HR 1.797, 95% CI 0.967–3.337, p = 0.064) in patients with NASRN (although not statistically significant). Of these patients, only 11 (1.9%) had adrenal involvement. Conclusions: The inherent limitations in our study include the impracticality of conducting a prospective randomized trial in this scenario. Our observational study with a 13-year follow-up suggests ASRN leads to better survival than NASRN. ASRN should be considered the gold standard in treating patients with RCC, unless it is contraindicated. PMID:26425218

  4. Robotic arm

    DOEpatents

    Kwech, Horst

    1989-04-18

    A robotic arm positionable within a nuclear vessel by access through a small diameter opening and having a mounting tube supported within the vessel and mounting a plurality of arm sections for movement lengthwise of the mounting tube as well as for movement out of a window provided in the wall of the mounting tube. An end effector, such as a grinding head or welding element, at an operating end of the robotic arm, can be located and operated within the nuclear vessel through movement derived from six different axes of motion provided by mounting and drive connections between arm sections of the robotic arm. The movements are achieved by operation of remotely-controllable servo motors, all of which are mounted at a control end of the robotic arm to be outside the nuclear vessel.

  5. Robotic vehicle

    DOEpatents

    Box, W.D.

    1998-08-11

    A robotic vehicle is described for travel through a conduit. The robotic vehicle includes forward and rear housings each having a hub portion, and each being provided with surface engaging mechanisms for selectively engaging the walls of the conduit such that the housings can be selectively held in stationary positions within the conduit. The surface engaging mechanisms of each housing includes a plurality of extendible appendages, each of which is radially extendible relative to the operatively associated hub portion between a retracted position and a radially extended position. The robotic vehicle also includes at least three selectively extendible members extending between the forward and rear housings, for selectively changing the distance between the forward and rear housings to effect movement of the robotic vehicle. 20 figs.

  6. Robotic vehicle

    DOEpatents

    Box, W.D.

    1997-02-11

    A robotic vehicle is described for travel through a conduit. The robotic vehicle includes forward and rear housings each having a hub portion, and each being provided with surface engaging mechanisms for selectively engaging the walls of the conduit such that the housings can be selectively held in stationary positions within the conduit. The surface engaging mechanisms of each housing includes a plurality of extendable appendages, each of which is radially extendable relative to the operatively associated hub portion between a retracted position and a radially extended position. The robotic vehicle also includes at least three selectively extendable members extending between the forward and rear housings, for selectively changing the distance between the forward and rear housings to effect movement of the robotic vehicle. 20 figs.

  7. Robotic vehicle

    DOEpatents

    Box, W. Donald

    1998-01-01

    A robotic vehicle for travel through a conduit. The robotic vehicle includes forward and rear housings each having a hub portion, and each being provided with surface engaging mechanisms for selectively engaging the walls of the conduit such that the housings can be selectively held in stationary positions within the conduit. The surface engaging mechanisms of each housing includes a plurality of extendable appendages, each of which is radially extendable relative to the operatively associated hub portion between a retracted position and a radially extended position. The robotic vehicle also includes at least three selectively extendable members extending between the forward and rear housings, for selectively changing the distance between the forward and rear housings to effect movement of the robotic vehicle.

  8. Robotic vehicle

    DOEpatents

    Box, W. Donald

    1997-01-01

    A robotic vehicle for travel through a conduit. The robotic vehicle includes forward and rear housings each having a hub portion, and each being provided with surface engaging mechanisms for selectively engaging the walls of the conduit such that the housings can be selectively held in stationary positions within the conduit. The surface engaging mechanisms of each housing includes a plurality of extendable appendages, each of which is radially extendable relative to the operatively associated hub portion between a retracted position and a radially extended position. The robotic vehicle also includes at least three selectively extendable members extending between the forward and rear housings, for selectively changing the distance between the forward and rear housings to effect movement of the robotic vehicle.

  9. Robot Rescue

    NASA Technical Reports Server (NTRS)

    Morring, Frank, Jr.

    2004-01-01

    Tests with robots and the high-fidelity Hubble Space Telescope mockup astronauts use to train for servicing missions have convinced NASA managers it may be possible to maintain and upgrade the orbiting observatory without sending a space shuttle to do the job. In a formal request last week, the agency gave bidders until July 16 to sub-mit proposals for a robotic mission to the space telescope before the end of 2007. At a minimum, the mission would attach a rocket motor to deorbit the telescope safely when its service life ends. In the best case, it would use state-of-the- art robotics to prolong its life on orbit and install new instruments. With the space shuttle off-limits for the job under strict post-Columbia safety policies set by Administrator Sean O'Keefe, NASA has designed a "straw- man" robotic mission that would use an Atlas V or Delta N to launch a 20,ooO-lb. "Hubble Robotic Vehicle" to service the telescope. There, a robotic arm would grapple it, much as the shuttle does.

  10. Handbook of industrial robotics

    SciTech Connect

    Nof, S.Y.

    1985-01-01

    This book presents papers on the application of artificial intelligence to robots used in industrial plants. Topics considered include vision systems, elements of industrial robot software, robot teaching, the off-line programming of robots, a structured programming robot language, task-level manipulator programming, expert systems, and the role of the computer in robot intelligence.

  11. Tutorial on robotics

    SciTech Connect

    Lee, C.S.G.; Gonzalez, R.C.; Fu, K.S.

    1986-01-01

    Basic fundamentals in robotics are presented in this tutorial. Topics covered are as follows: robot arm kinematics; robot arm dynamics; planning or manipulator trajectories; servo control for manipulators; force sensing and control; robot vision systems; robot programming languages; and machine intelligence and robot planning.

  12. Mechanism of adrenal angiotensin II receptor changes after nephrectomy in rats.

    PubMed Central

    Douglas, J G

    1981-01-01

    At 48 h after bilateral nephrectomy in rats there is a two- to threefold increase in the number of adrenal angiotensin II receptors and a decrease in Kd of smooth muscle angiotensin II receptors. These changes have been attributed to the absence of circulating angiotensin II. Serum K+, which increases after nephrectomy may be an important and overlooked modulator. Therefore, the present experiments were designed to assess the role of K+ as a regulator of angiotensin II receptors after nephrectomy. Serum K+ was controlled with Na polystyrene sulfonate (Kayexalate), a resin designed to exchange Na+ for K+ in the gastrointestinal tract. Acutely nephrectomized rats were divided into two groups: experimental animals received Kayexalate resin every 12 h for four doses, and controls received Kayexalate exchanged with KCl in vitro before gavage. There was a significant positive correlation serum K+ and aldosterone (r = 0.78, P less than 0.001). Kayexalate maintained a normal serum K+ of 5.9 +/- 0.2 meq/liter (n = 27), aldosterone 25 +/- 3 ng/dl (n = 27) and adrenal receptor concentration of 934 +/- 156 fmol/mg protein (n = 4). Control animals had significantly higher serum K+ of 10.5 +/- 0.4 meq/liter (n = 23), aldosterone 435 +/- 32 (n = 23), and adrenal receptors of 2726 +/- 235 fmol/mg protein (n = 4). There was a linear relationship between serum K+ and number of adrenal receptors (r = 0.87). No such relationship was present in uterine smooth muscle. Therefore, these studies demonstrate that K+ modulates the number of adrenal but not smooth muscle angiotensin II receptors after nephrectomy. This is the first evidence that potassium modulates angiotensin II receptors independently of changes in angiotensin II blood levels. PMID:6259213

  13. Compensatory renal growth after unilateral nephrectomy in the new-born rat

    PubMed Central

    Dicker, S. E.; Shirley, D. G.

    1973-01-01

    1. The right kidney in a series of control rats aged between 5 days and 115 days was weighed. The kidney weight/body weight ratio was greater in young than in older rats, but decreased linearly with increasing age. 2. After unilateral nephrectomy of rats 5 days old, the remaining kidney underwent compensatory growth. The rate and extent of this growth were greater than in adult rats. 3. The concentrations of RNA and DNA in the renal cortex and medulla of rats 5 days old were higher than in adult animals. The concentrations of the two nucleic acids fell with age, and reached adult levels after approximately 6 weeks. 4. After unilateral nephrectomy of rats 5 days old, the concentrations of RNA and DNA in the medulla were not significantly different from those in control animals. In the cortex, however, there was a delayed increase in the RNA/DNA ratio, which reached a level some 12% higher than that in control rats. This increase was smaller than that observed in unilaterally nephrectomized adult rats. 5. The cortical QO2 of the remaining kidney of unilaterally nephrectomized new-born rats was elevated by some 20% within 1 day of unilateral nephrectomy. Cortical QO2's remained higher than those of control animals for 3-4 weeks. 6. Since after unilateral nephrectomy, the increase in renal mass in new-borns was greater than that in adults, whereas the degree of cortical cellular hypertrophy (as estimated by the RNA/DNA ratio) was smaller than in adults, it is likely that in new-born animals a significant contribution to compensatory growth comes from cellular hyperplasia. PMID:4686024

  14. Open surgery versus retroperitoneal laparoscopic nephrectomy for renal tuberculosis: a retrospective study of 120 patients

    PubMed Central

    Wang, Cheng; Xiong, Hu; Fu, Sheng-Jun

    2016-01-01

    Background Laparoscopic renal surgery has been widely used in the treatment of renal diseases. However, there is still little research about its application in addressing renal tuberculosis. The purpose of this study is to retrospectively investigate the surgical results of laparoscopic and open surgery for nonfunctional tuberculous kidneys. Methods Between May 2011 and June 2016, 120 nephrectomies were performed in patients with a nonfunctional tuberculous kidney. Of these, 69 patients underwent retroperitoneal laparoscopic nephrectomy, and 51 patients underwent open nephrectomy. Data about the patients’ characteristics and surgical outcomes were collected from their electronic medical records. Outcomes were compared between these two groups. Results Our results showed that a number of renal tuberculosis patients presented no significant symptoms during their disease. Lower urinary tract symptoms (LUTS) were the most common at a rate of 73/120, followed by flank pain or accidently discovery (66/120), urine abnormality (30/120) and fever (27/120). Patients who underwent open surgery were similar to laparoscopic patients with regard to sex, BMI, location, previous tuberculous history, grade, anemia, adhesion, hypertension, diabetes and preoperative serum creatinine level, but were generally older than laparoscopic patients. There were no significant differences between open and laparoscopic surgery in estimated blood loss, transfusion, postoperative hospital days and perioperative complication rate. However, the median operation time of laparoscopic operation was much longer than open surgery (180 [150–225] vs 135 [120–165] minutes, P < 0.01). Seven of the 69 laparoscopic operations were converted to open surgery because of severe adhesions. Conclusion Laparoscopic nephrectomy is as an effective treatment as open surgery for a nonfunctional tuberculous kidney, although it requires more time during the surgical procedure. No significant differences in other

  15. Allelic and Epitopic Characterization of Intra-Kidney Allograft Anti-HLA Antibodies at Allograft Nephrectomy.

    PubMed

    Milongo, D; Kamar, N; Del Bello, A; Guilbeau-Frugier, C; Sallusto, F; Esposito, L; Dörr, G; Blancher, A; Congy-Jolivet, N

    2017-02-01

    The reasons for the increased incidence of de novo anti-human leukocyte antibody (HLA) donor-specific antibodies (DSAs) observed after kidney allograft nephrectomy are not fully understood. One advocated mechanism suggests that at graft loss, DSAs are not detected in the serum because they are fixed on the nonfunctional transplant; removal of the kidney allows DSAs to then appear in the blood circulation. The aim of our study was to compare anti-HLA antibodies present in the serum and in the graft at the time of an allograft nephrectomy. Using solid-phase assays, anti-HLA antibodies were searched for in the sera of 17 kidney transplant patients undergoing allograft nephrectomy. No anti-HLA antibodies were detected in the graft if they were not also detected in the serum. Eleven of the 12 patients who had DSAs detected in their sera also had DSAs detected in the grafts. Epitopic analysis revealed that most anti-HLA antibodies detected in removed grafts were directed against the donor. In summary, our data show that all anti-HLA antibodies that were detected in grafts were also detected in the sera. These intragraft anti-HLA antibodies are mostly directed against the donor at an epitopic level but not always at an antigenic level.

  16. Effects of nephrectomy on respiratory function and quality of life of living donors: a longitudinal study

    PubMed Central

    Moraes, Karen; Paisani, Denise M.; Pacheco, Nathália C. T.; Chiavegato, Luciana D.

    2015-01-01

    BACKGROUND: A living donor transplant improves the survival and quality of life of a transplant patient. However, the impact of transplantation on postoperative lung function and respiratory muscular strength in kidney donors remains unknown. OBJECTIVE: To evaluate pulmonary function, respiratory muscle strength, quality of life and the incidence of postoperative pulmonary complications (PPCs) in kidney donors undergoing nephrectomy. METHOD: This prospective cohort enrolled 110 consecutive kidney donors undergoing nephrectomy. Subjects underwent pulmonary function (using spirometry) and respiratory muscular strength (using manovacuometry) assessments on the day prior to surgery and 1, 2, 3 and 5 days postoperatively. Quality of life (measured by the SF-36) was evaluated preoperatively and 30 days postoperatively. PPCs were assessed daily by a blinded assessor. RESULTS: Donors exhibited a decrease of 27% in forced vital capacity, 58% in maximum inspiratory capacity and 51% in maximum expiratory pressure on the 1stpostoperative day (p<0.001) but this improved over days 2, 3 and 5 but had not returned to preoperative levels. Patient quality of life was still impaired at 30 days with regards to functional capacity, physical role, pain, vitality and social functioning (p<0.05) but these parameters improved slowly. None of the patients developed PPCs. CONCLUSION: Kidney donors submitted to nephrectomy exhibited a reduction in pulmonary function, respiratory muscular strength and quality of life, most of which were improving toward pre-surgical levels. PMID:26443973

  17. Medical robotics.

    PubMed

    Ferrigno, Giancarlo; Baroni, Guido; Casolo, Federico; De Momi, Elena; Gini, Giuseppina; Matteucci, Matteo; Pedrocchi, Alessandra

    2011-01-01

    Information and communication technology (ICT) and mechatronics play a basic role in medical robotics and computer-aided therapy. In the last three decades, in fact, ICT technology has strongly entered the health-care field, bringing in new techniques to support therapy and rehabilitation. In this frame, medical robotics is an expansion of the service and professional robotics as well as other technologies, as surgical navigation has been introduced especially in minimally invasive surgery. Localization systems also provide treatments in radiotherapy and radiosurgery with high precision. Virtual or augmented reality plays a role for both surgical training and planning and for safe rehabilitation in the first stage of the recovery from neurological diseases. Also, in the chronic phase of motor diseases, robotics helps with special assistive devices and prostheses. Although, in the past, the actual need and advantage of navigation, localization, and robotics in surgery and therapy has been in doubt, today, the availability of better hardware (e.g., microrobots) and more sophisticated algorithms(e.g., machine learning and other cognitive approaches)has largely increased the field of applications of these technologies,making it more likely that, in the near future, their presence will be dramatically increased, taking advantage of the generational change of the end users and the increasing request of quality in health-care delivery and management.

  18. Rehabilitation robotics.

    PubMed

    Krebs, H I; Volpe, B T

    2013-01-01

    This chapter focuses on rehabilitation robotics which can be used to augment the clinician's toolbox in order to deliver meaningful restorative therapy for an aging population, as well as on advances in orthotics to augment an individual's functional abilities beyond neurorestoration potential. The interest in rehabilitation robotics and orthotics is increasing steadily with marked growth in the last 10 years. This growth is understandable in view of the increased demand for caregivers and rehabilitation services escalating apace with the graying of the population. We provide an overview on improving function in people with a weak limb due to a neurological disorder who cannot properly control it to interact with the environment (orthotics); we then focus on tools to assist the clinician in promoting rehabilitation of an individual so that s/he can interact with the environment unassisted (rehabilitation robotics). We present a few clinical results occurring immediately poststroke as well as during the chronic phase that demonstrate superior gains for the upper extremity when employing rehabilitation robotics instead of usual care. These include the landmark VA-ROBOTICS multisite, randomized clinical study which demonstrates clinical gains for chronic stroke that go beyond usual care at no additional cost.

  19. Rehabilitation robotics

    PubMed Central

    KREBS, H.I.; VOLPE, B.T.

    2015-01-01

    This chapter focuses on rehabilitation robotics which can be used to augment the clinician’s toolbox in order to deliver meaningful restorative therapy for an aging population, as well as on advances in orthotics to augment an individual’s functional abilities beyond neurorestoration potential. The interest in rehabilitation robotics and orthotics is increasing steadily with marked growth in the last 10 years. This growth is understandable in view of the increased demand for caregivers and rehabilitation services escalating apace with the graying of the population. We will provide an overview on improving function in people with a weak limb due to a neurological disorder who cannot properly control it to interact with the environment (orthotics); we will then focus on tools to assist the clinician in promoting rehabilitation of an individual so that s/he can interact with the environment unassisted (rehabilitation robotics). We will present a few clinical results occurring immediately poststroke as well as during the chronic phase that demonstrate superior gains for the upper extremity when employing rehabilitation robotics instead of usual care. These include the landmark VA-ROBOTICS multisite, randomized clinical study which demonstrates clinical gains for chronic stroke that go beyond usual care at no additional cost. PMID:23312648

  20. Generic robot architecture

    DOEpatents

    Bruemmer, David J [Idaho Falls, ID; Few, Douglas A [Idaho Falls, ID

    2010-09-21

    The present invention provides methods, computer readable media, and apparatuses for a generic robot architecture providing a framework that is easily portable to a variety of robot platforms and is configured to provide hardware abstractions, abstractions for generic robot attributes, environment abstractions, and robot behaviors. The generic robot architecture includes a hardware abstraction level and a robot abstraction level. The hardware abstraction level is configured for developing hardware abstractions that define, monitor, and control hardware modules available on a robot platform. The robot abstraction level is configured for defining robot attributes and provides a software framework for building robot behaviors from the robot attributes. Each of the robot attributes includes hardware information from at least one hardware abstraction. In addition, each robot attribute is configured to substantially isolate the robot behaviors from the at least one hardware abstraction.

  1. Cooperating mobile robots

    DOEpatents

    Harrington, John J.; Eskridge, Steven E.; Hurtado, John E.; Byrne, Raymond H.

    2004-02-03

    A miniature mobile robot provides a relatively inexpensive mobile robot. A mobile robot for searching an area provides a way for multiple mobile robots in cooperating teams. A robotic system with a team of mobile robots communicating information among each other provides a way to locate a source in cooperation. A mobile robot with a sensor, a communication system, and a processor, provides a way to execute a strategy for searching an area.

  2. Robotic Vehicle

    NASA Technical Reports Server (NTRS)

    1994-01-01

    A commercially available ANDROS Mark V-A robot was used by Jet Propulsion Laboratory (JPL) as the departure point in the development of the HAZBOT III, a prototype teleoperated mobile robot designed for response to emergencies. Teleoperated robots contribute significantly to reducing human injury levels by performing tasks too hazardous for humans. ANDROS' manufacturer, REMOTEC, Inc., in turn, adopted some of the JPL concepts, particularly the control panel. HAZBOT III has exceptional mobility, employs solid state electronics and brushless DC motors for safer operation, and is designed so combustible gases cannot penetrate areas containing electronics and motors. Other features include the six-degree-of-freedom manipulator, the 30-pound squeeze force parallel jaw gripper and two video cameras, one for general viewing and navigation and the other for manipulation/grasping.

  3. Robot Swarms

    NASA Technical Reports Server (NTRS)

    Morring, Frank, Jr.

    2005-01-01

    Engineers and interns at this NASA field center are building the prototype of a robotic rover that could go where no wheeled rover has gone before-into the dark cold craters at the lunar poles and across the Moon s rugged highlands-like a walking tetrahedron. With NASA pushing to meet President Bush's new exploration objectives, the robots taking shape here today could be on the Moon in a decade. In the longer term, the concept could lead to shape-shifting robot swarms designed to explore distant planetary surfaces in advance of humans. "If you look at all of NASA s projections of the future, anyone s projections of the space program, they re all rigid-body architecture," says Steven Curtis, principal investigator on the effort. "This is not rigid-body. The whole key here is flexibility and reconfigurability with a capital R."

  4. Robot Manipulators

    NASA Technical Reports Server (NTRS)

    1988-01-01

    Space Shuttle's Remote Manipulator System (Canadarm) is a 50 foot robot arm used to deploy, retrieve or repair satellites in orbit. Initial spinoff version is designed to remove, inspect and replace large components of Ontario Hydro's CANDU nuclear reactors, which supply 50 percent of Ontario Hydro's total power reduction. CANDU robot is the first of SPAR's Remote Manipulator Systems intended for remote materials handling operations in nuclear servicing, chemical processing, smelting and manufacturing. Inco Limited used remote manipulator for remote control mining equipment to enhance safety and productivity of Inco's hardrock mining operations. System not only improves safety in a hazardous operation that costs more than a score of lives annually, it also increases productivity fourfold. Remote Manipulator System Division is also manufacturing a line of industrial robots and developing additional system for nuclear servicing, mining, defense and space operations.

  5. Planning actions in robot automated operations

    NASA Technical Reports Server (NTRS)

    Das, A.

    1988-01-01

    Action planning in robot automated operations requires intelligent task level programming. Invoking intelligence necessiates a typical blackboard based architecture, where, a plan is a vector between the start frame and the goal frame. This vector is composed of partially ordered bases. A partial ordering of bases presents good and bad sides in action planning. Partial ordering demands the use of a temporal data base management system.

  6. Robot Hand

    NASA Technical Reports Server (NTRS)

    1986-01-01

    Robots are limited only by the dexterity of the hand. Dr. Salisbury, in conjunction with Stanford, Caltech and Jet Propulsion Laboratory, developed the Salisbury Hand which has three, three-jointed human-like fingers. The tips are covered with a resilient, high friction material for gripping. The robot hand can manipulate objects by finger motion, and adapts to different aims. Advanced software allows the hand to interpret information from fingertip sensors. Further development is expected. A company has been formed to reproduce the device; copies have been delivered to several laboratories.

  7. Robot Tools

    NASA Technical Reports Server (NTRS)

    1996-01-01

    Mecanotron, now division of Robotics and Automation Corporation, developed a quick-change welding method called the Automatic Robotics Tool-change System (ARTS) under Marshall Space Flight Center and Rockwell International contracts. The ARTS system has six tool positions ranging from coarse sanding disks and abrasive wheels to cloth polishing wheels with motors of various horsepower. The system is used by fabricators of plastic body parts for the auto industry, by Texas Instruments for making radar domes, and for advanced composites at Aerospatiale in France.

  8. Robot gripper

    NASA Technical Reports Server (NTRS)

    Webb, Winston S. (Inventor)

    1987-01-01

    An electronic force-detecting robot gripper for gripping objects and attaching to an external robot arm is disclosed. The gripper comprises motor apparatus, gripper jaws, and electrical circuits for driving the gripper motor and sensing the amount of force applied by the jaws. The force applied by the jaws is proportional to a threshold value of the motor current. When the motor current exceeds the threshold value, the electrical circuits supply a feedback signal to the electrical control circuit which, in turn, stops the gripper motor.

  9. Robotics Challenge: Cognitive Robot for General Missions

    DTIC Science & Technology

    2015-01-01

    ROBOTICS CHALLENGE: COGNITIVE ROBOT FOR GENERAL MISSIONS UNIVERSITY OF KANSAS JANUARY 2015 FINAL TECHNICAL REPORT... ROBOTICS CHALLENGE: COGNITIVE ROBOT FOR GENERAL MISSIONS 5a. CONTRACT NUMBER FA8750-12-1-0302 5b. GRANT NUMBER N/A 5c. PROGRAM ELEMENT NUMBER 62702E...a complicated environment, a robotic system requires both high-level command facilities and low- level sensing/control mechanisms. This report

  10. Kidney removal - discharge

    MedlinePlus

    ... nephrectomy - discharge; Open nephrectomy - discharge; Laparoscopic nephrectomy - discharge; Partial nephrectomy - discharge ... Plan to have someone drive you home from the hospital. DO NOT drive yourself home. You may ...

  11. Robotics in Construction.

    DTIC Science & Technology

    1986-01-01

    MICROCOPY RESOLUTION TEST CHART NATIONAL BUREAU OF STANDARDS 1963 A 0 ROBOTICS IN CONSTRUCTIONt 10 BY MICHAEL R. BROZZO A REPORT PRESENTED TO THE GRADUATE... ROBOTS AND ROBOTICS ---------------------------- 3 2.1 HISTORY ------------------------------------------- 3 CHAPTER THREE - BASIC ROBOT MOVEMENTS...CHAPTER FOUR - BASIC ROBOT COMPONENTS ------------------------ 8 4.1 GENERAL ------------------------------------------- 8 4.1.1 Manipulator

  12. Beyond Robotics

    ERIC Educational Resources Information Center

    Tally, Beth; Laverdure, Nate

    2006-01-01

    Chantilly High School Academy Robotics Team Number 612 from Chantilly, Virginia, is an award-winning team of high school students actively involved with FIRST (For Inspiration and Recognition of Science and Technology), a multinational nonprofit organization that inspires students to transform culture--making science, math, engineering and…

  13. Robotic Surgery

    ERIC Educational Resources Information Center

    Childress, Vincent W.

    2007-01-01

    The medical field has many uses for automated and remote-controlled technology. For example, if a tissue sample is only handled in the laboratory by a robotic handling system, then it will never come into contact with a human. Such a system not only helps to automate the medical testing process, but it also helps to reduce the chances of…

  14. Novel method of laparoendoscopic single-site and natural orifice specimen extraction for live donor nephrectomy: single-port laparoscopic donor nephrectomy and transvaginal graft extraction

    PubMed Central

    Jeong, Won Jun; Choi, Byung Jo; Hwang, Jeong Kye; Yuk, Seung Mo; Song, Min Jong

    2016-01-01

    Laparoscopic live donor nephrectomy (DN) has been established as a useful alternative to the traditional open methods of procuring kidneys. To maximize the advantages of the laparoendoscopic single-site (LESS) method, we applied natural orifice specimen extraction to LESS-DN. A 46-year-old woman with no previous abdominal surgery history volunteered to donate her left kidney to her husband and underwent single-port laparoscopic DN with transvaginal extraction. The procedure was completed without intraoperative complications. The kidney functioned well immediately after transplantation, and the donor and recipient were respectively discharged 2 days and 2 weeks postoperatively. Single-port laparoscopic DN and transvaginal graft extraction is feasible and safe. PMID:26878020

  15. Telerobotic management system: coordinating multiple human operators with multiple robots

    NASA Astrophysics Data System (ADS)

    King, Jamie W.; Pretty, Raymond; Brothers, Brendan; Gosine, Raymond G.

    2003-09-01

    This paper describes an application called the Tele-robotic management system (TMS) for coordinating multiple operators with multiple robots for applications such as underground mining. TMS utilizes several graphical interfaces to allow the user to define a partially ordered plan for multiple robots. This plan is then converted to a Petri net for execution and monitoring. TMS uses a distributed framework to allow robots and operators to easily integrate with the applications. This framework allows robots and operators to join the network and advertise their capabilities through services. TMS then decides whether tasks should be dispatched to a robot or a remote operator based on the services offered by the robots and operators.

  16. Tandem mobile robot system

    DOEpatents

    Buttz, James H.; Shirey, David L.; Hayward, David R.

    2003-01-01

    A robotic vehicle system for terrain navigation mobility provides a way to climb stairs, cross crevices, and navigate across difficult terrain by coupling two or more mobile robots with a coupling device and controlling the robots cooperatively in tandem.

  17. Resolution of renal adenocarcinoma-induced secondary inappropriate polycythaemia after nephrectomy in two cats.

    PubMed

    Klainbart, Sigal; Segev, Gilad; Loeb, Emmanuel; Melamed, Dana; Aroch, Itamar

    2008-07-01

    Two cases of secondary, inappropriate polycythaemia caused by renal adenocarcinoma in domestic shorthair cats, are described. The cats were 9 and 12 years old and both were presented because of generalised seizures presumably due to hyperviscosity. Both cats had a markedly increased haematocrit (0.770 and 0.632 l/l) and thrombocytosis (744 x 10(9)/l and 926 x 10(9)/l). An abdominal ultrasound revealed a mass in the cranial pole of one kidney in both cats. Serum erythropoietin (EPO) concentration was within the reference interval (RI) in both cats but was inappropriately high considering the markedly increased haematocrit. The cats were initially stabilised and managed by multiple phlebotomies and intravenous fluid therapy and underwent nephrectomy of the affected kidney later on. Both the polycythaemia and thrombocytosis resolved following surgery. Postoperative serum EPO concentration, measured in one cat, decreased markedly. Histopathology of the affected kidneys confirmed a diagnosis of renal adenocarcinoma. Both cats were stable for an 8-month follow-up period; however, one cat had developed a stable chronic kidney disease (CKD), while the other was represented 8 months postoperatively due to dyspnoea, and had radiographic evidence of lung metastasis, presumably because of the spread of the original renal tumour and was euthanased. Initial stabilisation of polycythaemic cats should include multiple phlebotomies. Nephrectomy should be considered in cats with secondary, inappropriate, renal adenocarcinoma-related polycythaemia when only one kidney is affected by the tumour, and provided that the other kidney's function is satisfactory. Nephrectomy should be expected to resolve the polycythaemia and lead to normalisation of serum EPO concentration.

  18. Laparoendoscopic single-site simple nephrectomy using a magnetic anchoring system in a porcine model

    PubMed Central

    Choi, Young Hyo; Lee, Hye Won; Lee, Seo Yeon; Han, Deok Hyun; Seo, Seong Il; Jeon, Seong Soo; Lee, Hyun Moo; Choi, Han Yong

    2016-01-01

    Purpose Magnetic anchoring devices may reduce the number of port sites needed in laparoscopic surgery. In this study, we prospectively assessed the feasibility of using a magnetic anchoring and guidance system (MAGS) in laparoendoscopic single-site (LESS) surgery performed by novices. Materials and Methods A total of 10 LESS simple nephrectomies were performed with or without MAGS in a nonsurvival porcine model by 6 operators with no previous LESS surgery experience. After installation of the homemade single port, an intra-abdominal magnet was fixed to the renal parenchyma with suturing and stabilized by an external magnet placed on the flank so that the position of the kidney could be easily changed by moving the external handheld magnet. The length of the procedure and any intraoperative complications were evaluated. Results Operative time (mean±standard deviation) was shorter in the group using the magnetic anchoring device (M-LESS-N) than in the group with conventional LESS nephrectomy (C-LESS-N) (63±20.8 minutes vs. 82±40.7 minutes, respectively). Although all nephrectomies were completed uneventfully in the M-LESS-N group, renal vein injury occurred during dissection of the renal hilum in two cases of C-LESS-N and was resolved by simultaneous transection of the renal artery and vein with an Endo-GIA stapler. Conclusions LESS-N using MAGS is a feasible technique for surgeons with no LESS surgery experience. Taking into account the 2 cases of renal vein injury in the C-LESS-N group, the application of MAGS may be beneficial for overcoming the learning curve of LESS surgery. PMID:27195320

  19. Simultaneous pancreas and kidney transplantation with concurrent allograft nephrectomy for recipients with prior renal transplants lost to BK virus nephropathy: two case reports.

    PubMed

    Kubal, S; Powelson, J A; Taber, T E; Goble, M L; Fridell, J A

    2010-01-01

    Candidacy for retransplantation after allograft loss due to BK virus-associated nephropathy (BKVN) with or without allograft nephrectomy is controversial. This report describes 2 renal transplant recipients who lost their grafts to BKVN and subsequently underwent simultaneous kidney and pancreas transplantation with allograft nephrectomy.

  20. Bilateral simultaneous single-port (LESS) laparoscopic nephrectomy (laparoendoscopic single site surgery)

    PubMed Central

    Page, Toby; Soomro, N. A.

    2010-01-01

    Minimal access surgery is rapidly expanding and currently single-port surgery is at the forefront of laparoscopy. Operating through a single port is technically demanding but through advances in camera design and instrument design, it is now gaining popularity. It offers minimal scar surgery as well as decreased postoperative pain and swift recovery. Here we present a case of bilateral simultaneous single-port laparoscopic nephrectomy (LESS) laparoendoscopic single site surgery in a 51-year-old man. Illustrating that LESS can be used by surgeons with laparoscopic skills outside of a few major international centers. PMID:21369399

  1. Solitary parotid metastasis 8 years after a nephrectomy for renal cell carcinoma

    PubMed Central

    Hussain, Faiz; Yedavalli, Nina; Loeffler, David; Kajdacsy-Balla, Andre

    2016-01-01

    Renal cell carcinoma is a common cancer, known for its aggressive behavior and ability to metastasize nearly every organ system in the body. While the cancer commonly spreads to a select few organs and metastasis usually develops within 5 years of diagnosis, there have been numerous case reports of atypical sites of metastasis and cases of relapse up to decades after treatment. We present a case a 65-year-old male who presented with right preauricular swelling 8 years after the initial diagnosis and right nephrectomy for clear cell renal cell cancer. We take a look at previous case reports with similar presentations. PMID:27609721

  2. Renal cell carcinoma metastatic to gallbladder: a survival advantage to simultaneous nephrectomy and cholecystectomy.

    PubMed

    Hellenthal, Nicholas J; Stewart, Gregory S; Cambio, Angelo J; Delair, Sean M

    2007-01-01

    Renal cell carcinoma is a relatively uncommon cancer. Patients presenting with a renal adenocarcinoma are often found to have evidence of metastatic disease at the time of diagnosis. Herein, we describe the case of a 39-year-old male with renal cell carcinoma and a synchronous metastatic focus to the gallbladder. The patient underwent a successful simultaneous nephrectomy and cholecystectomy and is doing well 30 months after surgery without evidence of disease recurrence. A thorough metastatic work-up along with aggressive surgical intervention in patients with renal cell carcinoma and unusual metastatic foci can provide a long-term favorable outcome.

  3. Renal artery stenosis and hypertension after abdominal irradiation for Hodgkin disease. Successful treatment with nephrectomy

    SciTech Connect

    Salvi, S.; Green, D.M.; Brecher, M.L.; Magoos, I.; Gamboa, L.N.; Fisher, J.E.; Baliah, T.; Afshani, E.

    1983-06-01

    Hypertension secondary to stenosis of the left renal artery developed in a thirteen-year-old male six years after completion of inverted Y irradiation (3,600 rad) for abdominal Hodgkin disease. Surgical treatment with nephrectomy resulted in control of the hypertension without the use of antihypertensive agents. We review the literature for this unusual complication of abdominal irradiation, and recommend that a 99mTc-DMSA renal scan, selective renal vein sampling for renin determinations, and renal arteriography be performed on any patient in whom hypertension develops following abdominal irradiation in childhood.

  4. An immune-inspired swarm aggregation algorithm for self-healing swarm robotic systems.

    PubMed

    Timmis, J; Ismail, A R; Bjerknes, J D; Winfield, A F T

    2016-08-01

    Swarm robotics is concerned with the decentralised coordination of multiple robots having only limited communication and interaction abilities. Although fault tolerance and robustness to individual robot failures have often been used to justify the use of swarm robotic systems, recent studies have shown that swarm robotic systems are susceptible to certain types of failure. In this paper we propose an approach to self-healing swarm robotic systems and take inspiration from the process of granuloma formation, a process of containment and repair found in the immune system. We use a case study of a swarm performing team work where previous works have demonstrated that partially failed robots have the most detrimental effect on overall swarm behaviour. We have developed an immune inspired approach that permits the recovery from certain failure modes during operation of the swarm, overcoming issues that effect swarm behaviour associated with partially failed robots.

  5. Robotic System

    NASA Technical Reports Server (NTRS)

    1984-01-01

    A complicated design project, successfully carried out by New York manufacturing consultant with help from NERAC, Inc., resulted in new type robotic system being marketed for industrial use. Consultant Robert Price, operating at E.S.I, Inc. in Albany, NY, sought help from NERAC to develop an automated tool for deburring the inside of 8 inch breech ring assemblies for howitzers produced by Watervliet Arsenal. NERAC conducted a search of the NASA data base and six others. From information supplied, Price designed a system consisting of a standard industrial robot arm, with a specially engineered six-axis deburring tool fitted to it. A microcomputer and computer program direct the tool on its path through the breech ring. E.S.I. markets the system to aerospace and metal cutting industries for deburring, drilling, routing and refining machined parts.

  6. Climbing robot

    NASA Astrophysics Data System (ADS)

    Kerley, James J.; May, Edward L.; Ecklund, Wayne D.

    1993-11-01

    A mobile robot for traversing any surface consisting of a number of interconnected segments, each interconnected segment having an upper 'U' frame member, a lower 'U' frame member, a compliant joint between the upper 'U' frame member and the lower 'U' frame member, a number of linear actuators between the two frame members acting to provide relative displacement between the frame members, a foot attached to the lower 'U' frame member for adherence of the segment to the surface, an inter-segment attachment attached to the upper 'U' frame member for interconnecting the segments, a power source connected to the linear actuator, and a computer/controller for independently controlling each linear actuator in each interconnected segment such that the mobile robot moves in a caterpillar like fashion.

  7. Bilateral native nephrectomy reduces systemic oxalate level after combined liver-kidney transplant: A case report.

    PubMed

    Villani, Vincenzo; Gupta, Neena; Elias, Nahel; Vagefi, Parsia A; Markmann, James F; Paul, Elahna; Traum, Avram Z; Yeh, Heidi

    2017-03-05

    Primary hyperoxaluria type 1 (PH1) is a rare liver enzymatic defect that causes overproduction of plasma oxalate. Accumulation of oxalate in the kidney and subsequent renal failure are fatal to PH1 patients often in pediatric age. Combined liver and kidney transplantation is the therapy of choice for end-stage renal disease due to PH1. Levels of plasma oxalate remain elevated for several months after liver transplantation, as the residual body oxalate is slowly excreted. Patients with persistent hyperoxaluria after transplant often require hemodialysis, and accumulation of residual oxalate in the kidney can induce graft dysfunction. As the native kidneys are the main target of calcium oxalate accumulation, we postulated that removal of native kidneys could drastically decrease total body oxalate levels after transplantation. Here, we report a case of bilateral nephrectomy at the time of combined liver-kidney transplantation in a pediatric PH1 patient. Bilateral nephrectomy induced a rapid decrease in plasma oxalate to normal levels in less than 20 days, compared to the several months reported in the literature. Our results suggest that removal of native kidneys could be an effective strategy to decrease the need for hemodialysis and the risk of renal dysfunction after combined liver-kidney transplantation in patients with PH1.

  8. Systemic immunologic and inflammatory response after transperitoneal versus retroperitoneal laparoscopic donor nephrectomy: A prospective observational study.

    PubMed

    Gogoi, Debojit; Pal, Dilip Kumar; Bera, Malay K

    2016-01-01

    Laparoscopic donor nephrectomy (LDN) can be performed via either transperitoneal or retroperitoneal approach. Very few studies have been carried out till now, comparing immunologic and inflammatory responses in donors after these two approaches. This is a prospective observational study. Selection of approach was decided by the operating surgeon. All patients underwent peripheral venous blood sampling preoperatively and 24 h postoperatively for the measurement of C-reactive protein (CRP), interleukein-6 (IL-6), total leukocyte count (TLC), blood urea nitrogen (BUN), and serum creatinine (SCr). Operative time, warm ischemia time, hospital stay, requirement of analgesia, and complications were also recorded. From February 2013 to January 2015, we performed 54 LDNs (38 transperitoneal and 16 retroperitoneal). There were 49 females and five males. Mean operative time was not significantly different in these two approaches, but warm ischemia time was significantly less in the retroperitoneal laparoscopic donor nephrectomy (RLN) group. Postoperative inflammatory markers' (IL-6, CRP, and TLC) levels, BUN, and SCr rise in both of these approaches, but there was no significant difference observed between these two approaches. RLN is a safe and effective approach to preserve a longer right renal vein. It combines the benefit of both hand assistance and retroperitoneal approach. Warm ischemic time is significantly less in RLN group.

  9. The Effect of Obesity and Increased Waist Circumference on the Outcome of Laparoscopic Nephrectomy

    PubMed Central

    Bolton, E. M.; Thomas, A. Z.; Manecksha, R. P.; Lynch, T. H.

    2017-01-01

    Introduction. The prevalence of obesity is increasing worldwide. Obesity can be determined by body mass index (BMI); however waist circumference (WC) is a better measure of central obesity. This study evaluates the outcome of laparoscopic nephrectomy on patients with an abnormal WC. Methods. A WC of >88 cm for women and >102 cm for men was defined as obese. Data collected included age, gender, American Society of Anaesthesiologists (ASA) score, renal function, anaesthetic duration, surgery duration, blood loss, complications, and duration of hospital stay. Results. 144 patients were assessed; 73 (50.7%) of the patients had abnormal WC for their gender. There was no difference between the groups for conversion to open surgery, number of ports used, blood loss, and complications. Abnormal WC was associated with a longer median anaesthetic duration, 233 min, IQR (215–265) versus 204 min, IQR (190–210), p = 0.0022, and operative duration, 178 min, IQR (160–190) versus 137 min, IQR (128–162), p < 0.0001. Patients with an abnormal WC also had a longer inpatient stay, p = 0.0436. Conclusion. Laparoscopic nephrectomy is safe in obese patients. However, obese patients should be informed that their obesity prolongs the anaesthetic duration and duration of the surgery and is associated with a prolonged recovery. PMID:28210271

  10. Development of a surgical safety checklist for the performance of radical nephrectomy and tumor thrombectomy

    PubMed Central

    2012-01-01

    Background The surgical management of renal cell carcinoma with invasion of the renal vein or inferior vena cava is associated with significant rates of perioperative morbidity and mortality. In this report we propose a surgical checklist aimed at reducing adverse events associated with the resection of these tumors. Methods This review describes the development of an evidence- and experience-based surgical checklist aimed at improving the perioperative safety of patients undergoing radical nephrectomy and tumor thrombectomy. Results Reducing the risk of complications during the surgical management of renal tumors with venous invasion begins with appropriate pre-operative imaging aimed at defining the cranial extent of the tumor thrombus, thus facilitating accurate preoperative planning. Other key elements of the checklist are aimed at ensuring clear and precise pre-, intra- and postoperative communication between members of the multidisciplinary-care team. Conclusion A standardized surgical checklist may help to increase the perioperative safety of patients undergoing radical nephrectomy and tumor thrombectomy. Future validation studies are required to determine the clinical feasibility and post-implementation safety profile of this new checklist. PMID:23241448

  11. Dexterity analysis and robot hand design

    NASA Technical Reports Server (NTRS)

    Li, LU; Soni, A. H.; Chunsheng, Cai; Brown, Max

    1988-01-01

    Understanding about a dexterous robot hand's motion ranges is important to the precision grasping and precision manipulation. A planar robot hand is studied for object orientation, including ranges of motion, measures with respect to the palm, position reaching of a point in the grasped object, and rotation of the object about the reference point. The rotational dexterity index and dexterity chart are introduced and an analysis procedure is developed for calculating these quantities. A design procedure for determining the hand kinematic parameters based on a desired partial or complete dexterity chart is also developed. These procedures have been tested in detail for a planar robot hand with two 2- or 3-link fingers. The derived results are shown to be useful to performance evaluation, kinematic parameter design, and grasping motion planning for a planar robot hand.

  12. Robot environment expert system

    NASA Technical Reports Server (NTRS)

    Potter, J. L.

    1985-01-01

    The Robot Environment Expert System uses a hexidecimal tree data structure to model a complex robot environment where not only the robot arm moves, but also the robot itself and other objects may move. The hextree model allows dynamic updating, collision avoidance and path planning over time, to avoid moving objects.

  13. Continuum Mechanical Analysis of Collective Motion of Robots

    NASA Astrophysics Data System (ADS)

    Itami, Teturo

    Group of robots that works mainly in macroscopic systems is considered as a continuum. We need not mount specific sensors for mutual information among these robots. Increasing number of the robots makes it difficult to predict collective motion of the robots. To give a well organized strategy of designing the task, we describe these robots as that like fluid in continuum mechanics, where number density f_1 (\\vec{x},\\vec{p}; t) of the robots located at around \\vec{x} with momentum around \\vec{p} at time t is a main variable. Also we propose methods to move these robots by external potential energy V(\\vec{x};t). To specify a concept, we take a transportation system by group of robots. The objects located at \\vec{X}(t) that do not feel a potential V(\\vec{X}(t);t) can be transported by a collision with the robots moving aimlessly under the potential force -\\frac{\\partial V(\\vec{x};t)}{\\partial \\vec{x}}. The new scheme of a design based on continuum mechanics is validated by direct method of dynamical development of the system in time.

  14. A Randomized, Prospective, Parallel Group Study of Laparoscopic vs. Laparoendoscopic Single Site Donor Nephrectomy for Kidney Donation

    PubMed Central

    Aull, Meredith J.; Afaneh, Cheguevara; Charlton, Marian; Serur, David; Douglas, Melissa; Christos, Paul J.; Kapur, Sandip; Del Pizzo, Joseph J.

    2014-01-01

    Few prospective, randomized studies have assessed benefits of laparoendoscopic single site donor nephrectomy (LESS-DN) over laparoscopic donor nephrectomy (LDN). Our center initiated such a trial in January 2011, following subjects randomized to LESS-DN vs. LDN from surgery through 5 years post-donation. Subjects complete recovery/satisfaction questionnaires at 2, 6, and 12 months post-donation; transplant recipient outcomes are also recorded. 100 subjects (49 LESS-DN, 51 LDN) underwent surgery; donor demographics were similar between groups, and included a predominance of female, living unrelated donors, mean age of 47 years who underwent left donor nephrectomy. Operative parameters (overall time, time to extraction, warm ischemia time, blood loss) were similar between groups. Conversion to hand-assist laparoscopy was required in 3 LESS-DN (6.1%) vs. 2 LDN (3.9%; P=0.67). Questionnaires revealed 97.2% of LESS-DN vs. 79.5% of LDN (P=0.03) were 100% recovered by two months after donation. No significant difference was seen in satisfaction scores between the groups. Recipient outcomes were similar between groups. Our randomized trial comparing LESS donor nephrectomy to LDN confirms that LESS-DN offers a safe alternative to conventional LDN in terms of intra- and post-operative complications. LDN and LESS-DN offer similar recovery and satisfaction after donation. PMID:24934732

  15. A randomized, prospective, parallel group study of laparoscopic versus laparoendoscopic single site donor nephrectomy for kidney donation.

    PubMed

    Aull, M J; Afaneh, C; Charlton, M; Serur, D; Douglas, M; Christos, P J; Kapur, S; Del Pizzo, J J

    2014-07-01

    Few prospective, randomized studies have assessed the benefits of laparoendoscopic single site donor nephrectomy (LESS-DN) over laparoscopic donor nephrectomy (LDN). Our center initiated such a trial in January 2011, following subjects randomized to LESS-DN versus LDN from surgery through 5 years postdonation. Subjects complete recovery/satisfaction questionnaires at 2, 6 and 12 months postdonation; transplant recipient outcomes are also recorded. One hundred subjects (49 LESS-DN, 51 LDN) underwent surgery; donor demographics were similar between groups, and included a predominance of female, living-unrelated donors, mean age of 47 years who underwent left donor nephrectomy. Operative parameters (overall time, time to extraction, warm ischemia time, blood loss) were similar between groups. Conversion to hand-assist laparoscopy was required in 3 LESS-DN (6.1%) versus 2 LDN (3.9%; p = 0.67). Questionnaires revealed that 97.2% of LESS-DN versus 79.5% of LDN (p = 0.03) were 100% recovered by 2 months after donation. No significant difference was seen in satisfaction scores between the groups. Recipient outcomes were similar between groups. Our randomized trial comparing LESS donor nephrectomy to LDN confirms that LESS-DN offers a safe alternative to conventional LDN in terms of intra- and post-operative complications. LDN and LESS-DN offer similar recovery and satisfaction after donation.

  16. Predictive Ability of Preoperative CT Scan in Determining Whether the Adrenal Gland is Spared at Radical Nephrectomy

    PubMed Central

    Nason, Gregory J.; Aslam, Asadullah; Giri, Subhasis K.

    2016-01-01

    Introduction The aim of this study was to assess whether preoperative multiple detector computed tomography (MDCT) accurately predicts adrenal involvement for patients undergoing non-adrenal sparing radical nephrectomy for renal cell carcinoma. Methods and Materials A retrospective observational study based on a composite patient population of two university teaching hospitals who underwent radical nephrectomy. Sensitivity, specificity, overall accuracy, positive and negative predictive values and likelihood ratios were calculated from radiological reports. Results Total 579 patients underwent radical nephrectomy, of which 199 (34.4%) patients underwent a non-adrenal sparing radical nephrectomy, in which 128 (64.3%) were male and 118 (59.3%) were left side tumors. Mean tumor size was 8.2 cm (range 1.4-20cm). MDCT was found to have a sensitivity of 100% and specificity of 95.2% for identifying adrenal invasion. Total 179 patients (89.9%) had a radiographically normal ipsilateral adrenal gland, of which none were found to have adrenal involvement. Therefore, the negative predictive value of preoperative cross-sectional imaging for identification of adrenal involvement was 100%. Conclusion Cross- sectional MDCT imaging accurately predicts adrenal involvement and the decision to remove or spare the adrenal gland should be made preoperative planning regardless of tumour size or location at the time of multi-disciplinary discussion unless there is intraoperative evidence of adrenal invasion. PMID:27867332

  17. Robots and manipulators

    NASA Technical Reports Server (NTRS)

    Heer, E.

    1981-01-01

    Robots are defined and described for various applications. The key feature of robots is programmability, which allows teleoperation, repair work in hazardous situations, and unsupervised operation in industrial functions. Two types of robots now exist: special purpose, with equipment for a specific task; and general purpose, which include nonservo-controlled robots, servo-controlled robots, and sensory control robots. Sensory robots are the most sophisticated, and are equipped with both internal control sensors and external sensors such as TV cameras, pressure detectors, laser range finders, etc. Sensory feedback to a central computer enables the robots to make appropriate modifications to the control program to adapt to new situations. Pattern recognition and scans for size are features of the TV sensors, and programs to develop a universal effector (hand) are outlined. Finally, robot programming in terms of manual, walkthrough, and textual methods are described, and the potential uses of robots for space and undersea construction and repair are discussed.

  18. Robotic Telesurgery Research

    DTIC Science & Technology

    2010-03-01

    dexterous workspace, as in the NB2.1 [5]. This robotic platform is designed specifically for Laparoendoscopic Single - Site Surgery (LESS), and consists...Laparoendoscopic Single - Site Surgery using a Multi-Functional Miniature In Vivo Robot,” The International Journal of Medical Robotics and Computer Assisted...Farritor, S.M., Oleynikov, D. “Laparoendoscopic Single - Site Surgery using a Multi-Functional Miniature In Vivo Robot,” Minimally Invasive Robotic

  19. Collaborative Robotics Design Considerations

    DTIC Science & Technology

    2004-05-06

    I~D~·L Paper Number Collaborative Robotics Design Considerations ABSTRACT As research advances individual robot capabilities, a logical...progression is the use of multiple robots to complete a task more effectively. Mission performance can be improved by the ability to allocate robots with...diverse capabilities to perform different parts of a complex task. To paraphrase [[10], there are many advantages to enabling robotic collaborative

  20. Robotic Vision for Welding

    NASA Technical Reports Server (NTRS)

    Richardson, R. W.

    1986-01-01

    Vision system for robotic welder looks at weld along axis of welding electrode. Gives robot view of most of weld area, including yet-unwelded joint, weld pool, and completed weld bead. Protected within welding-torch body, lens and fiber bundle give robot closeup view of weld in progress. Relayed to video camera on robot manipulator frame, weld image provides data for automatic control of robot motion and welding parameters.

  1. Value of Robotically Assisted Surgery for Mitral Valve Disease

    PubMed Central

    Mihaljevic, Tomislav; Koprivanac, Marijan; Kelava, Marta; Goodman, Avi; Jarrett, Craig; Williams, Sarah J.; Gillinov, A. Marc; Bajwa, Gurjyot; Mick, Stephanie L.; Bonatti, Johannes; Blackstone, Eugene H.

    2014-01-01

    Importance The value of robotically assisted surgery for mitral valve disease is questioned because the high cost of care associated with robotic technology may outweigh its clinical benefits. Objective To investigate conditions under which benefits of robotic surgery mitigate high technology costs. Design Clinical cohort study comparing costs of robotic vs. three contemporaneous conventional surgical approaches for degenerative mitral disease. Surgery was performed from 2006–2011, and comparisons were based on intent-to-treat, with propensity-matching used to reduce selection bias. Setting Large multi-specialty academic medical center. Participants 1,290 patients aged 57±11 years, 27% women, underwent mitral repair for regurgitation from posterior leaflet prolapse. Robotic surgery was used in 473, complete sternotomy in 227, partial sternotomy in 349, and anterolateral thoracotomy in 241. Three propensity-matched groups were formed based on demographics, symptoms, cardiac and noncardiac comorbidities, valve pathophysiology, and echocardiographic measurements: robotic vs. sternotomy (n=198 pairs) vs. partial sternotomy (n=293 pairs) vs. thoracotomy (n=224 pairs). Interventions Mitral valve repair. Main Outcome Measures Cost of care, expressed as robotic capital investment, maintenance, and direct technical hospital cost, and benefit of care, based on differences in recovery time. Results Median cost of care for robotically assisted surgery exceeded the cost of alternative approaches by 27% (−5%, 68%), 32% (−6%, 70%), and 21% (−2%, 54%) (median [15th, 85th percentiles]) for complete sternotomy, partial sternotomy, and anterolateral thoracotomy, respectively. Higher operative costs were partially offset by lower postoperative costs and earlier return to work: median 35 days for robotic surgery, 49 for complete sternotomy, 56 for partial sternotomy, and 42 for anterolateral thoracotomy. Resulting net differences in cost of robotic surgery vs. the three

  2. Perioperative morbidity and long-term outcome of unilateral nephrectomy in feline kidney donors: 141 cases (1998-2013).

    PubMed

    Wormser, Chloe; Aronson, Lilian R

    2016-02-01

    OBJECTIVE To evaluate the outcome associated with unilateral nephrectomy in feline kidney donors. DESIGN Retrospective case series. ANIMALS 141 cats. PROCEDURES Medical records of cats that underwent nephrectomy for renal donation were reviewed for information on signalment, date of renal donation, results of blood and urine analyses, infectious disease history, anesthetic protocols, intra- and postoperative complications, and postoperative analgesic protocols. Long-term follow-up data were obtained via client telephone interview and review of referring veterinarian medical records. RESULTS All donors were healthy young adult cats with a median age of 1.5 years (range, 0.8 to 2 years). No cats died or were euthanized during the perioperative period. Intraoperative complications occurred in 2 cats, and postoperative complications occurred in 17. Median time from nephrectomy to hospital discharge was 3.6 days (range, 2 to 8 days). Long-term follow-up information was available for 99 cats, with a median interval between nephrectomy and follow-up of 10 years (range, 0.25 to 15 years). Six cats had a history of urinary tract disease including stable chronic kidney disease (n = 3), acute kidney injury (2), and cystitis (1). Nine cats were dead at follow-up; death was attributed to chronic renal failure in 2 and acute ureteral obstruction in 4. CONCLUSIONS AND CLINICAL RELEVANCE Feline donor nephrectomy had an acceptably low perioperative morbidity in this series. Most cats (84%) for which follow-up information was available had no associated long-term effects. However, a small subset (7%) developed renal insufficiency or died of urinary tract disease.

  3. Hexapod Robot

    NASA Technical Reports Server (NTRS)

    Begody, Ericka

    2016-01-01

    The project I am working on at NASA-Johnson Space Center in Houston, TX is a hexapod robot. This project was started by various engineers at the Trick Lab. The goal of this project is to have the hexapod track a yellow ball or possibly another object from left to right and up/down. The purpose is to have it track an object like a real creature. The project will consist of using software and hardware. This project started with a hexapod robot which uses a senor bar to track a yellow ball but with a limited field of vision. The sensor bar acts as the robots "head." Two servos will be added to the hexapod to create flexion and extension of the head. The neck and head servos will have to be programmed to be added to the original memory map of the existing servos. I will be using preexisting code. The main programming language that will be used to add to the preexisting code is C++. The trick modeling and simulation software will also be used in the process to improve its tracking and movement. This project will use a trial and error approach, basically seeing what works and what does not. The first step is to initially understand how the hexapod works. To get a general understanding of how the hexapod maneuvers and plan on how to had a neck and head servo which works with the rest of the body. The second step would be configuring the head and neck servos with the leg servos. During this step, limits will be programmed specifically for the each servo. By doing this, the servo is limited to how far it can rotate both clockwise and counterclockwise and this is to prevent hardware damage. The hexapod will have two modes in which it works in. The first mode will be if the sensor bar does not detect an object. If the object it is programmed to look for is not in its view it will automatically scan from left to right 3 times then up and down once. The second mode will be if the sensor bar does detect the object. In this mode the hexapod will track the object from left to

  4. Initial experience with the EndoAssist camera-holding robot in laparoscopic urological surgery.

    PubMed

    Kommu, Sashi S; Rimington, Peter; Anderson, Christopher; Rané, Abhay

    2007-01-01

    Although the advantages of laparoscopic surgery are well documented, one disadvantage is that, for optimum performance, an experienced camera driver is required who can provide the necessary views for the operating surgeon. In this paper we describe our experience with urological laparoscopic techniques using the novel EndoAssist robotic camera holder and review the current status of alternative devices. A total of 51 urological procedures (25 using the EndoAssist device and 26 using a conventional human camera driver) conducted by three experienced surgeons were studied prospectively, including nephrectomy (simple and radical), pyeloplasty, radical prostatectomy, and radical cystoprostatectomy. The surgeon noted the extent of body comfort and muscle fatigue in each case. Other aspects documented were ease of scope movement, i.e. usability, need to clean the telescope, time of set-up, surgical performance, and whether it was necessary to change the position of the arm during the surgery. All three surgeons involved in the evaluation felt comfortable throughout all procedures, with no loss of autonomy. It was, however, obvious that the large arc generated whilst doing a nephrectomy led to more episodes of lens cleaning, and the arm had to be relocated on some occasions. Clearer benefits were seen while performing pelvic surgery or pyeloplasty, perhaps because the arc of movement was smaller. The EndoAssist is an effective, easy to use device for robotic camera driving which reduces the constraint of having to have an experienced camera driver for optimum visualisation during laparoscopic urological procedures.

  5. A review: the application of minimally invasive surgery to pediatric urology: upper urinary tract procedures.

    PubMed

    Traxel, Erica J; Minevich, Eugene A; Noh, Paul H

    2010-07-01

    This paper is one-half of a 2 part review on minimally-invasive procedures in pediatric urology. This article focuses on upper tract procedures, including complete nephrectomy, partial nephrectomy, pyeloplasty, and ureterocalicostomy. We note important articles on pure laparoscopic as well as robotic-assisted laparoscopic upper urinary tract surgeries, concentrating on their techniques and outcomes.

  6. Successful Pregnancy in a 31-Year-Old Peritoneal Dialysis Patient with Bilateral Nephrectomy

    PubMed Central

    Nazer, Ahmed; AlOmar, Osama; Al-Badawi, Ismail A.

    2013-01-01

    Frequency of pregnancy among childbearing age women with end-stage renal disease (ESRD) undergoing long-term periodic dialysis ranges from 1% to 7%. Although pregnancy in dialysis women with ESRD is considered a largely high-risk pregnancy, occurrence of successful pregnancy is not impossible with success rates approaching 70%. Rates of successful pregnancy are greatly impacted by early pregnancy diagnosis and preserved residual renal functions. Herein, to the best of our knowledge, we report the first case of successful pregnancy (despite late diagnosis at 14 weeks of gestation) in a 31-year-old peritoneal dialysis patient with bilateral nephrectomy and no whatsoever preserved residual renal function. Moreover, a literature review on pregnancy in dialysis patients is presented. PMID:24198990

  7. Robotic intelligence kernel

    DOEpatents

    Bruemmer, David J.

    2009-11-17

    A robot platform includes perceptors, locomotors, and a system controller. The system controller executes a robot intelligence kernel (RIK) that includes a multi-level architecture and a dynamic autonomy structure. The multi-level architecture includes a robot behavior level for defining robot behaviors, that incorporate robot attributes and a cognitive level for defining conduct modules that blend an adaptive interaction between predefined decision functions and the robot behaviors. The dynamic autonomy structure is configured for modifying a transaction capacity between an operator intervention and a robot initiative and may include multiple levels with at least a teleoperation mode configured to maximize the operator intervention and minimize the robot initiative and an autonomous mode configured to minimize the operator intervention and maximize the robot initiative. Within the RIK at least the cognitive level includes the dynamic autonomy structure.

  8. Laparoscopic radical and partial cystectomy

    PubMed Central

    Challacombe, Ben J.; Rose, Kristen; Dasgupta, Prokar

    2005-01-01

    Radical cystectomy remains the standard treatment for muscle invasive organ confined bladder carcinoma. Laparoscopic radical cystoprostatectomy (LRC) is an advanced laparoscopic procedure that places significant demands on the patient and the surgeon alike. It is a prolonged procedure which includes several technical steps and requires highly developed laparoscopic skills including intra-corporeal suturing. Here we review the development of the technique, the indications, complications and outcomes. We also examine the potential benefits of robotic-assisted LRC and explore the indications and technique of laparoscopic partial cystectomy. PMID:21206662

  9. Intelligent robots and computer vision

    SciTech Connect

    Casasent, D.P.

    1985-01-01

    This book presents the papers given at a conference which examined artificial intelligence and image processing in relation to robotics. Topics considered at the conference included feature extraction and pattern recognition for computer vision, image processing for intelligent robotics, robot sensors, image understanding and artificial intelligence, optical processing techniques in robotic applications, robot languages and programming, processor architectures for computer vision, mobile robots, multisensor fusion, three-dimensional modeling and recognition, intelligent robots applications, and intelligent robot systems.

  10. Humanoid Robot

    NASA Technical Reports Server (NTRS)

    Linn, Douglas M. (Inventor); Ambrose, Robert O. (Inventor); Diftler, Myron A. (Inventor); Askew, Scott R. (Inventor); Platt, Robert (Inventor); Mehling, Joshua S. (Inventor); Radford, Nicolaus A. (Inventor); Strawser, Phillip A. (Inventor); Bridgwater, Lyndon (Inventor); Wampler, II, Charles W. (Inventor); Abdallah, Muhammad E. (Inventor); Ihrke, Chris A. (Inventor); Reiland, Matthew J. (Inventor); Sanders, Adam M. (Inventor); Reich, David M. (Inventor); Hargrave, Brian (Inventor); Parsons, Adam H. (Inventor); Permenter, Frank N. (Inventor); Davis, Donald R. (Inventor)

    2013-01-01

    A humanoid robot includes a torso, a pair of arms, two hands, a neck, and a head. The torso extends along a primary axis and presents a pair of shoulders. The pair of arms movably extend from a respective one of the pair of shoulders. Each of the arms has a plurality of arm joints. The neck movably extends from the torso along the primary axis. The neck has at least one neck joint. The head movably extends from the neck along the primary axis. The head has at least one head joint. The shoulders are canted toward one another at a shrug angle that is defined between each of the shoulders such that a workspace is defined between the shoulders.

  11. Robotics for Human Exploration

    NASA Technical Reports Server (NTRS)

    Fong, Terrence; Deans, Mathew; Bualat, Maria

    2013-01-01

    Robots can do a variety of work to increase the productivity of human explorers. Robots can perform tasks that are tedious, highly repetitive or long-duration. Robots can perform precursor tasks, such as reconnaissance, which help prepare for future human activity. Robots can work in support of astronauts, assisting or performing tasks in parallel. Robots can also perform "follow-up" work, completing tasks designated or started by humans. In this paper, we summarize the development and testing of robots designed to improve future human exploration of space.

  12. Competencies Identification for Robotics Training.

    ERIC Educational Resources Information Center

    Tang, Le D.

    A study focused on the task of identifying competencies for robotics training. The level of robotics training was limited to that of robot technicians. Study objectives were to obtain a list of occupational competencies; to rank their order of importance; and to compare opinions from robot manufacturers, robot users, and robotics educators…

  13. Robot strings: Long, thin continuum robots

    NASA Astrophysics Data System (ADS)

    Walker, I. D.

    We describe and discuss the development of long, thin, continuous “ string-like” robots aimed at Space exploration missions. These continuous backbone “ continuum” robots are inspired by numerous biological structures, particularly vines, worms, and the tongues of animals such as the anteater. The key novelty is the high length-to-diameter ratio of the robots. This morphology offers penetration into, and exploration of, significantly narrower and deeper environments than accessible using current robot technology. In this paper, we introduce new design alternatives for long thin continuum robots, based on an analysis and extension of three core existing continuum robot design types. The designs are evaluated based on their mechanical feasibility, structural properties, kinematic simplicity, and degrees of freedom.

  14. Simultaneous liver kidney transplantation and (bilateral) nephrectomy through a midline is feasible and safe in polycystic disease

    PubMed Central

    Monbaliu, Diethard; Ceulemans, Laurens J.; Pirenne, Jacques; Fronek, Jiri

    2017-01-01

    In Eurotransplant, 50% of simultaneous liver kidney transplantations (SLK) are performed for polycystic disease. Classically, liver and kidney are transplanted in two steps: liver through a subcostal incision, kidney through a separate oblique incision. Liver and kidney volume can make this ‘two-step’ procedure challenging, especially if simultaneous native nephrectomy is indicated. A ‘one-step’ SLK through a xiphopubic laparotomy might be a safe alternative, facilitating mobilization of the voluminous polycystic liver and native nephrectomy whilst offering access to iliac fossae for kidney transplantation. One-step SLK procedures for polycystic disease were introduced in 08/2013 at IKEM Prague (n = 6) and 11/2014 at University Hospitals Leuven (n = 6). Feasibility and safety of the one-step technique were investigated. We compared surgical data and outcomes obtained with the one-step technique to all consecutive two-step procedures performed for polycystic disease at the University Hospitals Leuven between 2008–2014 (n = 23). Median (interquartile range) are given. One-step SLK offered broad and adequate exposure for the hepatectomy, nephrectomies and transplantations, which were all uneventful. Morbidity, patient (100% vs 91%, p = 0.53) and graft survival (100% graft survival for liver and kidney in both groups) were comparable between one-step and two-step SLK. Liver cold ischaemia time was comparable [6.0 (4.4–7.6) vs. 7.1 (3.9–7.3), p = 0.077], kidney cold ischaemia time was shorter in one-step compared to two-step SLK [8.1 (6.4–9.3) vs. 11.7 (10.0–14.0), p<0.001)]. Total procedural time was also shorter in one-step compared to two-step SLK [6.8 (4.1–9.3) vs. 9.0 (8.7–10.1), p = 0.032], while all underwent bilateral (67%) or unilateral (33%) nephrectomy (compared to 0% and 52% in two-step SLK, respectively). In one-step SLK, 67% received a pre-emptive kidney transplant compared to 46% in two-step SLK. 5/12 two-step SLK became dialysis

  15. Simultaneous liver kidney transplantation and (bilateral) nephrectomy through a midline is feasible and safe in polycystic disease.

    PubMed

    Jochmans, Ina; Monbaliu, Diethard; Ceulemans, Laurens J; Pirenne, Jacques; Fronek, Jiri

    2017-01-01

    In Eurotransplant, 50% of simultaneous liver kidney transplantations (SLK) are performed for polycystic disease. Classically, liver and kidney are transplanted in two steps: liver through a subcostal incision, kidney through a separate oblique incision. Liver and kidney volume can make this 'two-step' procedure challenging, especially if simultaneous native nephrectomy is indicated. A 'one-step' SLK through a xiphopubic laparotomy might be a safe alternative, facilitating mobilization of the voluminous polycystic liver and native nephrectomy whilst offering access to iliac fossae for kidney transplantation. One-step SLK procedures for polycystic disease were introduced in 08/2013 at IKEM Prague (n = 6) and 11/2014 at University Hospitals Leuven (n = 6). Feasibility and safety of the one-step technique were investigated. We compared surgical data and outcomes obtained with the one-step technique to all consecutive two-step procedures performed for polycystic disease at the University Hospitals Leuven between 2008-2014 (n = 23). Median (interquartile range) are given. One-step SLK offered broad and adequate exposure for the hepatectomy, nephrectomies and transplantations, which were all uneventful. Morbidity, patient (100% vs 91%, p = 0.53) and graft survival (100% graft survival for liver and kidney in both groups) were comparable between one-step and two-step SLK. Liver cold ischaemia time was comparable [6.0 (4.4-7.6) vs. 7.1 (3.9-7.3), p = 0.077], kidney cold ischaemia time was shorter in one-step compared to two-step SLK [8.1 (6.4-9.3) vs. 11.7 (10.0-14.0), p<0.001)]. Total procedural time was also shorter in one-step compared to two-step SLK [6.8 (4.1-9.3) vs. 9.0 (8.7-10.1), p = 0.032], while all underwent bilateral (67%) or unilateral (33%) nephrectomy (compared to 0% and 52% in two-step SLK, respectively). In one-step SLK, 67% received a pre-emptive kidney transplant compared to 46% in two-step SLK. 5/12 two-step SLK became dialysis dependant after pre

  16. A Framework for Information Distribution, Task Execution and Decision Making in Multi-Robot Systems

    NASA Astrophysics Data System (ADS)

    Rambow, Matthias; Rohrmüller, Florian; Kourakos, Omiros; Bršcic, Drazen; Wollherr, Dirk; Hirche, Sandra; Buss, Martin

    Robotic systems operating in the real-world have to cope with unforeseen events by determining appropriate decisions based on noisy or partial knowledge. In this respect high functional robots are equipped with many sensors and actuators and run multiple processing modules in parallel. The resulting complexity is even further increased in case of cooperative multi-robot systems, since mechanisms for joint operation are needed. In this paper a complete and modular framework that handles this complexity in multi-robot systems is presented. It provides efficient exchange of generated data as well as a generic scheme for task execution and robot coordination.

  17. Robotic Lander Prototype

    NASA Video Gallery

    NASA engineers successfully integrated and completed system testing on a new robotic lander recently at Teledyne Brown Engineering’s facility in Huntsville in support of the Robotic Lunar Lander ...

  18. Robotic Lander Development Project

    NASA Video Gallery

    The Robotic Lander Development Project at the Marshall Center is testing a prototype lander that will aid in the design and development of a new generation of small, smart, versatile robotic lander...

  19. Robotic Intelligence Kernel: Communications

    SciTech Connect

    Walton, Mike C.

    2009-09-16

    The INL Robotic Intelligence Kernel-Comms is the communication server that transmits information between one or more robots using the RIK and one or more user interfaces. It supports event handling and multiple hardware communication protocols.

  20. Robots and the Economy.

    ERIC Educational Resources Information Center

    Albus, James S.

    1984-01-01

    Spectacular advances in microcomputers are forging new technological frontiers in robotics. For example, many factories will be totally automated. Economic implications of the new technology of robotics for the future are examined. (RM)

  1. Robotic Surveying

    SciTech Connect

    Suzy Cantor-McKinney; Michael Kruzic

    2007-03-01

    ZAPATA ENGINEERING challenged our engineers and scientists, which included robotics expertise from Carnegie Mellon University, to design a solution to meet our client's requirements for rapid digital geophysical and radiological data collection of a munitions test range with no down-range personnel. A prime concern of the project was to minimize exposure of personnel to unexploded ordnance and radiation. The field season was limited by extreme heat, cold and snow. Geographical Information System (GIS) tools were used throughout this project to accurately define the limits of mapped areas, build a common mapping platform from various client products, track production progress, allocate resources and relate subsurface geophysical information to geographical features for use in rapidly reacquiring targets for investigation. We were hopeful that our platform could meet the proposed 35 acres per day, towing both a geophysical package and a radiological monitoring trailer. We held our breath and crossed our fingers as the autonomous Speedrower began to crawl across the playa lakebed. We met our proposed production rate, and we averaged just less than 50 acres per 12-hour day using the autonomous platform with a path tracking error of less than +/- 4 inches. Our project team mapped over 1,800 acres in an 8-week (4 days per week) timeframe. The expertise of our partner, Carnegie Mellon University, was recently demonstrated when their two autonomous vehicle entries finished second and third at the 2005 Defense Advanced Research Projects Agency (DARPA) Grand Challenge. 'The Grand Challenge program was established to help foster the development of autonomous vehicle technology that will some day help save the lives of Americans who are protecting our country on the battlefield', said DARPA Grand Challenge Program Manager, Ron Kurjanowicz. Our autonomous remote-controlled vehicle (ARCV) was a modified New Holland 2550 Speedrower retrofitted to allow the machine

  2. RHOBOT: Radiation hardened robotics

    SciTech Connect

    Bennett, P.C.; Posey, L.D.

    1997-10-01

    A survey of robotic applications in radioactive environments has been conducted, and analysis of robotic system components and their response to the varying types and strengths of radiation has been completed. Two specific robotic systems for accident recovery and nuclear fuel movement have been analyzed in detail for radiation hardness. Finally, a general design approach for radiation-hardened robotics systems has been developed and is presented. This report completes this project which was funded under the Laboratory Directed Research and Development program.

  3. Tool Changer For Robot

    NASA Technical Reports Server (NTRS)

    Voellmer, George M.

    1992-01-01

    Mechanism enables robot to change tools on end of arm. Actuated by motion of robot: requires no additional electrical or pneumatic energy to make or break connection between tool and wrist at end of arm. Includes three basic subassemblies: wrist interface plate attached to robot arm at wrist, tool interface plate attached to tool, and holster. Separate tool interface plate and holster provided for each tool robot uses.

  4. Robotics Research for Cybersecurity

    DTIC Science & Technology

    2012-01-24

    Wei-Min Shen 1/24/12 Page 1 of 3 Robotics Research for Cybersecurity Wei-Min Shen Polymorphic Robotics Laboratory USC/ISI, 4676 Admiralty Way...Marina del Rey, CA 90292 Phone: 310-448-8710, Fax: 310-822-0751 Email: shen@isi.edu, Web: http://www.isi.edu/ robots / Executive Summary This...project is to conduct a comprehensive study of robotics research in the context of cybersecurity. Specifically, 1) Create a realistic cybersecurity test

  5. Towards Pervasive Robotics

    DTIC Science & Technology

    2003-01-01

    Towards Pervasive Robotics Artur M. Arsenio Artificial Intelligence Lab - Massachusetts Institute of Technology 545 Technology Square, Room NE43-936...MA 02139 arsenio@ai.mit.edu Abstract Pervasive robotics will require, in a near future, small, light and cheap robots that exhibit complex behaviors...These demands led to the development of the M2-M4 Macaco project - a robotic active vi- sion head. Macaco is a portable system, capable of emulating

  6. Ground Vehicle Robotics

    DTIC Science & Technology

    2013-08-20

    Ground Vehicle Robotics Jim Parker Associate Director, Ground Vehicle Robotics UNCLASSIFIED: Distribution Statement A. Approved for public...DATE 20 AUG 2013 2. REPORT TYPE Briefing Charts 3. DATES COVERED 09-05-2013 to 15-08-2013 4. TITLE AND SUBTITLE Ground Vehicle Robotics 5a...Willing to take Risk on technology -User Evaluated -Contested Environments -Operational Data Applied Robotics for Installation & Base Ops -Low Risk

  7. Telepresence and Intervention Robotics

    DTIC Science & Technology

    2000-11-01

    UNCLASSIFIED Defense Technical Information Center Compilation Part Notice ADPO10628 TITLE: Telepresence and Intervention Robotics DISTRIBUTION...comprise the compilation report: ADPO10609 thru ADP010633 UNCLASSIFIED 20-1 TELEPRESENCE AND INTERVENTION ROBOTICS Nathalie Cislo Laboratoire de...Robotique de Paris 10-12, Avenue de 1’Europe 78140 VWlizy-Villacoublay, FRANCE cislo@robot.uvsq.fr ABSTRACT In the field of Mobile Robotics applications

  8. Nephrectomy in an Asian small-clawed otter (Amblonyx cinereus) with pyelonephritis and hydronephrosis secondary to ureteral obstruction.

    PubMed

    Higbie, Christine T; Carpenter, James W; Armbrust, Laura J; Klocke, Emily; Almes, Kelli

    2014-09-01

    A 10-yr-old, captive, intact male Asian small-clawed otter (Amblonyx cinereus) with a history of bilateral nephrolithiasis was presented for acute-onset lethargy and inappetance of 5 days duration. On physical examination, the otter was about 8% dehydrated and a palpable fluid wave was present in the abdomen. An abdominal ultrasound revealed hydronephrosis of the left kidney and a hyperechoic structure present within the lumen of the left ureter, causing an obstruction. A urinalysis revealed struvite crystalluria, bacteriuria, and an elevated pH. Following 4 days of antibiotic therapy, a left ureteronephrectomy was performed. Upon opening the kidney to retrieve calculi, a large amount of purulent material was noted within the renal pelvis. To the authors' knowledge, this is the first documented case of a nephrectomy in an Asian small-clawed otter. Nephrectomy should be considered as a viable option for treatment of ureteral obstruction, hydronephrosis, or severe pyelonephritis.

  9. Robotics of human movements.

    PubMed

    van der Smagt, Patrick; Grebenstein, Markus; Urbanek, Holger; Fligge, Nadine; Strohmayr, Michael; Stillfried, Georg; Parrish, Jonathon; Gustus, Agneta

    2009-01-01

    The construction of robotic systems that can move the way humans do, with respect to agility, stability and precision, is a necessary prerequisite for the successful integration of robotic systems in human environments. We explain human-centered views on robotics, based on the three basic ingredients (1) actuation; (2) sensing; and (3) control, and formulate detailed examples thereof.

  10. Building a Better Robot

    ERIC Educational Resources Information Center

    Navah, Jan

    2012-01-01

    Kids love to build robots, letting their imaginations run wild with thoughts of what they might look like and what they could be programmed to do. Yet when students use cereal boxes and found objects to make robots, often the projects look too similar and tend to fall apart. This alternative allows students to "build" robots in a different way,…

  11. Robotics development programs overview

    SciTech Connect

    Heckendorn, F.M.

    1990-11-01

    This paper discusses the applications of robotics at the Westinghouse Savannah River Site. The Savannah River Laboratory (SRL) continues to provide support to the Savannah River Site (SRS) in many areas of Robotics and Remote Vision. An overview of the current and near term future developments are presented. The driving forces for Robotics and Vision developments at SRS include the classic reasons for industrial robotics installation (i.e. repetitive and undesirable jobs) and those reasons related to radioactive environments. Protection of personnel from both radiation and radioactive contamination benefit greatly from both Robotics and Telerobotics. Additionally, the quality of information available from remote locations benefits greatly from the ability to visually monitor and remotely sense. The systems discussed include a glovebox waste handling and bagout robot, a shielded cells robot for radioactive waste sample transfer, waste handling gantry robots, a two armed master/slave manipulator as an attachment to a gantry robot, navigation robot research/testing, demonstration of the mobile underwater remote cleaning and inspection device, a camera deployment robot to support remote crane operations and for deployment of radiation sensors directly over a hazardous site, and demonstration of a large mobile robot for high radiation environments. Development of specialized and limited life vision/viewing systems for hazardous environments is also discussed.

  12. Networking a mobile robot

    NASA Astrophysics Data System (ADS)

    McKee, Gerard T.

    1994-10-01

    Conventional mobile robotic systems are `stand alone'. Program development involves loading programs into the mobile, via an umbilical. Autonomous operation, in this context, means `isolation': the user cannot interact with the program as the robot is moving around. Recent research in `swarm robotics' has exploited wireless networks as a means of providing inter- robot communication, but the population is still isolated from the human user. In this paper we report on research we are conducting into the provision of mobile robots as resources on a local area computer network, and thus breaking the isolation barrier. We are making use of new multimedia workstation and wireless networking technology to link the robots to the network in order to provide a new type of resource for the user. We model the robot as a set of resources and propose a client-server architecture as the basis for providing user access to the robots. We describe the types of resources each robot can provide and we outline the potential for cooperative robotics, human-robot cooperation, and teleoperation and autonomous robot behavior within this context.

  13. Robotic Telesurgery Research

    DTIC Science & Technology

    2010-10-01

    concepts have been pursued to provide imaging capabilities for use in robotic surgery . The first concept involves developing a camera system that...Oleynikov, D. Project Title: CAESAR: Computer Automated Enhanced Support and Analysis for Robotic Surgery Source of Support: Intelligent Automation, Inc...successful autonomous robotic surgery . REFERENCES Dolghi, O., Strabala, K., Wortman, T., Goede, M., Farritor, S., & Oleynikov. (2010). Miniature

  14. Mobile robot knowledge base

    NASA Astrophysics Data System (ADS)

    Heath Pastore, Tracy; Barnes, Mitchell; Hallman, Rory

    2005-05-01

    Robot technology is developing at a rapid rate for both commercial and Department of Defense (DOD) applications. As a result, the task of managing both technology and experience information is growing. In the not-to-distant past, tracking development efforts of robot platforms, subsystems and components was not too difficult, expensive, or time consuming. To do the same today is a significant undertaking. The Mobile Robot Knowledge Base (MRKB) provides the robotics community with a web-accessible, centralized resource for sharing information, experience, and technology to more efficiently and effectively meet the needs of the robot system user. The resource includes searchable information on robot components, subsystems, mission payloads, platforms, and DOD robotics programs. In addition, the MRKB website provides a forum for technology and information transfer within the DOD robotics community and an interface for the Robotic Systems Pool (RSP). The RSP manages a collection of small teleoperated and semi-autonomous robotic platforms, available for loan to DOD and other qualified entities. The objective is to put robots in the hands of users and use the test data and fielding experience to improve robot systems.

  15. Total portal robotic pneumonectomy.

    PubMed

    Rodriguez, Jose R

    2013-09-01

    Robotic pulmonary lobectomies have been reported to be technically and oncologically achievable; however, only three robotic pneumonectomy cases have been described. Two of them used a mini thoracotomy. We describe one case of a total portal robotic pneumonectomy without utility incision. We describe the step-by-step process.

  16. Inertially Aided Robotics

    DTIC Science & Technology

    1989-12-31

    0031 dis~bti:,1 is uitsnjt( Deczmllcr 31: 1989 92-05530 2:.-: 3o : T >VE?-A ~ : Inertially Aided Robotics FINAL REPORT for Contract No. DAAHO1 -88-D-0057...1 2 Advantages of Inertially Aided Robotics ...86 iii List of Figures Figure 1 - Robot Manipulator having Joint Sensor Based Control ..................... 2

  17. Robotic Intelligence Kernel: Visualization

    SciTech Connect

    2009-09-16

    The INL Robotic Intelligence Kernel-Visualization is the software that supports the user interface. It uses the RIK-C software to communicate information to and from the robot. The RIK-V illustrates the data in a 3D display and provides an operating picture wherein the user can task the robot.

  18. Robotic Follow Algorithm

    SciTech Connect

    2005-03-30

    The Robotic Follow Algorithm enables allows any robotic vehicle to follow a moving target while reactively choosing a route around nearby obstacles. The robotic follow behavior can be used with different camera systems and can be used with thermal or visual tracking as well as other tracking methods such as radio frequency tags.

  19. Modular robot

    DOEpatents

    Ferrante, T.A.

    1997-11-11

    A modular robot may comprise a main body having a structure defined by a plurality of stackable modules. The stackable modules may comprise a manifold, a valve module, and a control module. The manifold may comprise a top surface and a bottom surface having a plurality of fluid passages contained therein, at least one of the plurality of fluid passages terminating in a valve port located on the bottom surface of the manifold. The valve module is removably connected to the manifold and selectively fluidically connects the plurality of fluid passages contained in the manifold to a supply of pressurized fluid and to a vent. The control module is removably connected to the valve module and actuates the valve module to selectively control a flow of pressurized fluid through different ones of the plurality of fluid passages in the manifold. The manifold, valve module, and control module are mounted together in a sandwich-like manner and comprise a main body. A plurality of leg assemblies are removably connected to the main body and are removably fluidically connected to the fluid passages in the manifold so that each of the leg assemblies can be selectively actuated by the flow of pressurized fluid in different ones of the plurality of fluid passages in the manifold. 12 figs.

  20. Modular robot

    DOEpatents

    Ferrante, Todd A.

    1997-01-01

    A modular robot may comprise a main body having a structure defined by a plurality of stackable modules. The stackable modules may comprise a manifold, a valve module, and a control module. The manifold may comprise a top surface and a bottom surface having a plurality of fluid passages contained therein, at least one of the plurality of fluid passages terminating in a valve port located on the bottom surface of the manifold. The valve module is removably connected to the manifold and selectively fluidically connects the plurality of fluid passages contained in the manifold to a supply of pressurized fluid and to a vent. The control module is removably connected to the valve module and actuates the valve module to selectively control a flow of pressurized fluid through different ones of the plurality of fluid passages in the manifold. The manifold, valve module, and control module are mounted together in a sandwich-like manner and comprise a main body. A plurality of leg assemblies are removably connected to the main body and are removably fluidically connected to the fluid passages in the manifold so that each of the leg assemblies can be selectively actuated by the flow of pressurized fluid in different ones of the plurality of fluid passages in the manifold.

  1. Donor complications following laparoscopic compared to hand-assisted living donor nephrectomy: an analysis of the literature.

    PubMed

    Halgrimson, Whitney R; Campsen, Jeffrey; Mandell, M Susan; Kelly, Mara A; Kam, Igal; Zimmerman, Michael A

    2010-01-01

    THERE ARE TWO APPROACHES TO LAPAROSCOPIC DONOR NEPHRECTOMY: standard laparoscopic donor nephrectomy (LDN) and hand-assisted laparoscopic donor nephrectomy (HALDN). In this study we report the operative statistics and donor complications associated with LDN and HALDN from large-center peer-reviewed publications. Methods. We conducted PubMed and Ovid searches to identify LDN and HALDN outcome studies that were published after 2004. Results. There were 37 peer-reviewed studies, each with more than 150 patients. Cumulatively, over 9000 patients were included in this study. LDN donors experienced a higher rate of intraoperative complications than HALDN donors (5.2% versus. 2.0%, P < .001). Investigators did not report a significant difference in the rate of major postoperative complications between the two groups (LDN 0.5% versus HALDN 0.7%, P = .111). However, conversion to open procedures from vascular injury was reported more frequently in LDN procedures (0.8% versus 0.4%, P = .047). Conclusion. At present there is no evidence to support the use of one laparoscopic approach in preference to the other. There are trends in the data suggesting that intraoperative injuries are more common in LDN while minor postoperative complications are more common in HALDN.

  2. Intelligent robots and computer vision

    SciTech Connect

    Casasent, D.P.

    1986-01-01

    This book presents the papers given at a conference on artificial intelligence and robot vision. Topics considered at the conference included pattern recognition, image processing for intelligent robotics, three-dimensional vision (depth and motion), vision modeling and shape estimation, spatial reasoning, the symbolic processing visual information, robotic sensors and applications, intelligent control architectures for robot systems, robot languages and programming, human-machine interfaces, robotics applications, and architectures of robotics.

  3. Position of laparo-endoscopic single-site surgery nephrectomy in clinical practice and comparison (matched case-control study) with standard laparoscopic nephrectomy

    PubMed Central

    Eret, Viktor; Stránský, Petr; Trávníček, Ivan; Ürge, Tomáš; Ferda, Jiří; Petersson, Fredrik; Hes, Ondřej

    2014-01-01

    Introduction One way how to reduce morbidity and improve cosmesic of kidney surgery is single site laparoscopy. Relatively well described concept but without defined position in clincal practise. Aim To report of institutional experience with laparoendoscopic single-site surgery (LESS) nephrectomy (NE) and compare (matched case-control study) it with that of standard laparoscopic NE (LNE). Material and methods In the period 8/2011 to 10/2013, we performed 183 mini-invasive NE (132 tumours, 51 benign aetiology); 45 of them (24.6%) were LESS, the rest LNE. The main but not absolute indications for LESS were: non-obese men, and less advanced tumours. In 13 patients undergoing LESS-NEs (28.9%) there was a transumbilical approach. For the rest, a pararectal incision was performed and an accessory port was added in 31.1% (14) – 2/22 (9.1%) left sided, 12/23 (52.2%) right sided. Twenty-four LESS-NE were performed by a more experienced surgeon (mean operation time (MOT) 73.1 min), 21 LESS-NE by 4 other surgeons (MOT 132.8 min). These 24 were compared with 43 LNE done by the same surgeon before the period of LESS (1/2007–8/2011) and with similar characteristics of cases (body mass index (BMI) ≤ 35 kg/m2, less advanced tumour). Results We found no statistically significant differences in any of the parameters studied. The MOT 73.1 min vs. 75.0 min (p = 0.78), BMI 27.4 kg/m2 vs. 29.2 kg/m2 (p = 0.08), blood loss 54.7 vs. 39.2 (p = 0.47). Complications (4.2% vs. 11.6%) were only of internal character in origin. No conversion in either group. In LESS-NE, staplers were used more frequently (more expensive than clips) for division of renal hilar vessels (70.8% vs. 51.2%). The mean price of LESS-NE was €367 higher. Conclusions The LESS NE performed by an experienced surgeon is a safe and efficient method for the surgical treatment of both malignant and benign renal conditions in patients with BMI < 30 kg/m2 and with low-stage tumours. The LESS NE is more expensive compared

  4. Return to normal activities and work after living donor laparoscopic nephrectomy.

    PubMed

    Larson, Dawn B; Jacobs, Cheryl; Berglund, Danielle; Wiseman, Jennifer; Garvey, Catherine; Gillingham, Kristen; Ibrahim, Hassan N; Matas, Arthur J

    2017-01-01

    Transplant programs inform potential donors that they should be able to return to normal activities within ~2 weeks and to work by 6 weeks after laparoscopic nephrectomy. We studied actual time. Between 10/2004 and 9/2014, 911 donors having laparoscopic nephrectomy were surveyed 6 months post-donation. Surveys asked questions specific to their recovery experience, including time to return to normal activities and work and a description of their recovery time relative to pre-donation expectations. Of the 911, 646 (71%) responded: mean age at donation was 43.5±10.6 years; 65% were female, 95% were white, 51% were biologically related to their recipient, and 83% reported education beyond high school. Of the 646 respondents, a total of 35% returned to normal activities by 2 weeks post-donation; 79% by 4 weeks post-donation; 94% by 5-6 weeks; however, 6% took >6 weeks. Of the 646, 551 (85%) were working for pay; of these, mean time to return to work was 5.3±2.8 weeks; median, 5 weeks. Of the 551, a total of 14% returned to work in 1-2 weeks, 46% by 3-4 weeks, and 76% by 5-6 weeks. Importantly, 24% required >6 weeks before returning to work with the highest rates for donors in manual labor or a skilled trade. Significantly longer return to work was reported by females (vs males; P=.01), those without (vs those with) post-high school education (P=.010, those with longer hospital stay (P=.01), and those with a postoperative complication (P=.02). Of respondents, 37% described their recovery time as longer than expected. During the donor informed consent process, additional emphasis on realistic expectations around recovery to baseline activities and return to work is warranted.

  5. Adjuvant Sunitinib in High-Risk Renal-Cell Carcinoma after Nephrectomy.

    PubMed

    Ravaud, Alain; Motzer, Robert J; Pandha, Hardev S; George, Daniel J; Pantuck, Allan J; Patel, Anup; Chang, Yen-Hwa; Escudier, Bernard; Donskov, Frede; Magheli, Ahmed; Carteni, Giacomo; Laguerre, Brigitte; Tomczak, Piotr; Breza, Jan; Gerletti, Paola; Lechuga, Mariajose; Lin, Xun; Martini, Jean-Francois; Ramaswamy, Krishnan; Casey, Michelle; Staehler, Michael; Patard, Jean-Jacques

    2016-12-08

    Background Sunitinib, a vascular endothelial growth factor pathway inhibitor, is an effective treatment for metastatic renal-cell carcinoma. We sought to determine the efficacy and safety of sunitinib in patients with locoregional renal-cell carcinoma at high risk for tumor recurrence after nephrectomy. Methods In this randomized, double-blind, phase 3 trial, we assigned 615 patients with locoregional, high-risk clear-cell renal-cell carcinoma to receive either sunitinib (50 mg per day) or placebo on a 4-weeks-on, 2-weeks-off schedule for 1 year or until disease recurrence, unacceptable toxicity, or consent withdrawal. The primary end point was disease-free survival, according to blinded independent central review. Secondary end points included investigator-assessed disease-free survival, overall survival, and safety. Results The median duration of disease-free survival was 6.8 years (95% confidence interval [CI], 5.8 to not reached) in the sunitinib group and 5.6 years (95% CI, 3.8 to 6.6) in the placebo group (hazard ratio, 0.76; 95% CI, 0.59 to 0.98; P=0.03). Overall survival data were not mature at the time of data cutoff. Dose reductions because of adverse events were more frequent in the sunitinib group than in the placebo group (34.3% vs. 2%), as were dose interruptions (46.4% vs. 13.2%) and discontinuations (28.1% vs. 5.6%). Grade 3 or 4 adverse events were more frequent in the sunitinib group (48.4% for grade 3 events and 12.1% for grade 4 events) than in the placebo group (15.8% and 3.6%, respectively). There was a similar incidence of serious adverse events in the two groups (21.9% for sunitinib vs. 17.1% for placebo); no deaths were attributed to toxic effects. Conclusions Among patients with locoregional clear-cell renal-cell carcinoma at high risk for tumor recurrence after nephrectomy, the median duration of disease-free survival was significantly longer in the sunitinib group than in the placebo group, at a cost of a higher rate of toxic events

  6. Ozone Therapy on Rats Submitted to Subtotal Nephrectomy: Role of Antioxidant System

    PubMed Central

    Calunga, José Luis; Zamora, Zullyt B.; Borrego, Aluet; del Río, Sarahí; Barber, Ernesto; Menéndez, Silvia; Hernández, Frank; Montero, Teresita; Taboada, Dunia

    2005-01-01

    Chronic renal failure (CRF) represents a world health problem. Ozone increases the endogenous antioxidant defense system, preserving the cell redox state. The aim of this study is to evaluate the effect of ozone/oxygen mixture in the renal function, morphology, and biochemical parameters, in an experimental model of CRF (subtotal nephrectomy). Ozone/oxygen mixture was applied daily, by rectal insufflation (0.5 mg/kg) for 15 sessions after the nephrectomy. Renal function was evaluated, as well as different biochemical parameters, at the beginning and at the end of the study (10 weeks). Renal plasmatic flow (RPF), glomerular filtration rate (GFR), the urine excretion index, and the sodium and potassium excretions (as a measurement of tubular function) in the ozone group were similar to those in Sham group. Nevertheless, nephrectomized rats without ozone (positive control group) showed the lowest RPF, GFR, and urine excretion figures, as well as tubular function. Animals treated with ozone showed systolic arterial pressure (SAP) figures lower than those in the positive control group, but higher values compared to Sham group. Serum creatinine values and protein excretion in 24 hours in the ozone group were decreased compared with nephrectomized rats, but were still higher than normal values. Histological study demonstrated that animals treated with ozone showed less number of lesions in comparison with nephrectomized rats. Thiobarbituric acid reactive substances were significantly increased in nephrectomized and ozone-treated nephrectomized rats in comparison with Sham group. In the positive control group, superoxide dismutase (SOD) and catalase (CAT) showed the lowest figures in comparison with the other groups. However, ozone/oxygen mixture induced a significant stimulation in the enzymatic activity of CAT, SOD, and glutathione peroxidase, as well as reduced glutathione in relation with Sham and positive control groups. In this animal model of CRF, ozone rectal

  7. [Robotics in pediatric surgery].

    PubMed

    Camps, J I

    2011-10-01

    Despite the extensive use of robotics in the adult population, the use of robotics in pediatrics has not been well accepted. There is still a lack of awareness from pediatric surgeons on how to use the robotic equipment, its advantages and indications. Benefit is still controversial. Dexterity and better visualization of the surgical field are one of the strong values. Conversely, cost and a lack of small instruments prevent the use of robotics in the smaller patients. The aim of this manuscript is to present the controversies about the use of robotics in pediatric surgery.

  8. Miniaturized autonomous robot

    NASA Astrophysics Data System (ADS)

    Ishihara, Hidenori; Fukuda, Toshio

    1998-01-01

    Many projects developing the miniaturized autonomous robot have been carried out in the whole world. This paper deals with our challenges developing a miniaturized autonomous robot. The miniaturized autonomous robot is defined as the miniaturized closed-loop system with micro processor, microactuators and microsensors. We have developed the micro autonomous robotic system (MARS) consisting of the microprocessor, microsensors, microactuators, communication units and batteries. The MARS controls itself by the downloaded program supplied through the IR communication system. In this paper, we demonstrate several performance of the MARS, and discuss the properties of the miniaturized autonomous robot.

  9. Robotic technology in urology

    PubMed Central

    Murphy, D; Challacombe, B; Khan, M S; Dasgupta, P

    2006-01-01

    Urology has increasingly become a technology‐driven specialty. The advent of robotic surgical systems in the past 10 years has led to urologists becoming the world leaders in the use of such technology. In this paper, we review the history and current status of robotic technology in urology. From the earliest uses of robots for transurethral resection of the prostate, to robotic devices for manipulating laparoscopes and to the current crop of master–slave devices for robotic‐assisted laparoscopic surgery, the evolution of robotics in the urology operating theatre is presented. Future possibilities, including the prospects for nanotechnology in urology, are awaited. PMID:17099094

  10. Robotics Technical Note 102.

    DTIC Science & Technology

    1981-06-01

    IAfl-AIBZ 4U2 AIR FORCE BUSINESS RESEARCH MANAGEMENT CENTER WRIGHT-ETC F/6 13/8 I ROBOTICS TECHNIICAL NOTE 102.(U) JUN Al B M BLABIERSALL UNCLASSIFE...CATALOG uME 1T4.T7- Subtitle S. TYPE OF REPOR & PERIOO COVERED Technical Note 102 Robotics 𔄁 FInal r ---- 6. PERFORMING O1G. REPORT NUMBER C 7. A tNORa B...Identify by block number) Robotics Manufacturing Industrial Robots Robot Technology SRobotics Application BQ~.STRACT (Continue on revere* side It

  11. Space robotics in Japan

    NASA Astrophysics Data System (ADS)

    Whittaker, William; Lowrie, James W.; McCain, Harry; Bejczy, Antal; Sheridan, Tom; Kanade, Takeo; Allen, Peter

    1994-03-01

    Japan has been one of the most successful countries in the world in the realm of terrestrial robot applications. The panel found that Japan has in place a broad base of robotics research and development, ranging from components to working systems for manufacturing, construction, and human service industries. From this base, Japan looks to the use of robotics in space applications and has funded work in space robotics since the mid-1980's. The Japanese are focusing on a clear image of what they hope to achieve through three objectives for the 1990's: developing long-reach manipulation for tending experiments on Space Station Freedom, capturing satellites using a free-flying manipulator, and surveying part of the moon with a mobile robot. This focus and a sound robotics infrastructure is enabling the young Japanese space program to develop relevant systems for extraterrestrial robotics applications.

  12. Space robotics in Japan

    NASA Technical Reports Server (NTRS)

    Whittaker, William; Lowrie, James W.; Mccain, Harry; Bejczy, Antal; Sheridan, Tom; Kanade, Takeo; Allen, Peter

    1994-01-01

    Japan has been one of the most successful countries in the world in the realm of terrestrial robot applications. The panel found that Japan has in place a broad base of robotics research and development, ranging from components to working systems for manufacturing, construction, and human service industries. From this base, Japan looks to the use of robotics in space applications and has funded work in space robotics since the mid-1980's. The Japanese are focusing on a clear image of what they hope to achieve through three objectives for the 1990's: developing long-reach manipulation for tending experiments on Space Station Freedom, capturing satellites using a free-flying manipulator, and surveying part of the moon with a mobile robot. This focus and a sound robotics infrastructure is enabling the young Japanese space program to develop relevant systems for extraterrestrial robotics applications.

  13. A Single Perioperative Injection of Dexamethasone Decreases Nausea, Vomiting, and Pain after Laparoscopic Donor Nephrectomy

    PubMed Central

    Yamanaga, Shigeyoshi; Posselt, Andrew Mark; Freise, Chris Earl; Kobayashi, Takaaki; Tavakol, Mehdi

    2017-01-01

    Background. A single dose of perioperative dexamethasone (8–10 mg) reportedly decreases postoperative nausea, vomiting, and pain but has not been widely used in laparoscopic donor nephrectomy (LDN). Methods. We performed a retrospective cohort study of living donors who underwent LDN between 2013 and 2015. Donors who received a lower dose (4–6 mg)  (n = 70) or a higher dose (8–14 mg) of dexamethasone (n = 100) were compared with 111 donors who did not receive dexamethasone (control). Outcomes and incidence of postoperative nausea, vomiting, and pain within 24 h after LDN were compared before and after propensity-score matching. Results. The higher dose of dexamethasone reduced postoperative nausea and vomiting incidences by 28% (P = 0.010) compared to control, but the lower dose did not. Total opioid use was 29% lower in donors who received the higher dose than in control (P = 0.004). The higher dose was identified as an independent factor for preventing postoperative nausea and vomiting. Postoperative complication rates and hospital stays did not differ between the groups. After propensity-score matching, the results were the same as for the unmatched analysis. Conclusion. A single perioperative injection of 8–14 mg dexamethasone decreases antiemetic and narcotic requirements in the first 24 h, with no increase in surgical complications. PMID:28210502

  14. Vascular management during live donor nephrectomy: an online survey among transplant surgeons.

    PubMed

    Janki, S; Verver, D; Klop, K W J; Friedman, A L; Peters, T G; Ratner, L E; Ijzermans, J N M; Dor, F J M F

    2015-06-01

    In 2006, a survey from the American Society of Transplant Surgeons disclosed significant and sometimes fatal hemorrhagic events in live donor nephrectomies (LDN) related to failure of clips, leading to the contraindication of the Weck® Hem-o-lok® clip for control of the renal artery during LDN. A survey regarding vascular control techniques, their perceived safety ratings and their failures was sent to 645 European Society for Organ Transplantation members who profiled their profession as "surgeon" and selected "kidney" as organ type. Two hundred forty-three (41%) members responded, of whom 171 (63.3%) independently perform LDN. Their responses were analyzed. For arterial and venous vascular control, the GIA™ and TA™stapler are used most frequently, and were rated the safest. Of the 121 reported hemorrhagic events, slippage and dislodgement of clips occurred at least 58 times, while stapler malfunction occurred at least 40 times. One donor death from hemorrhage related to clip dysfunction was reported. Hemorrhagic complications of LDN with fatal and non-fatal outcomes still occur. Strikingly, many surgeons do not use the vascular closing technique that they consider most safe. Failure of non-transfixion techniques is associated with greater risks for the donor. Control of major vessels in LDN must employ transfixion techniques for optimal donor safety.

  15. Increased urinary lysophosphatidic acid in mouse with subtotal nephrectomy: potential involvement in chronic kidney disease.

    PubMed

    Mirzoyan, Koryun; Baïotto, Anna; Dupuy, Aude; Marsal, Dimitri; Denis, Colette; Vinel, Claire; Sicard, Pierre; Bertrand-Michel, Justine; Bascands, Jean-Loup; Schanstra, Joost P; Klein, Julie; Saulnier-Blache, Jean-Sébastien

    2016-12-01

    Increased incidence of chronic kidney disease (CKD) with consecutive progression to end-stage renal disease represents a significant burden to healthcare systems. Renal tubulointerstitial fibrosis (TIF) is a classical hallmark of CKD and is well correlated with the loss of renal function. The bioactive lysophospholipid lysophosphatidic acid (LPA), acting through specific G-protein-coupled receptors, was previously shown to be involved in TIF development in a mouse model of unilateral ureteral obstruction. Here, we study the role of LPA in a mouse subjected to subtotal nephrectomy (SNx), a more chronic and progressive model of CKD. Five months after surgical nephron reduction, SNx mice showed massive albuminuria, extensive TIF, and glomerular hypertrophy when compared to sham-operated animals. Urinary and plasma levels of LPA were analyzed using liquid chromatography tandem mass spectrometry. LPA was significantly increased in SNx urine, not in plasma, and was significantly correlated with albuminuria and TIF. Moreover, SNx mice showed significant downregulation in the renal expression of lipid phosphate phosphohydrolases (LPP1, 2, and 3) that might be involved in reduced LPA bioavailability through dephosphorylation. We concluded that SNx increases urinary LPA through a mechanism that could involve co-excretion of plasma LPA with albumin associated with a reduction of its catabolism in the kidney. Because of the previously demonstrated profibrotic activity of LPA, the association of urinary LPA with TIF suggests the potential involvement of LPA in the development of advanced CKD in the SNx mouse model. Targeting LPA metabolism might represent an interesting approach in CKD treatment.

  16. Concentration of phosphoribosyl pyrophosphate in renal hypertrophy. Contrasting effects of early diabetes and unilateral nephrectomy.

    PubMed Central

    Kunjara, S; Sochor, M; Greenbaum, A L; McLean, P

    1986-01-01

    Studies were made of the renal phosphoribosyl pyrophosphate (PPRibP) content and PPRibP synthetase (EC 2.7.6.1) activity in rats diabetic for 5, 14 or 20 days, or unilaterally nephrectomized (UN) for 5 days, and in doubly lesioned animals. Approximately equal degrees of renal enlargement were found after 5 days diabetes or 5 days UN. In the doubly lesioned animals the increment of growth was additive. Unilateral nephrectomy of 5 days duration, in contrast with diabetes, had no effect on the PPRibP content of the contralateral kidney, nor did it modify the renal PPRibP content when performed on animals diabetic for 5, 14 or 20 days. The activity of PPRibP synthetase was unaffected by diabetes, UN or diabetes +UN. The results pinpoint a stage of nucleotide synthesis which is differentially affected by the two stimuli, in line with evidence for differences in regulation of nucleic acid turnover in the two conditions. PMID:2432888

  17. Prevention of reflex natriuresis after acute unilateral nephrectomy by neonatal administration of MSG

    SciTech Connect

    Lin, S.Y.; Wiedemann, E.; Deschepper, C.F.; Alper, R.H.; Humphreys, M.H.

    1987-02-01

    Acute unilateral nephrectomy (AUN) results in natriuresis from the remaining kidney through reflex pathways involving the central nervous system and requiring an intact pituitary gland. The natriuresis is accompanied by an increase in the plasma concentration of a peptide or peptides derived from the N-terminal fragment (NTF) of proopiomelanocortin. The authors measured plasma immunoreactive NTF-like material (IR-NTF) by radioimmunoassay, before and after AUN in control rats and rats treated neonatally with monosodium glutamate (MSG), a procedure that produces neuroendocrine dysfunction by destroying cell bodies in the hypothalamic arcuate nucleus, median eminence, and other brain regions. In control rats, IR-NTF increased from 85.8 +/- 54.9 (SD) to 207 +/- 98.1 fmol/ml after AUN as sodium excretion (U/sub Na/V) doubled. In MSG-treated rats, AUN produced no change in plasma IR-NTF concentration, nor did U/sub Na/V increase. Tissue content of IR-NTF was reduced in the arcuate nucleus and anterior lobe of pituitaries from MSG-treated rats compared with controls, but was no different in the neurointermediate lobe. These results indicate that the hypothalamic lesion produced by neonatal administration of MSG prevents both the increase in plasma IR-NTF concentration and the natruiuresis after AUN, and therefore lend further support to the concept of a casual relationship between these two consequences of AUN.

  18. Effect of nephrectomy and captopril on autoregulation of cerebral blood flow in rats.

    PubMed

    Pedersen, Trine Fischer; Paulson, Olaf B; Nielsen, Arne Høj; Strandgaard, Svend

    2003-09-01

    The present study investigated the effect of circulating versus locally present renin on cerebral blood flow (CBF) and its autoregulation in rats. CBF was measured repetitively with the intracarotid 133Xe injection method, whereas blood pressure was lowered to determine the lower limit of autoregulation. To remove renin from the blood, rats were bilaterally nephrectomized and kept alive with peritoneal dialysis for 48 h. Five groups of animals were studied: 1) nephrectomized dialyzed rats, 2) nephrectomized dialyzed rats given a single intravenous dose of the angiotensin-converting enzyme inhibitor captopril (10 mg/kg), 3) sham nephrectomized and dialyzed rats, 4) rats receiving drugs as dialyzed rats but no surgery, and 5) rats given the same diet as the other groups but no drugs and no surgery. Baseline blood pressure was significantly lower in nephrectomized rats compared with controls. Nephrectomy, captopril, sham operation, or dialysis did not influence baseline CBF. The lower limit of CBF autoregulation was significantly lower in nephrectomized (53 +/- 4 mmHg) and sham-operated (58 +/- 4 mmHg) rats compared with diet control rats (78 +/- 3 mmHg). Captopril significantly decreased the lower limit in nephrectomized rats (35 +/- 2 mmHg). Thus removal of circulating renin caused no change in the lower limit of autoregulation. By contrast, captopril lowered the lower limit even in the absence of circulating renin and hence appeared to exert its effect on components of the renin-angiotensin system in the cerebral resistance vessel walls.

  19. Marsupial robots for law enforcement

    NASA Astrophysics Data System (ADS)

    Murphy, Robin R.

    2001-02-01

    Marsupial robots are a type of heterogeneous mobile robot team. A mother robot transports, supports, and recovers one or more daughter robots. This paper will cover the marsupial robot concept, the application of law enforcement, and recent results in collaborative teleoperation for the related task of urban search and rescue.

  20. Algorithms and architectures for robot vision

    NASA Technical Reports Server (NTRS)

    Schenker, Paul S.

    1990-01-01

    The scope of the current work is to develop practical sensing implementations for robots operating in complex, partially unstructured environments. A focus in this work is to develop object models and estimation techniques which are specific to requirements of robot locomotion, approach and avoidance, and grasp and manipulation. Such problems have to date received limited attention in either computer or human vision - in essence, asking not only how perception is in general modeled, but also what is the functional purpose of its underlying representations. As in the past, researchers are drawing on ideas from both the psychological and machine vision literature. Of particular interest is the development 3-D shape and motion estimates for complex objects when given only partial and uncertain information and when such information is incrementally accrued over time. Current studies consider the use of surface motion, contour, and texture information, with the longer range goal of developing a fused sensing strategy based on these sources and others.

  1. Evolution of robotic arms.

    PubMed

    Moran, Michael E

    2007-01-01

    The foundation of surgical robotics is in the development of the robotic arm. This is a thorough review of the literature on the nature and development of this device with emphasis on surgical applications. We have reviewed the published literature and classified robotic arms by their application: show, industrial application, medical application, etc. There is a definite trend in the manufacture of robotic arms toward more dextrous devices, more degrees-of-freedom, and capabilities beyond the human arm. da Vinci designed the first sophisticated robotic arm in 1495 with four degrees-of-freedom and an analog on-board controller supplying power and programmability. von Kemplen's chess-playing automaton left arm was quite sophisticated. Unimate introduced the first industrial robotic arm in 1961, it has subsequently evolved into the PUMA arm. In 1963 the Rancho arm was designed; Minsky's Tentacle arm appeared in 1968, Scheinman's Stanford arm in 1969, and MIT's Silver arm in 1974. Aird became the first cyborg human with a robotic arm in 1993. In 2000 Miguel Nicolalis redefined possible man-machine capacity in his work on cerebral implantation in owl-monkeys directly interfacing with robotic arms both locally and at a distance. The robotic arm is the end-effector of robotic systems and currently is the hallmark feature of the da Vinci Surgical System making its entrance into surgical application. But, despite the potential advantages of this computer-controlled master-slave system, robotic arms have definite limitations. Ongoing work in robotics has many potential solutions to the drawbacks of current robotic surgical systems.

  2. GRACE and GEORGE: Autonomous Robots for the AAAI Robot Challenge

    DTIC Science & Technology

    2004-01-01

    GRACE and GEORGE: Autonomous Robots for the AAAI Robot Challenge Reid Simmons, Allison Bruce, Dani Goldberg, Adam Goode, Michael Montemerlo, Nicholas...2004 2. REPORT TYPE 3. DATES COVERED - 4. TITLE AND SUBTITLE GRACE and GEORGE: Autonomous Robots for the AAAI Robot Challenge 5a. CONTRACT...Simmons. “A Social Robot that Stands in Line.” Autonomous Robots , 12:3 pp.313-324, May 2002. [Ortony, 1988] A. Ortony, G. L. Clore, and A. Collins

  3. Humanlike Robots - The Upcoming Revolution in Robotics

    NASA Technical Reports Server (NTRS)

    Bar-Cohen, Yoseph

    2009-01-01

    Humans have always sought to imitate the human appearance, functions and intelligence. Human-like robots, which for many years have been a science fiction, are increasingly becoming an engineering reality resulting from the many advances in biologically inspired technologies. These biomimetic technologies include artificial intelligence, artificial vision and hearing as well as artificial muscles, also known as electroactive polymers (EAP). Robots, such as the vacuum cleaner Rumba and the robotic lawnmower, that don't have human shape, are already finding growing use in homes worldwide. As opposed to other human-made machines and devices, this technology raises also various questions and concerns and they need to be addressed as the technology advances. These include the need to prevent accidents, deliberate harm, or their use in crime. In this paper the state-of-the-art of the ultimate goal of biomimetics, the development of humanlike robots, the potentials and the challenges are reviewed.

  4. Humanlike robots: the upcoming revolution in robotics

    NASA Astrophysics Data System (ADS)

    Bar-Cohen, Yoseph

    2009-08-01

    Humans have always sought to imitate the human appearance, functions and intelligence. Human-like robots, which for many years have been a science fiction, are increasingly becoming an engineering reality resulting from the many advances in biologically inspired technologies. These biomimetic technologies include artificial intelligence, artificial vision and hearing as well as artificial muscles, also known as electroactive polymers (EAP). Robots, such as the vacuum cleaner Rumba and the robotic lawnmower, that don't have human shape, are already finding growing use in homes worldwide. As opposed to other human-made machines and devices, this technology raises also various questions and concerns and they need to be addressed as the technology advances. These include the need to prevent accidents, deliberate harm, or their use in crime. In this paper the state-of-the-art of the ultimate goal of biomimetics, the development of humanlike robots, the potentials and the challenges are reviewed.

  5. INL Multi-Robot Control Interface

    SciTech Connect

    2005-03-30

    The INL Multi-Robot Control Interface controls many robots through a single user interface. The interface includes a robot display window for each robot showing the robot’s condition. More than one window can be used depending on the number of robots. The user interface also includes a robot control window configured to receive commands for sending to the respective robot and a multi-robot common window showing information received from each robot.

  6. Applying robotics to HAZMAT

    NASA Technical Reports Server (NTRS)

    Welch, Richard V.; Edmonds, Gary O.

    1994-01-01

    The use of robotics in situations involving hazardous materials can significantly reduce the risk of human injuries. The Emergency Response Robotics Project, which began in October 1990 at the Jet Propulsion Laboratory, is developing a teleoperated mobile robot allowing HAZMAT (hazardous materials) teams to remotely respond to incidents involving hazardous materials. The current robot, called HAZBOT III, can assist in locating characterizing, identifying, and mitigating hazardous material incidents without risking entry team personnel. The active involvement of the JPL Fire Department HAZMAT team has been vital in developing a robotic system which enables them to perform remote reconnaissance of a HAZMAT incident site. This paper provides a brief review of the history of the project, discusses the current system in detail, and presents other areas in which robotics can be applied removing people from hazardous environments/operations.

  7. Robots in modern industry

    NASA Technical Reports Server (NTRS)

    Heer, E.

    1981-01-01

    A survey is presented of robotic device types and capabilities, and an assessment is made of the relative benefits they confer in present and planned numbers on such industrial countries as Japan, the U.S., and West Germany. Attention is also given to possible social impacts of large-scale implementation, and the need for close consultation between management and labor is stressed. It is reported that, while the hourly cost of robot labor remained at between $4.00 and $4.60 over the period 1960-present, human hourly labor costs (including fringe benefits) have risen from less than $4.00 to nearly $17.00. Among the types of devices described are: (1) remotely controlled manipulator vehicles; (2) undersea robotic craft; (3) servo-controlled robots; and (4) articulated robots. Also covered are robot programming languages derived from such standard languages as ALGOL, FORTRAN, and BASIC.

  8. ROBOTIC SURGERY: BIOETHICAL ASPECTS

    PubMed Central

    SIQUEIRA-BATISTA, Rodrigo; SOUZA, Camila Ribeiro; MAIA, Polyana Mendes; SIQUEIRA, Sávio Lana

    2016-01-01

    ABSTRACT Introduction: The use of robots in surgery has been increasingly common today, allowing the emergence of numerous bioethical issues in this area. Objective: To present review of the ethical aspects of robot use in surgery. Method: Search in Pubmed, SciELO and Lilacs crossing the headings "bioethics", "surgery", "ethics", "laparoscopy" and "robotic". Results: Of the citations obtained, were selected 17 articles, which were used for the preparation of the article. It contains brief presentation on robotics, its inclusion in health and bioethical aspects, and the use of robots in surgery. Conclusion: Robotic surgery is a reality today in many hospitals, which makes essential bioethical reflection on the relationship between health professionals, automata and patients. PMID:28076489

  9. Robotic surgical simulation.

    PubMed

    Liss, Michael A; McDougall, Elspeth M

    2013-01-01

    Robotic surgery has undergone exponential growth and has ever developing utilization. The explosion of new technologies and regulation have led to challenges in training surgeons who desire this skill set. We review the current state of robotic simulation and incorporation of simulation into surgical training curricula. In addition to the literature review, results of a questionnaire survey study of 21 expert and novice surgeons attending a Urologic Robotic Oncology conference using 3 different robotic skill simulation devices are discussed. An increasing number of robotic surgery simulators have had some degree of validation study of their use in surgical education curricula and proficiency testing. Although simulators are advantageous, confirmation of construct and predictive validity of robotic simulators and their reliability as a training tool will be necessary before they are integrated into the surgical credentialing process.

  10. Survival of falling robots

    NASA Astrophysics Data System (ADS)

    Cameron, Jonathan M.; Arkin, Ronald C.

    1992-02-01

    As mobile robots are used in more uncertain and dangerous environments, it will become important to design them so that they can survive falls. In this paper, we examine a number of mechanisms and strategies that animals use to withstand these potentially catastrophic events and extend them to the design of robots. A brief survey of several aspects of how common cats survive falls provides an understanding of the issues involved in preventing traumatic injury during a falling event. After outlining situations in which robots might fall, a number of factors affecting their survival are described. From this background, several robot design guidelines are derived. These include recommendations for the physical structure of the robot as well as requirements for the robot control architecture. A control architecture is proposed based on reactive control techniques and action-oriented perception that is geared to support this form of survival behavior.

  11. Survival of falling robots

    NASA Technical Reports Server (NTRS)

    Cameron, Jonathan M.; Arkin, Ronald C.

    1992-01-01

    As mobile robots are used in more uncertain and dangerous environments, it will become important to design them so that they can survive falls. In this paper, we examine a number of mechanisms and strategies that animals use to withstand these potentially catastrophic events and extend them to the design of robots. A brief survey of several aspects of how common cats survive falls provides an understanding of the issues involved in preventing traumatic injury during a falling event. After outlining situations in which robots might fall, a number of factors affecting their survival are described. From this background, several robot design guidelines are derived. These include recommendations for the physical structure of the robot as well as requirements for the robot control architecture. A control architecture is proposed based on reactive control techniques and action-oriented perception that is geared to support this form of survival behavior.

  12. Robotics and expert systems

    SciTech Connect

    Not Available

    1986-01-01

    This volume contains papers presented at ROBEXS' 86, the Second Annual Workshop on Robotics and Expert Systems. Many diverse perspectives on automation problems, and on the merging of robotics and expert systems technology with conventional systems, are contained in this book. The contents include: Integrated Expert Systems Applications; Expert Systems Theory and Applications, Robotics, Intelligent Control, CAD/CAE/CAM, AI Tools, Human Factors, and intelligent Interfaces.

  13. Robotic liver surgery

    PubMed Central

    Leung, Universe

    2014-01-01

    Robotic surgery is an evolving technology that has been successfully applied to a number of surgical specialties, but its use in liver surgery has so far been limited. In this review article we discuss the challenges of minimally invasive liver surgery, the pros and cons of robotics, the evolution of medical robots, and the potentials in applying this technology to liver surgery. The current data in the literature are also presented. PMID:25392840

  14. NASA Robot Brain Surgeon

    NASA Technical Reports Server (NTRS)

    1997-01-01

    Mechanical Engineer Michael Guerrero works on the Robot Brain Surgeon testbed in the NeuroEngineering Group at the Ames Research Center, Moffett Field, California. Principal investigator Dr. Robert W. Mah states that potentially the simple robot will be able to feel brain structures better than any human surgeon, making slow, very precise movements during an operation. The brain surgery robot that may give surgeons finer control of surgical instruments during delicate brain operations is still under development.

  15. TARDEC Ground Vehicle Robotics

    DTIC Science & Technology

    2013-05-30

    TARDEC Ground Vehicle Robotics Mr. Jim Parker, Associate Director Dr. Greg Hudas, Chief Engineer UNCLASSIFIED: Distribution Statement A (OPSEC...TARDEC Ground Vehicle Robotics 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Jim Parker; Greg Hudas 5d. PROJECT...Provide Transition-Ready, Cost-Effective, and Innovative Robotics and Control System Solutions for Manned, Optionally-Manned, and Unmanned Ground Vehicles

  16. A Modular Robotic Architecture

    DTIC Science & Technology

    1990-11-01

    DATES COVERED AD-A232 007 Januar 1991 professional paper5 FUNOING NUMBERS A MODULAR ROBOTIC ARCHITECTURE PR: ZE92 WU: DN300029 PE: 0602936N - S. AUTHOR...mobile robots will help alleviate these problems, and, if made widely available, will promote standardization and compatibility among systems throughout...the industry. The Modular Robotic Architecture (MRA) is a generic control system that meets the above needs by providing developers with a standard set

  17. Ground Vehicle Robotics Presentation

    DTIC Science & Technology

    2012-08-14

    Mr. Jim Parker Associate Director Ground Vehicle Robotics Distribution Statement A. Approved for public release Report Documentation Page...Briefing 3. DATES COVERED 01-07-2012 to 01-08-2012 4. TITLE AND SUBTITLE Ground Vehicle Robotics Presentation 5a. CONTRACT NUMBER 5b. GRANT...ABSTRACT Provide Transition-Ready, Cost-Effective, and Innovative Robotics and Control System Solutions for Manned, Optionally-Manned, and Unmanned

  18. Robotic Security Systems

    DTIC Science & Technology

    2003-12-01

    robotic security platforms that automatically respond in an adaptive fashion to potential disturbances reported by a broad-area field of fixed unattended...sensors represents a powerful new defensive tool for mitigating the terrorist threat. Background The primary purpose of any robotic system is to...mobile robots , the predominant challenge is one of perception, in that the very nature of mobility introduces a never-ending sequence of dynamically

  19. Army Medical Robotics Research

    DTIC Science & Technology

    2007-01-01

    Army Medical Robotics Research Gary Gilbert, Ph.D., U.S. Army TATRC, Ph: (301) 619-4043, Fax: (301) 619-2518 gilbert@tatrc.org, www.tatrc.org...politically sensitive low intensity combat in urban terrain. Research progress has been made in the areas of robotics ; artificial intelligence...institutions have demonstrated intelligent robots that execute functions ranging from performing mechanical repairs to playing soccer. The military has

  20. Robotics Strategy White Paper

    DTIC Science & Technology

    2009-03-19

    VIRGINIA 23651-1087 REPlY TO A1Tl!NTlON OF ATFC-DS 19 MEMORANDUM FOR SEE DISTRIBUTION SUBJECT: Robotics Strategy White Paper 1. The enclosed... Robotics Strategy White Paper is the result of a collaborative effort between the U.S. Anny Training and Doctrine Command (TRADOC) and the Tank-Automotive...Research, Development and Engineering Center (TARDEC). This paper builds on a confederated Anny robotics "strategy" that is described by senior leader

  1. AMAS Robotics Seminar Brief

    DTIC Science & Technology

    2011-07-19

    Unclassified Unclassified 19 July 2011 AMAS ROBOTICS SEMINAR BRIEF Aaron Hart, Product Integrator, RS JPO DISTRIBUTION STATEMENT A. Approved for...19-07-2011 to 19-07-2011 4. TITLE AND SUBTITLE robotics seminar brief 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6...12. DISTRIBUTION/AVAILABILITY STATEMENT Approved for public release; distribution unlimited 13. SUPPLEMENTARY NOTES AMAS ROBOTICS SEMINAR BRIEF 14

  2. Artificial Intelligence and Robotics.

    DTIC Science & Technology

    1984-02-01

    D-Ai42 488 ARTIFICIAL INEELLIGENCE AND ROBOTICS (U) MASSACHUSETTS i/1 INST OF TECH CAMBRIDGE ARTIFICIAL INTELLIGENCE LAB M BRADY FEB 84 AI-M-756...Subtile) S. TYPE OF REPORT A PERIOD COVERED Artificial Intelligence and Robotics 6. PERFORMING ORG. REPORT NUMBER 7. AUTHOR(*) S. CONTRACT OR GRANT NUMBER...Identify by block niiniber) -. Since Robotics is the field concerned with the connection of perception to action, Artificial Intelligence must have a

  3. Compliant Robotic Structures

    DTIC Science & Technology

    1985-08-01

    robotic structure is one or more continuously flexible arms -hat can be controlled to manipulate objects. A typical arm is comprised of ... of ideas for the design of versatile, strong robotic manipulators. In this paper a mathematical model of an elephant trunk lifting a weight is...Results may be used for the design of robotic actuators driven by internal pressure. I,g or 67 I* .,.. INTRODUCTION Improvement in the

  4. Industrial robots: Handbook

    NASA Astrophysics Data System (ADS)

    Kozyrev, Iu. G.

    Topics covered include terms, definitions, and classification; operator-directed manipulators; autooperators as used in automated pressure casting; construction and application of industrial robots; and the operating bases of automated systems. Attention is given to adaptive and interactive robots; gripping mechanisms; applications to foundary production, press-forging plants, heat treatment, welding, and assembly operations. A review of design recommendations includes a determination of fundamental structural and technological indicators for industrial robots and a consideration of drive mechanisms.

  5. Asteroid Redirect Mission: Robotic Segment

    NASA Video Gallery

    This concept animation illustrates the robotic segment of NASA's Asteroid Redirect Mission. The Asteroid Redirect Vehicle, powered by solar electric propulsion, travels to a large asteroid to robot...

  6. Children's Perception and Interpretation of Robots and Robot Behaviour

    NASA Astrophysics Data System (ADS)

    Bhamjee, Sajida; Griffiths, Frances; Palmer, Julie

    Technology is advancing rapidly; especially in the field of robotics. The purpose of this study was to examine children's perception and interpretation of robots and robot behaviour. The study was divided into two phases: phase one involved 144 children (aged 7-8) from two primary schools drawing a picture of a robot and then writing a story about the robot that they had drawn. In phase two, in small groups, 90 children observed four e-puck robots interacting within an arena. The children were asked three questions during the observation: 'What do you think the robots are doing?', 'Why are they doing these things?' and 'What is going on inside the robot?' The results indicated that children can hold multiple understandings of robots simultaneously. Children tend to attribute animate characteristics to robots. Although this may be explained by their stage of development, it may also influence how their generation integrates robots into society.

  7. Hopping Robot with Wheels

    NASA Technical Reports Server (NTRS)

    Barlow, Edward; Marzwell, Nevellie; Fuller, Sawyer; Fionni, Paolo; Tretton, Andy; Burdick, Joel; Schell, Steve

    2003-01-01

    A small prototype mobile robot is capable of (1) hopping to move rapidly or avoid obstacles and then (2) moving relatively slowly and precisely on the ground by use of wheels in the manner of previously reported exploratory robots of the "rover" type. This robot is a descendant of a more primitive hopping robot described in "Minimally Actuated Hopping Robot" (NPO- 20911), NASA Tech Briefs, Vol. 26, No. 11 (November 2002), page 50. There are many potential applications for robots with hopping and wheeled-locomotion (roving) capabilities in diverse fields of endeavor, including agriculture, search-and-rescue operations, general military operations, removal or safe detonation of land mines, inspection, law enforcement, and scientific exploration on Earth and remote planets. The combination of hopping and roving enables this robot to move rapidly over very rugged terrain, to overcome obstacles several times its height, and then to position itself precisely next to a desired target. Before a long hop, the robot aims itself in the desired hopping azimuth and at a desired takeoff angle above horizontal. The robot approaches the target through a series of hops and short driving operations utilizing the steering wheels for precise positioning.

  8. Human-Robot Interaction

    NASA Technical Reports Server (NTRS)

    Sandor, Aniko; Cross, E. Vincent, II; Chang, Mai Lee

    2015-01-01

    Human-robot interaction (HRI) is a discipline investigating the factors affecting the interactions between humans and robots. It is important to evaluate how the design of interfaces affect the human's ability to perform tasks effectively and efficiently when working with a robot. By understanding the effects of interface design on human performance, workload, and situation awareness, interfaces can be developed to appropriately support the human in performing tasks with minimal errors and with appropriate interaction time and effort. Thus, the results of research on human-robot interfaces have direct implications for the design of robotic systems. For efficient and effective remote navigation of a rover, a human operator needs to be aware of the robot's environment. However, during teleoperation, operators may get information about the environment only through a robot's front-mounted camera causing a keyhole effect. The keyhole effect reduces situation awareness which may manifest in navigation issues such as higher number of collisions, missing critical aspects of the environment, or reduced speed. One way to compensate for the keyhole effect and the ambiguities operators experience when they teleoperate a robot is adding multiple cameras and including the robot chassis in the camera view. Augmented reality, such as overlays, can also enhance the way a person sees objects in the environment or in camera views by making them more visible. Scenes can be augmented with integrated telemetry, procedures, or map information. Furthermore, the addition of an exocentric (i.e., third-person) field of view from a camera placed in the robot's environment may provide operators with the additional information needed to gain spatial awareness of the robot. Two research studies investigated possible mitigation approaches to address the keyhole effect: 1) combining the inclusion of the robot chassis in the camera view with augmented reality overlays, and 2) modifying the camera

  9. [Robots and intellectual property].

    PubMed

    Larrieu, Jacques

    2013-12-01

    This topic is part of the global issue concerning the necessity to adapt intellectual property law to constant changes in technology. The relationship between robots and IP is dual. On one hand, the robots may be regarded as objects of intellectual property. A robot, like any new machine, could qualify for a protection by a patent. A copyright may protect its appearance if it is original. Its memory, like a database, could be covered by a sui generis right. On the other hand, the question of the protection of the outputs of the robot must be raised. The robots, as the physical embodiment of artificial intelligence, are becoming more and more autonomous. Robot-generated works include less and less human inputs. Are these objects created or invented by a robot copyrightable or patentable? To whom the ownership of these IP rights will be allocated? To the person who manufactured the machine ? To the user of the robot? To the robot itself? All these questions are worth discussing.

  10. Robotics for welding research

    SciTech Connect

    Braun, G.; Jones, J.

    1984-09-01

    The welding metallurgy research and education program at Colorado School of Mines (CSM) is helping industries make the transition toward automation by training students in robotics. Industry's interest is primarily in pick and place operations, although robotics can increase efficiency in areas other than production. Training students to develop fully automated robotic welding systems will usher in new curriculum requirements in the area of computers and microprocessors. The Puma 560 robot is CSM's newest acquisition for welding research 5 references, 2 figures, 1 table.

  11. [Robotic surgery in gynecology].

    PubMed

    Csorba, Roland

    2012-06-24

    Minimally invasive surgery has revolutionized gynecological interventions over the past 30 years. The introduction of the da Vinci robotic surgery in 2005 has resulted in large changes in surgical management. The robotic platform allows less experienced laparoscopic surgeons to perform more complex procedures. It can be utilized mainly in general gynecology and reproductive gynecology. The robot is being increasingly used for procedures such as hysterectomy, myomectomy, adnexal surgery, and tubal anastomosis. In urogynecology, the robot is being utilized for sacrocolopexy as well. In the field of gynecologic oncology, the robot is being increasingly used for hysterectomy and lymphadenectomy in oncologic diseases. Despite the rapid and widespread adaption of robotic surgery in gynecology, there are no randomized trials comparing its efficacy and safety to other traditional surgical approaches. This article presents the development, technical aspects and indications of robotic surgery in gynecology, based on the previously published reviews. Robotic surgery can be highly advantageous with the right amount of training, along with appropriate patient selection. Patients will have less blood loss, less post-operative pain, faster recovery, and fewer complications compared to open surgery and laparoscopy. However, until larger randomized control trials are completed which report long-term outcomes, robotic surgery cannot be stated to have priority over other surgical methods.

  12. Advanced robot locomotion.

    SciTech Connect

    Neely, Jason C.; Sturgis, Beverly Rainwater; Byrne, Raymond Harry; Feddema, John Todd; Spletzer, Barry Louis; Rose, Scott E.; Novick, David Keith; Wilson, David Gerald; Buerger, Stephen P.

    2007-01-01

    This report contains the results of a research effort on advanced robot locomotion. The majority of this work focuses on walking robots. Walking robot applications include delivery of special payloads to unique locations that require human locomotion to exo-skeleton human assistance applications. A walking robot could step over obstacles and move through narrow openings that a wheeled or tracked vehicle could not overcome. It could pick up and manipulate objects in ways that a standard robot gripper could not. Most importantly, a walking robot would be able to rapidly perform these tasks through an intuitive user interface that mimics natural human motion. The largest obstacle arises in emulating stability and balance control naturally present in humans but needed for bipedal locomotion in a robot. A tracked robot is bulky and limited, but a wide wheel base assures passive stability. Human bipedal motion is so common that it is taken for granted, but bipedal motion requires active balance and stability control for which the analysis is non-trivial. This report contains an extensive literature study on the state-of-the-art of legged robotics, and it additionally provides the analysis, simulation, and hardware verification of two variants of a proto-type leg design.

  13. Robotic Thumb Assembly

    NASA Technical Reports Server (NTRS)

    Ihrke, Chris A. (Inventor); Bridgwater, Lyndon (Inventor); Platt, Robert (Inventor); Wampler, II, Charles W. (Inventor); Goza, S. Michael (Inventor)

    2013-01-01

    An improved robotic thumb for a robotic hand assembly is provided. According to one aspect of the disclosure, improved tendon routing in the robotic thumb provides control of four degrees of freedom with only five tendons. According to another aspect of the disclosure, one of the five degrees of freedom of a human thumb is replaced in the robotic thumb with a permanent twist in the shape of a phalange. According to yet another aspect of the disclosure, a position sensor includes a magnet having two portions shaped as circle segments with different center points. The magnet provides a linearized output from a Hall effect sensor.

  14. Experiments in autonomous robotics

    SciTech Connect

    Hamel, W.R.

    1987-01-01

    The Center for Engineering Systems Advanced Research (CESAR) is performing basic research in autonomous robotics for energy-related applications in hazardous environments. The CESAR research agenda includes a strong experimental component to assure practical evaluation of new concepts and theories. An evolutionary sequence of mobile research robots has been planned to support research in robot navigation, world sensing, and object manipulation. A number of experiments have been performed in studying robot navigation and path planning with planar sonar sensing. Future experiments will address more complex tasks involving three-dimensional sensing, dexterous manipulation, and human-scale operations.

  15. Hazardous Environment Robotics

    NASA Technical Reports Server (NTRS)

    1996-01-01

    Jet Propulsion Laboratory (JPL) developed video overlay calibration and demonstration techniques for ground-based telerobotics. Through a technology sharing agreement with JPL, Deneb Robotics added this as an option to its robotics software, TELEGRIP. The software is used for remotely operating robots in nuclear and hazardous environments in industries including automotive and medical. The option allows the operator to utilize video to calibrate 3-D computer models with the actual environment, and thus plan and optimize robot trajectories before the program is automatically generated.

  16. Low-pressure pneumoperitoneum during laparoscopic donor nephrectomy to optimize live donors' comfort.

    PubMed

    Warlé, M C; Berkers, A W; Langenhuijsen, J F; van der Jagt, M F; Dooper, Ph M; Kloke, H J; Pilzecker, D; Renes, S H; Wever, K E; Hoitsma, A J; van der Vliet, J A; D'Ancona, F C H

    2013-01-01

    Nowadays, laparoscopic donor nephrectomy (LDN) has become the gold standard to procure live donor kidneys. As the relationship between donor and recipient loosens, it becomes of even greater importance to optimize safety and comfort of the surgical procedure. Low-pressure pneumoperitoneum has been shown to reduce pain scores after laparoscopic cholecystectomy. Live kidney donors may also benefit from the use of low pressure during LDN. To evaluate feasibility and efficacy to reduce post-operative pain, we performed a randomized blinded study. Twenty donors were randomly assigned to standard (14 mmHg) or low (7 mmHg) pressure during LDN. One conversion from low to standard pressure was indicated by protocol due to lack of progression. Intention-to-treat analysis showed that low pressure resulted in a significantly longer skin-to-skin time (149 ± 86 vs. 111 ± 19 min), higher urine output during pneumoperitoneum (23 ± 35 vs. 11 ± 20 mL/h), lower cumulative overall pain score after 72 h (9.4 ± 3.2 vs. 13.5 ± 4.5), lower deep intra-abdominal pain score (11 ± 3.3 vs. 7.5 ± 3.1), and a lower cumulative overall referred pain score (1.8 ± 1.9 vs. 4.2 ± 3). Donor serum creatinine levels, complications, and quality of life dimensions were not significantly different. Our data show that low-pressure pneumoperitoneum during LDN is feasible and may contribute to increase live donors' comfort during the early post-operative phase.

  17. A novel approach to the modelling and control of flexible robot arms

    NASA Technical Reports Server (NTRS)

    Ding, Xuru; Tarn, Tzyh-Jong; Bejczy, Antal K.

    1988-01-01

    A general dynamic model of a two-link Euler-Bernoulli beam flexible robot arm is presented in the form of partial-differential-integral equations. Observations are made on important properties of the dynamic model. The resulting infinite-dimensional system is then input-output decoupled and partially linearized by a diffeomorphic state transformation and nonlinear state feedback. The local stability issue is addressed for a one-link flexible robot arm.

  18. Unilateral nephrectomy 24 hours after bilateral kidney irradiation reduces damage to the function and structure of the remaining kidney

    SciTech Connect

    Liao, Z.X.; Travis, E.L.

    1994-09-01

    The effect of unilateral nephrectomy 24 h after irradiation on renal function and death with renal insufficiency as well as histopathological changes in the kidney was assessed. Single doses totaling 8-18 Gy were given bilaterally to unanesthetized female and male C3Hf/Kam mice. Renal function damage was assayed by blood urea nitrogen (BUN) and hematocrit (Hct). Histological damage was quantified by two parameters: kidney area and number of surviving tubule cells along the renal capsule. The number of glomeruli was scored as an indication of the number of nephrons. Changes in the two functional parameters did not appear sooner after irradiation in the nephrectomized mice than in the non-nephrectomized mice. Rather, less impairment of function was measured by both parameters in the nephrectomized mice but only after radiation doses greater than 12 Gy. The LD{sub 50} at 424 days after irradiation was also higher in the nephrectomized mice than in the mice receiving only irradiation, 13.98 Gy (95% confidence limits = 12.03, 15.93) and 11.71 Gy (95% confidence limits = 10.4, 13.1), respectively, in agreement with the data on function. Unilateral nephrectomy alone induced a 10% increase in size of the contralateral kidney. The dose-response curve for the kidney area from nephrectomized mice was parallel to and displaced above that for non-nephrectomized mice, indicating that the increase in renal mass occurred independent of and was not compromised by radiation. Unilateral nephrectomy alone induced no increase in the number of proximal tubules in the contralateral kidney. 30 refs., 9 figs., 1 tab.

  19. The Dominant Robot: Threatening Robots Cause Psychological Reactance, Especially When They Have Incongruent Goals

    NASA Astrophysics Data System (ADS)

    Roubroeks, M. A. J.; Ham, J. R. C.; Midden, C. J. H.

    Persuasive technology can take the form of a social agent that persuades people to change behavior or attitudes. However, like any persuasive technology, persuasive social agents might trigger psychological reactance, which can lead to restoration behavior. The current study investigated whether interacting with a persuasive robot can cause psychological reactance. Additionally, we investigated whether goal congruency plays a role in psychological reactance. Participants programmed a washing machine while a robot gave threatening advice. Confirming expectations, participants experienced more psychological reactance when receiving high-threatening advice compared to low-threatening advice. Moreover, when the robot gave high-threatening advice and expressed an incongruent goal, participants reported the highest level of psychological reactance (on an anger measure). Finally, high-threatening advice led to more restoration, and this relationship was partially mediated by psychological reactance. Overall, results imply that under certain circumstances persuasive technology can trigger opposite effects, especially when people have incongruent goal intentions.

  20. Left Hand-assisted Laparoscopic Nephrectomy With Renal Vein Thrombectomy for Stage T3b Renal Cell Carcinoma.

    PubMed

    Ghareeb, George M; Kenleigh, Dorian A; Brown, James A

    2016-04-01

    A 60-year-old male was found to have an 8.0 cm left renal mass and associated renal vein thrombus on computed tomography. The thrombus extended 3 mm beyond the right aortic border to within 1.6 cm of the left border of the inferior vena cava. The patient underwent left nephrectomy with renal vein thrombectomy using a hand-assisted laparoscopic approach. The tumor thrombus was "milked" proximally back into left renal vein, which was then divided with an endovascular stapler. Left renal vein thrombi extending to right margin of the aorta can be managed with hand-assisted laparoscopic approach.

  1. Multi-robot control interface

    DOEpatents

    Bruemmer, David J [Idaho Falls, ID; Walton, Miles C [Idaho Falls, ID

    2011-12-06

    Methods and systems for controlling a plurality of robots through a single user interface include at least one robot display window for each of the plurality of robots with the at least one robot display window illustrating one or more conditions of a respective one of the plurality of robots. The user interface further includes at least one robot control window for each of the plurality of robots with the at least one robot control window configured to receive one or more commands for sending to the respective one of the plurality of robots. The user interface further includes a multi-robot common window comprised of information received from each of the plurality of robots.

  2. Canadian space robotic activities

    NASA Astrophysics Data System (ADS)

    Sallaberger, Christian; Space Plan Task Force, Canadian Space Agency

    The Canadian Space Agency has chosen space robotics as one of its key niche areas, and is currently preparing to deliver the first flight elements for the main robotic system of the international space station. The Mobile Servicing System (MSS) is the Canadian contribution to the international space station. It consists of three main elements. The Space Station Remote Manipulator System (SSRMS) is a 7-metre, 7-dof, robotic arm. The Special Purpose Dextrous Manipulator (SPDM), a smaller 2-metre, 7-dof, robotic arm can be used independently, or attached to the end of the SSRMS. The Mobile Base System (MBS) will be used as a support platform and will also provide power and data links for both the SSRMS and the SPDM. A Space Vision System (SVS) has been tested on Shuttle flights, and is being further developed to enhance the autonomous capabilities of the MSS. The CSA also has a Strategic Technologies in Automation and Robotics Program which is developing new technologies to fulfill future robotic space mission needs. This program is currently developing in industry technological capabilities in the areas of automation of operations, autonomous robotics, vision systems, trajectory planning and object avoidance, tactile and proximity sensors, and ground control of space robots. Within the CSA, a robotic testbed and several research programs are also advancing technologies such as haptic devices, control via head-mounted displays, predictive and preview displays, and the dynamic characterization of robotic arms. Canada is also now developing its next Long Term Space Plan. In this context, a planetary exploration program is being considered, which would utilize Canadian space robotic technologies in this new arena.

  3. The dipeptidyl peptidase inhibitor linagliptin and the angiotensin II receptor blocker telmisartan show renal benefit by different pathways in rats with 5/6 nephrectomy.

    PubMed

    Tsuprykov, Oleg; Ando, Ryotaro; Reichetzeder, Christoph; von Websky, Karoline; Antonenko, Viktoriia; Sharkovska, Yuliya; Chaykovska, Lyubov; Rahnenführer, Jan; Hasan, Ahmed A; Tammen, Harald; Alter, Markus; Klein, Thomas; Ueda, Seiji; Yamagishi, Sho-Ichi; Okuda, Seiya; Hocher, Berthold

    2016-05-01

    Dipeptidyl peptidase (DPP)-4 inhibitors delay chronic kidney disease (CKD) progression in experimental diabetic nephropathy in a glucose-independent manner. Here we compared the effects of the DPP-4 inhibitor linagliptin versus telmisartan in preventing CKD progression in non-diabetic rats with 5/6 nephrectomy. Animals were allocated to 1 of 4 groups: sham operated plus placebo; 5/6 nephrectomy plus placebo; 5/6 nephrectomy plus linagliptin; and 5/6 nephrectomy plus telmisartan. Interstitial fibrosis was significantly decreased by 48% with linagliptin but a non-significant 24% with telmisartan versus placebo. The urine albumin-to-creatinine ratio was significantly decreased by 66% with linagliptin and 92% with telmisartan versus placebo. Blood pressure was significantly lowered by telmisartan, but it was not affected by linagliptin. As shown by mass spectrometry, the number of altered peptide signals for linagliptin in plasma was 552 and 320 in the kidney. For telmisartan, there were 108 peptide changes in plasma and 363 in the kidney versus placebo. Linagliptin up-regulated peptides derived from collagen type I, apolipoprotein C1, and heterogeneous nuclear ribonucleoproteins A2/B1, a potential downstream target of atrial natriuretic peptide, whereas telmisartan up-regulated angiotensin II. A second study was conducted to confirm these findings in 5/6 nephrectomy wild-type and genetically deficient DPP-4 rats treated with linagliptin or placebo. Linagliptin therapy in wild-type rats was as effective as DPP-4 genetic deficiency in terms of albuminuria reduction. Thus, linagliptin showed comparable efficacy to telmisartan in preventing CKD progression in non-diabetic rats with 5/6 nephrectomy. However, the underlying pathways seem to be different.

  4. Body-mounted robotic instrument guide for image-guided cryotherapy of renal cancer

    PubMed Central

    Hata, Nobuhiko; Song, Sang-Eun; Olubiyi, Olutayo; Arimitsu, Yasumichi; Fujimoto, Kosuke; Kato, Takahisa; Tuncali, Kemal; Tani, Soichiro; Tokuda, Junichi

    2016-01-01

    Purpose: Image-guided cryotherapy of renal cancer is an emerging alternative to surgical nephrectomy, particularly for those who cannot sustain the physical burden of surgery. It is well known that the outcome of this therapy depends on the accurate placement of the cryotherapy probe. Therefore, a robotic instrument guide may help physicians aim the cryotherapy probe precisely to maximize the efficacy of the treatment and avoid damage to critical surrounding structures. The objective of this paper was to propose a robotic instrument guide for orienting cryotherapy probes in image-guided cryotherapy of renal cancers. The authors propose a body-mounted robotic guide that is expected to be less susceptible to guidance errors caused by the patient’s whole body motion. Methods: Keeping the device’s minimal footprint in mind, the authors developed and validated a body-mounted, robotic instrument guide that can maintain the geometrical relationship between the device and the patient’s body, even in the presence of the patient’s frequent body motions. The guide can orient the cryotherapy probe with the skin incision point as the remote-center-of-motion. The authors’ validation studies included an evaluation of the mechanical accuracy and position repeatability of the robotic instrument guide. The authors also performed a mock MRI-guided cryotherapy procedure with a phantom to compare the advantage of robotically assisted probe replacements over a free-hand approach, by introducing organ motions to investigate their effects on the accurate placement of the cryotherapy probe. Measurements collected for performance analysis included accuracy and time taken for probe placements. Multivariate analysis was performed to assess if either or both organ motion and the robotic guide impacted these measurements. Results: The mechanical accuracy and position repeatability of the probe placement using the robotic instrument guide were 0.3 and 0.1 mm, respectively, at a depth

  5. Robotic Intelligence Kernel: Architecture

    SciTech Connect

    2009-09-16

    The INL Robotic Intelligence Kernel Architecture (RIK-A) is a multi-level architecture that supports a dynamic autonomy structure. The RIK-A is used to coalesce hardware for sensing and action as well as software components for perception, communication, behavior and world modeling into a framework that can be used to create behaviors for humans to interact with the robot.

  6. Robot Rodeo 2013

    ScienceCinema

    Deuel, Jake

    2016-07-12

    Sandia National Laboratories hosted the seventh annual Western National Robot Rodeo and Capability Exercise in June 2013. The five-day event is a lively and challenging competition that draws civilian and military bomb squad teams from across the country to see who can most effectively defuse dangerous situations with the help of robots.

  7. Robot Rodeo 2013

    SciTech Connect

    Deuel, Jake

    2013-08-27

    Sandia National Laboratories hosted the seventh annual Western National Robot Rodeo and Capability Exercise in June 2013. The five-day event is a lively and challenging competition that draws civilian and military bomb squad teams from across the country to see who can most effectively defuse dangerous situations with the help of robots.

  8. Next generation space robot

    NASA Technical Reports Server (NTRS)

    Iwata, Tsutomu; Oda, Mitsushige; Imai, Ryoichi

    1989-01-01

    The recent research effort on the next generation space robots is presented. The goals of this research are to develop the fundamental technologies and to acquire the design parameters of the next generation space robot. Visual sensing and perception, dexterous manipulation, man machine interface and artificial intelligence techniques such as task planning are identified as the key technologies.

  9. Real World Robotics.

    ERIC Educational Resources Information Center

    Clark, Lisa J.

    2002-01-01

    Introduces a project for elementary school students in which students build a robot by following instructions and then write a computer program to run their robot by using LabView graphical development software. Uses ROBOLAB curriculum which is designed for grade levels K-12. (YDS)

  10. Robotics technology discipline

    NASA Technical Reports Server (NTRS)

    Montemerlo, Melvin D.

    1990-01-01

    Viewgraphs on robotics technology discipline for Space Station Freedom are presented. Topics covered include: mechanisms; sensors; systems engineering processes for integrated robotics; man/machine cooperative control; 3D-real-time machine perception; multiple arm redundancy control; manipulator control from a movable base; multi-agent reasoning; and surfacing evolution technologies.

  11. Motivating Students with Robotics

    ERIC Educational Resources Information Center

    Brand, Brenda; Collver, Michael; Kasarda, Mary

    2008-01-01

    In recent years, the need to advance the number of individuals pursuing science, technology, engineering, and mathematics fields has gained much attention. The Montgomery County/Virginia Tech Robotics Collaborative (MCVTRC), a yearlong high school robotics program housed in an educational shop facility in Montgomery County, Virginia, seeks to…

  12. Robotics in medicine

    NASA Astrophysics Data System (ADS)

    Kuznetsov, D. N.; Syryamkin, V. I.

    2015-11-01

    Modern technologies play a very important role in our lives. It is hard to imagine how people can get along without personal computers, and companies - without powerful computer centers. Nowadays, many devices make modern medicine more effective. Medicine is developing constantly, so introduction of robots in this sector is a very promising activity. Advances in technology have influenced medicine greatly. Robotic surgery is now actively developing worldwide. Scientists have been carrying out research and practical attempts to create robotic surgeons for more than 20 years, since the mid-80s of the last century. Robotic assistants play an important role in modern medicine. This industry is new enough and is at the early stage of development; despite this, some developments already have worldwide application; they function successfully and bring invaluable help to employees of medical institutions. Today, doctors can perform operations that seemed impossible a few years ago. Such progress in medicine is due to many factors. First, modern operating rooms are equipped with up-to-date equipment, allowing doctors to make operations more accurately and with less risk to the patient. Second, technology has enabled to improve the quality of doctors' training. Various types of robots exist now: assistants, military robots, space, household and medical, of course. Further, we should make a detailed analysis of existing types of robots and their application. The purpose of the article is to illustrate the most popular types of robots used in medicine.

  13. The Uranus Mobile Robot

    DTIC Science & Technology

    1990-09-01

    Schematics 26 Wi List of Figures 1 Neptune and Pluto .. .. .. .. .. ... .. ... ... ... ... .... 2 2 Uranus...began building our first mobile robot, Pluto (see Figure 1 a). We envisioned Pluto as the ultimate indoor robot within the grasp of current technology...smooth arced trajectory while rotating about its center. This omni-directionality combined with very precise positioning would allow Pluto to easily

  14. Neurotechnology for Biomimetic Robots

    DTIC Science & Technology

    2007-11-02

    This award funded in part, the travel of three investigators to the international conference on Neurotechnology for Biomimetic Robots. The three...investigators participated in a conference held at Northeastern University May 14-16 on the subject of ’ Neurotechnology for Biomimetic Robots’. Each

  15. Concurrent programming and robotics

    SciTech Connect

    Cox, I.J.; Gehani, N.H.

    1989-04-01

    Many current robot systems exhibit a significant degree of concurrency, doing many activities in parallel. Future sensor-based robots are expected to exhibit even more concurrency. Programs to control such robots are characterized by the need to wait for external events and/or handle interrupts, deal with concurrent activities, synchronize actions with external events, and communicate with other robots and processes. In this paper, the authors focus on the advantages of concurrent programming for robotics and suggest that a general-purpose language with the right facilities is a good vehicle for robot programming. In this context they discuss Concurrent C, an upward-compatible extension of the C language that provides high-level concurrent programming facilities. They give an historical perspective of concurrent programming followed by a brief description of Concurrent C and how Concurrent C programs communicate with robots and devices. They show by examples how Concurrent C simplifies writing robot programs. Of specific interest are the process interaction and related interrupt handling facilities.

  16. Going Green Robots

    ERIC Educational Resources Information Center

    Nelson, Jacqueline M.

    2011-01-01

    In looking at the interesting shapes and sizes of old computer parts, creating robots quickly came to the author's mind. In this article, she describes how computer parts can be used creatively. Students will surely enjoy creating their very own robots while learning about the importance of recycling in the society. (Contains 1 online resource.)

  17. Robotics and Industrial Arts.

    ERIC Educational Resources Information Center

    Edmison, Glenn A.; And Others

    Robots are becoming increasingly common in American industry. By l990, they will revolutionize the way industry functions, replacing hundreds of workers and doing hot, dirty jobs better and more quickly than the workers could have done them. Robotics should be taught in high school industrial arts programs as a major curriculum component. The…

  18. INL Generic Robot Architecture

    SciTech Connect

    2005-03-30

    The INL Generic Robot Architecture is a generic, extensible software framework that can be applied across a variety of different robot geometries, sensor suites and low-level proprietary control application programming interfaces (e.g. mobility, aria, aware, player, etc.).

  19. Robot Vision Library

    NASA Technical Reports Server (NTRS)

    Howard, Andrew B.; Ansar, Adnan I.; Litwin, Todd E.; Goldberg, Steven B.

    2009-01-01

    The JPL Robot Vision Library (JPLV) provides real-time robot vision algorithms for developers who are not vision specialists. The package includes algorithms for stereo ranging, visual odometry and unsurveyed camera calibration, and has unique support for very wideangle lenses

  20. Honda humanoid robots development.

    PubMed

    Hirose, Masato; Ogawa, Kenichi

    2007-01-15

    Honda has been doing research on robotics since 1986 with a focus upon bipedal walking technology. The research started with straight and static walking of the first prototype two-legged robot. Now, the continuous transition from walking in a straight line to making a turn has been achieved with the latest humanoid robot ASIMO. ASIMO is the most advanced robot of Honda so far in the mechanism and the control system. ASIMO's configuration allows it to operate freely in the human living space. It could be of practical help to humans with its ability of five-finger arms as well as its walking function. The target of further development of ASIMO is to develop a robot to improve life in human society. Much development work will be continued both mechanically and electronically, staying true to Honda's 'challenging spirit'.

  1. Intelligent Articulated Robot

    NASA Astrophysics Data System (ADS)

    Nyein, Aung Kyaw; Thu, Theint Theint

    2008-10-01

    In this paper, an articulated type of industrial used robot is discussed. The robot is mainly intended to be used in pick and place operation. It will sense the object at the specified place and move it to a desired location. A peripheral interface controller (PIC16F84A) is used as the main controller of the robot. Infrared LED and IR receiver unit for object detection and 4-bit bidirectional universal shift registers (74LS194) and high current and high voltage Darlington transistors arrays (ULN2003) for driving the arms' motors are used in this robot. The amount of rotation for each arm is regulated by the limit switches. The operation of the robot is very simple but it has the ability of to overcome resetting position after power failure. It can continue its work from the last position before the power is failed without needing to come back to home position.

  2. [The robotic surgeon training].

    PubMed

    Crestani, Alessandro; Rossanese, Marta; Abbinante, Maria; Calandriello, Mattia; Kungulli, Afrovita; Giannarini, Gianluca; Ficarra, Vincenzo

    2015-10-01

    The widespread robotic surgery in the world highlighted the relevance of the training programs for young urologists and residents. In the last years, urologic societies and some independent robotic surgeons strongly worked to standardize some general and specific training modules. Theoretical and practical sections of robotic training programs have been recently specified. The role of simulators, dry and wet laboratories, bedside assistance, and modular (step-by-step) training at console represent the most relevant elements of robotic surgeon training. Ideally, these didactic tools should be available in modern training centers. The development of structured robotic training programs should be considered as one of the priorities that the urologic community must take into account in the near future.

  3. Fuzzy Integral-Based Gaze Control of a Robotic Head for Human Robot Interaction.

    PubMed

    Yoo, Bum-Soo; Kim, Jong-Hwan

    2015-09-01

    During the last few decades, as a part of effort to enhance natural human robot interaction (HRI), considerable research has been carried out to develop human-like gaze control. However, most studies did not consider hardware implementation, real-time processing, and the real environment, factors that should be taken into account to achieve natural HRI. This paper proposes a fuzzy integral-based gaze control algorithm, operating in real-time and the real environment, for a robotic head. We formulate the gaze control as a multicriteria decision making problem and devise seven human gaze-inspired criteria. Partial evaluations of all candidate gaze directions are carried out with respect to the seven criteria defined from perceived visual, auditory, and internal inputs, and fuzzy measures are assigned to a power set of the criteria to reflect the user defined preference. A fuzzy integral of the partial evaluations with respect to the fuzzy measures is employed to make global evaluations of all candidate gaze directions. The global evaluation values are adjusted by applying inhibition of return and are compared with the global evaluation values of the previous gaze directions to decide the final gaze direction. The effectiveness of the proposed algorithm is demonstrated with a robotic head, developed in the Robot Intelligence Technology Laboratory at Korea Advanced Institute of Science and Technology, through three interaction scenarios and three comparison scenarios with another algorithm.

  4. Model-free execution monitoring in behavior-based robotics.

    PubMed

    Pettersson, Ola; Karlsson, Lars; Saffiotti, Alessandro

    2007-08-01

    In the near future, autonomous mobile robots are expected to help humans by performing service tasks in many different areas, including personal assistance, transportation, cleaning, mining, or agriculture. In order to manage these tasks in a changing and partially unpredictable environment without the aid of humans, the robot must have the ability to plan its actions and to execute them robustly and safely. The robot must also have the ability to detect when the execution does not proceed as planned and to correctly identify the causes of the failure. An execution monitoring system allows the robot to detect and classify these failures. Most current approaches to execution monitoring in robotics are based on the idea of predicting the outcomes of the robot's actions by using some sort of predictive model and comparing the predicted outcomes with the observed ones. In contrary, this paper explores the use of model-free approaches to execution monitoring, that is, approaches that do not use predictive models. In this paper, we show that pattern recognition techniques can be applied to realize model-free execution monitoring by classifying observed behavioral patterns into normal or faulty execution. We investigate the use of several such techniques and verify their utility in a number of experiments involving the navigation of a mobile robot in indoor environments.

  5. Utilizing Robot Operating System (ROS) in Robot Vision and Control

    DTIC Science & Technology

    2015-09-01

    OPERATING SYSTEM (ROS) IN ROBOT VISION AND CONTROL by Joshua S. Lum September 2015 Thesis Advisor: Xiaoping Yun Co-Advisor: Zac Staples...Master’s Thesis 4. TITLE AND SUBTITLE UTILIZING ROBOT OPERATING SYSTEM (ROS) IN ROBOT VISION AND CONTROL 5. FUNDING NUMBERS 6. AUTHOR(S) Lum, Joshua S...release; distribution is unlimited UTILIZING ROBOT OPERATING SYSTEM (ROS) IN ROBOT VISION AND CONTROL Joshua S. Lum Captain, United States

  6. Expanding Frontiers of Humanoid Robotics

    DTIC Science & Technology

    2000-08-01

    From the IEEE Intelligent Systems Special Issue on Humanoid Robotics , July/August 2000 GUEST EDITORS’ Expanding Frontiers of Humanoid Robotics ...Mark L. Swinson, DARPA David J. Bruemmer, Strategic Analysis Mobile robots pose a unique set of challenges to artificial intelligence researchers...the constraints of logical correctness but also some assortment of crosscutting, physical constraints. Particularly interesting among these robots

  7. Robots in Space -Psychological Aspects

    NASA Technical Reports Server (NTRS)

    Sipes, Walter E.

    2006-01-01

    A viewgraph presentation on the psychological aspects of developing robots to perform routine operations associated with monitoring, inspection, maintenance and repair in space is shown. The topics include: 1) Purpose; 2) Vision; 3) Current Robots in Space; 4) Ground Based Robots; 5) AERCam; 6) Rotating Bladder Robot (ROBLR); 7) DART; 8) Robonaut; 9) Full Immersion Telepresence Testbed; 10) ERA; and 11) Psychological Aspects

  8. [Application of robots in stomatology].

    PubMed

    Zhou, Meng-Qi; Zhang, Jin-Ning; Hong, Jin

    2016-10-01

    Recently, the robot technology has been developed rapidly and the medical robot has been used in many clinical areas, especially in the field of stomatology. The application of robot in stomatology will break the traditional mode of treatment and bring a new technological revolution. This paper introduced the advantages, the current situation and the development prospect of applying robot in stomatology.

  9. A new efficient optimal path planner for mobile robot based on Invasive Weed Optimization algorithm

    NASA Astrophysics Data System (ADS)

    Mohanty, Prases K.; Parhi, Dayal R.

    2014-12-01

    Planning of the shortest/optimal route is essential for efficient operation of autonomous mobile robot or vehicle. In this paper Invasive Weed Optimization (IWO), a new meta-heuristic algorithm, has been implemented for solving the path planning problem of mobile robot in partially or totally unknown environments. This meta-heuristic optimization is based on the colonizing property of weeds. First we have framed an objective function that satisfied the conditions of obstacle avoidance and target seeking behavior of robot in partially or completely unknown environments. Depending upon the value of objective function of each weed in colony, the robot avoids obstacles and proceeds towards destination. The optimal trajectory is generated with this navigational algorithm when robot reaches its destination. The effectiveness, feasibility, and robustness of the proposed algorithm has been demonstrated through series of simulation and experimental results. Finally, it has been found that the developed path planning algorithm can be effectively applied to any kinds of complex situation.

  10. A Survey of Space Robotics

    NASA Technical Reports Server (NTRS)

    Pedersen, L.; Kortenkamp, D.; Wettergreen, D.; Nourbakhsh, I.; Korsmeyer, David (Technical Monitor)

    2003-01-01

    In this paper we summarize a survey conducted by NASA to determine the state-of-the-art in space robotics and to predict future robotic capabilities under either nominal and intensive development effort. The space robotics assessment study examined both in-space operations including assembly, inspection, and maintenance and planetary surface operations like mobility and exploration. Applications of robotic autonomy and human-robot cooperation were considered. The study group devised a decomposition of robotic capabilities and then suggested metrics to specify the technical challenges associated with each. The conclusion of this paper identifies possible areas in which investment in space robotics could lead to significant advances of important technologies.

  11. Inferior vena cava reconstruction for leiomyosarcoma of Zone I-III requiring complete hepatectomy and bilateral nephrectomy with autotransplantation.

    PubMed

    Fernandez, Hoylan T; Kim, Peter T W; Anthony, Tiffany L; Hamman, Baron L; Goldstein, Robert M; Testa, Giuliano

    2015-10-01

    The inferior vena cava (IVC) is the most common site of leiomyosarcomas arising from a vascular origin. Leiomyosarcomas of the IVC are categorized by anatomical location. Zone I refers to the infrarenal portion of the IVC, Zone II from the hepatic veins to the renal veins, and Zone III from the right atrium to the hepatic veins. This is a rare presentation of a Zone I-III leiomyosarcoma. Fifty-two-years-old female with a medical history significant only for HTN was admitted to the hospital with bilateral lower extremity edema and dyspnea. Two-dimensional echo demonstrated a right atrial thrombus, extending into the IVC. On subsequent CT and MRI, a 15 cm mass was noted that began in the right atrium and extended into the IVC, with continuation below the renal veins to above the level of the confluence of the common iliac veins. The patient underwent a complete resection of the mass, replacement of the IVC with Dacron graft, total hepatectomy and bilateral nephrectomy, with liver and kidney autotransplantation. Pathology was consistent with a high grade spindle cell sarcoma of vena cava origin. Patient was readmitted approximately 4 weeks postoperatively to begin adjuvant chemotherapy. This case represents a zone I-III IVC leiomyosarcoma treated with surgical R0 resection. This included a hepatectomy, bilateral nephrectomy, and hepatic and left renal autotransplantation. These complex tumors should be treated with surgical resection, and require a multidisciplinary approach.

  12. MDCT evaluation of potential living renal donor, prior to laparoscopic donor nephrectomy: What the transplant surgeon wants to know?

    PubMed

    Ghonge, Nitin P; Gadanayak, Satyabrat; Rajakumari, Vijaya

    2014-10-01

    As Laparoscopic Donor Nephrectomy (LDN) offers several advantages for the donor such as lesser post-operative pain, fewer cosmetic concerns and faster recovery time, there is growing global trend towards LDN as compared to open nephrectomy. Comprehensive pre-LDN donor evaluation includes assessment of renal morphology including pelvi-calyceal and vascular system. Apart from donor selection, evaluation of the regional anatomy allows precise surgical planning. Due to limited visualization during laparoscopic renal harvesting, detailed pre-transplant evaluation of regional anatomy, including the renal venous anatomy is of utmost importance. MDCT is the modality of choice for pre-LDN evaluation of potential renal donors. Apart from appropriate scan protocol and post-processing methods, detailed understanding of surgical techniques is essential for the Radiologist for accurate image interpretation during pre-LDN MDCT evaluation of potential renal donors. This review article describes MDCT evaluation of potential living renal donor, prior to LDN with emphasis on scan protocol, post-processing methods and image interpretation. The article laid special emphasis on surgical perspectives of pre-LDN MDCT evaluation and addresses important points which transplant surgeons want to know.

  13. Induction of AMPK activity corrects early pathophysiological alterations in the subtotal nephrectomy model of chronic kidney disease.

    PubMed

    Satriano, Joseph; Sharma, Kumar; Blantz, Roland C; Deng, Aihua

    2013-09-01

    The rat kidney ablation and infarction (A/I) model of subtotal or 5/6th nephrectomy is the most commonly studied model of nondiabetic chronic kidney disease (CKD). The A/I kidney at 1 wk exhibits reductions in kidney function, as determined by glomerular filtration rate, and diminished metabolic efficiency as determined by oxygen consumption per sodium transport (QO2/TNa). As renoprotective AMPK activity is affected by metabolic changes and cellular stress, we evaluated AMPK activity in this model system. We show that these early pathophysiological changes are accompanied by a paradoxical decrease in AMPK activity. Over time, these kidney parameters progressively worsen with extensive kidney structural, functional, metabolic, and fibrotic changes observed at 4 wk after A/I. We show that induction of AMPK activity with either metformin or 5-aminoimidazole-4-carboxamide ribonucleotide increases AMPK activity in this model and also corrects kidney metabolic inefficiency, improves kidney function, and ameliorates kidney fibrosis and structural alterations. We conclude that AMPK activity is reduced in the subtotal nephrectomy model of nondiabetic CKD, that altered regulation of AMPK is coincident with the progression of disease parameters, and that restoration of AMPK activity can suppress the progressive loss of function characteristic of this model. We propose that induction of AMPK activity may prove an effective therapeutic target for the treatment of nondiabetic CKD.

  14. Robotic Surgery for Thoracic Disease.

    PubMed

    Yamashita, Shin-Ichi; Yoshida, Yasuhiro; Iwasaki, Akinori

    2016-01-01

    Robotic surgeries have developed in the general thoracic field over the past decade, and publications on robotic surgery outcomes have accumulated. However, controversy remains about the application of robotic surgery, with a lack of well-established evidence. Robotic surgery has several advantages such as natural movement of the surgeon's hands when manipulating the robotic arms and instruments controlled by computer-assisted systems. Most studies have reported the feasibility and safety of robotic surgery based on acceptable morbidity and mortality compared to open or video-assisted thoracic surgery (VATS). Furthermore, there are accumulated data to indicate longer operation times and shorter hospital stay in robotic surgery. However, randomized controlled trials between robotic and open or VATS procedures are needed to clarify the advantage of robotic surgery. In this review, we focused the literature about robotic surgery used to treat lung cancer and mediastinal tumor.

  15. Ultrastructural changes and nestin expression accompanying compensatory renal growth after unilateral nephrectomy in adult rats

    PubMed Central

    Eladl, Mohamed Ahmed; M Elsaed, Wael; Atef, Hoda; El-Sherbiny, Mohamed

    2017-01-01

    Background Several renal disorders affect the glomerular podocytes. Compensatory structural and functional changes have been observed in animals that have undergone unilateral renal ablation. These changes occur as a pliant response to quench the increased functional demand to maintain homeostasis of fluid and solutes. Nestin is an intermediate filament protein present in the glomerular podocytes of the adult kidney and is linked with the maintenance of its foot process structure. Structural changes in the podocytes ultimately restructure the filtration barrier. Very few studies related to the ultrastructural and histopathologic changes of the podocytes are documented. The present study aimed to assess the histopathologic changes at the ultrastructural level in the adapted kidney at different time intervals following unilateral renal ablation in adult rats and its relation with nestin. Methods Forty-eight rats were divided into four groups (n=12 in each group). The animals of Group A were control naïve rats, while the group B, group C and group D animals underwent left unilateral nephrectomy and the remaining right kidney was removed on days 10, 20 and 30, respectively. Each group included four sham-operated rats, which were sacrificed at the same time as the naïve rats. Each nephrectomized sample was weighed and its sections were subjected to hematoxylin and eosin examination, transmission electron microscopic study as well as immunostaining using the intermediate filament protein nestin. Results No difference was found between the kidney sections from the control group and the sham-operated groups. A significant increase in the weight of the right kidneys was noted in groups B, C and D (P<0.001). The ultrastructural adaptive changes seen in the glomeruli of group B were subsequently reduced in groups C and D. This finding corresponded to a similar pattern of nestin expression in the podocytes, which showed significant increase in group B followed by reduced

  16. Partner Ballroom Dance Robot -PBDR-

    NASA Astrophysics Data System (ADS)

    Kosuge, Kazuhiro; Takeda, Takahiro; Hirata, Yasuhisa; Endo, Mitsuru; Nomura, Minoru; Sakai, Kazuhisa; Koizumi, Mizuo; Oconogi, Tatsuya

    In this research, we have developed a dance partner robot, which has been developed as a platform for realizing the effective human-robot coordination with physical interaction. The robot could estimate the next dance step intended by a human and dance the step with the human. This paper introduce the robot referred to as PBDR (Partner Ballroom Dance Robot), which has performed graceful dancing with the human in EXPO 2005, Aichi, Japan.

  17. Guarded Motion for Mobile Robots

    SciTech Connect

    2005-03-30

    The Idaho National Laboratory (INL) has created codes that ensure that a robot will come to a stop at a precise, specified distance from any obstacle regardless of the robot's initial speed, its physical characteristics, and the responsiveness of the low-level motor control schema. This Guarded Motion for Mobile Robots system iteratively adjusts the robot's action in response to information about the robot's environment.

  18. An improved kernel based extreme learning machine for robot execution failures.

    PubMed

    Li, Bin; Rong, Xuewen; Li, Yibin

    2014-01-01

    Robot execution failures prediction (classification) in the robot tasks is a difficult learning problem due to partially corrupted or incomplete measurements of data and unsuitable prediction techniques for this prediction problem with little learning samples. Therefore, how to predict the robot execution failures problem with little (incomplete) or erroneous data deserves more attention in the robot field. For improving the prediction accuracy of robot execution failures, this paper proposes a novel KELM learning algorithm using the particle swarm optimization approach to optimize the parameters of kernel functions of neural networks, which is called the AKELM learning algorithm. The simulation results with the robot execution failures datasets show that, by optimizing the kernel parameters, the proposed algorithm has good generalization performance and outperforms KELM and the other approaches in terms of classification accuracy. Other benchmark problems simulation results also show the efficiency and effectiveness of the proposed algorithm.

  19. Shared Challenges in Object Perception for Robots and Infants

    ERIC Educational Resources Information Center

    Fitzpatrick, Paul; Needham, Amy; Natale, Lorenzo; Metta, Giorgio

    2008-01-01

    Robots and humans receive partial, fragmentary hints about the world's state through their respective sensors. These hints--tiny patches of light intensity, frequency components of sound, etc.--are far removed from the world of objects which we feel and perceive so effortlessly around us. The study of infant development and the construction of…

  20. Novel Robotic Tools for Piping Inspection and Repair, Phase 1

    DTIC Science & Technology

    2014-02-13

    11 Basic automated motion using software ... mockup horizontally and vertically. Gripping force testing Pulling in an axial direction the gripper assembly achieved 36.33lbs of gripping force...bags being partially inflated (Figure 11). Figure 11 - Gripper sleds Basic automated motion using software The robot successfully ran on auto

  1. Micro autonomous robotic system

    NASA Astrophysics Data System (ADS)

    Ishihara, Hidenori; Fukuda, Toshio

    1995-12-01

    This paper deals with the structural proposal of the micro autonomous robotic system, and shows the design of the prototype. We aim at developing the micro robot, which autonomously acts based on its detection, in order to propose a solution to constitute the micro autonomous robotic system. However, as miniaturizing the size, the number of the sensors gets restricted and the information from them becomes lack. Lack of the information makes it difficult to realize an intelligence of quality. Because of that, the micro robotic system needs to develop the simple algorithm. In this paper, we propose the simply logical algorithms to control the actuator, and show the performance of the micro robot controlled by them, and design the Micro Line Trace Robot, which dimension is about 1 cm cube and which moves along the black line on the white-colored ground, and the programmable micro autonomous robot, which dimension is about 2 cm cube and which performs according to the program optionally.

  2. Future of robotic surgery.

    PubMed

    Lendvay, Thomas Sean; Hannaford, Blake; Satava, Richard M

    2013-01-01

    In just over a decade, robotic surgery has penetrated almost every surgical subspecialty and has even replaced some of the most commonly performed open oncologic procedures. The initial reports on patient outcomes yielded mixed results, but as more medical centers develop high-volume robotics programs, outcomes appear comparable if not improved for some applications. There are limitations to the current commercially available system, and new robotic platforms, some designed to compete in the current market and some to address niche surgical considerations, are being developed that will change the robotic landscape in the next decade. Adoption of these new systems will be dependent on overcoming barriers to true telesurgery that range from legal to logistical. As additional surgical disciplines embrace robotics and open surgery continues to be replaced by robotic approaches, it will be imperative that adequate education and training keep pace with technology. Methods to enhance surgical performance in robotics through the use of simulation and telementoring promise to accelerate learning curves and perhaps even improve surgical readiness through brief virtual-reality warm-ups and presurgical rehearsal. All these advances will need to be carefully and rigorously validated through not only patient outcomes, but also cost efficiency.

  3. Robotic comfort zones

    NASA Astrophysics Data System (ADS)

    Likhachev, Maxim; Arkin, Ronald C.

    2000-10-01

    The paper investigates how the psychological notion of comfort can be useful in the design of robotic systems. A review of the existing study of human comfort, especially regarding its presence in infants, is conducted with the goal being to determine the relevant characteristics for mapping it onto the robotics domain. Focus is place on the identification of the salient features in the environment that affect the comfort level. Factors involved include current state familiarity, working conditions, the amount and location of available resources, etc. As part of our newly developed comfort function theory, the notion of an object as a psychological attachment for a robot is also introduced, as espoused in Bowlby's theory of attachment. The output space of the comfort function and its dependency on the comfort level are analyzed. The results of the derivation of this comfort function are then presented in terms of the impact they have on robotic behavior. Justification for the use of the comfort function are then presented in terms of the impact they have on robotic behavior. Justification for the use of the comfort function in the domain of robotics is presented with relevance for real-world operations. Also, a transformation of the theoretical discussion into a mathematical framework suitable for implementation within a behavior-based control system is presented. The paper concludes with results of simulation studies and real robot experiments using the derived comfort function.

  4. Autonomous mobile robot

    SciTech Connect

    Mattaboni, P.J.

    1987-01-20

    This patent describes a mobile robot of the type having (a) a vision system, (b) memory means for storing data derived from the robot vision system, and (c) a computer for processing data derived from the robot's vision system, the improvement wherein the robot's vision system comprises (i) a first array of ranging transducers for obtaining data on the position and distance of far objects in a volume of space, the transducers of the first array being symmetrically disposed on the mobile robot with respect to an axis of symmetry within the mobile robot. Each transducer of the first array is fixed in position with respect to that axis of symmetry and sees a portion of the volume of space seen by its entire array; (ii) a second array of ranging transducers for obtaining data of the position and distance of near objects in the same or an overlapping volume of space, the transducers of the second array being symmetrically disposed on the mobile robot with respect to the axis of symmetry. Each transducer of the second array is fixed in position with respect to the axis of symmetry and sees a portion of the volume of space seen by its entire array, the angle of view of the transducers of the second array being different from the angle of view of the transducers of the first array with respect to the same object in space; and (iii) means for polling the ranging transducers in sequences determined by the computer.

  5. Toward cognitive robotics

    NASA Astrophysics Data System (ADS)

    Laird, John E.

    2009-05-01

    Our long-term goal is to develop autonomous robotic systems that have the cognitive abilities of humans, including communication, coordination, adapting to novel situations, and learning through experience. Our approach rests on the recent integration of the Soar cognitive architecture with both virtual and physical robotic systems. Soar has been used to develop a wide variety of knowledge-rich agents for complex virtual environments, including distributed training environments and interactive computer games. For development and testing in robotic virtual environments, Soar interfaces to a variety of robotic simulators and a simple mobile robot. We have recently made significant extensions to Soar that add new memories and new non-symbolic reasoning to Soar's original symbolic processing, which should significantly improve Soar abilities for control of robots. These extensions include episodic memory, semantic memory, reinforcement learning, and mental imagery. Episodic memory and semantic memory support the learning and recalling of prior events and situations as well as facts about the world. Reinforcement learning provides the ability of the system to tune its procedural knowledge - knowledge about how to do things. Mental imagery supports the use of diagrammatic and visual representations that are critical to support spatial reasoning. We speculate on the future of unmanned systems and the need for cognitive robotics to support dynamic instruction and taskability.

  6. Door breaching robotic manipulator

    NASA Astrophysics Data System (ADS)

    Schoenfeld, Erik; Parrington, Lawrence; von Muehlen, Stephan

    2008-04-01

    As unmanned systems become more commonplace in military, police, and other security forces, they are tasked to perform missions that the original hardware was not designed for. Current military robots are built for rough outdoor conditions and have strong inflexible manipulators designed to handle a wide range of operations. However, these manipulators are not well suited for some essential indoor tasks, including opening doors. This is a complicated kinematic task that places prohibitively difficult control challenges on the robot and the operator. Honeybee and iRobot have designed a modular door-breaching manipulator that mechanically simplifies the demands upon operator and robot. The manipulator connects to the existing robotic arm of the iRobot PackBot EOD. The gripper is optimized for grasping a variety of door knobs, levers, and car-door handles. It works in conjunction with a compliant wrist and magnetic lock-out mechanism that allows the wrist to remain rigid until the gripper has a firm grasp of the handle and then bend with its rotation and the swing of the door. Once the door is unlatched, the operator simply drives the robot through the doorway while the wrist compensates for the complex, multiple degree-of-freedom motion of the door. Once in the doorway the operator releases the handle, the wrist pops back into place, and the robot is ready for the next door. The new manipulator dramatically improves a robot's ability to non-destructively breach doors and perform an inspection of a room's content, a capability that was previously out of reach of unmanned systems.

  7. Soft Robotics: New Perspectives for Robot Bodyware and Control

    PubMed Central

    Laschi, Cecilia; Cianchetti, Matteo

    2014-01-01

    The remarkable advances of robotics in the last 50 years, which represent an incredible wealth of knowledge, are based on the fundamental assumption that robots are chains of rigid links. The use of soft materials in robotics, driven not only by new scientific paradigms (biomimetics, morphological computation, and others), but also by many applications (biomedical, service, rescue robots, and many more), is going to overcome these basic assumptions and makes the well-known theories and techniques poorly applicable, opening new perspectives for robot design and control. The current examples of soft robots represent a variety of solutions for actuation and control. Though very first steps, they have the potential for a radical technological change. Soft robotics is not just a new direction of technological development, but a novel approach to robotics, unhinging its fundamentals, with the potential to produce a new generation of robots, in the support of humans in our natural environments. PMID:25022259

  8. Agile Walking Robot

    NASA Technical Reports Server (NTRS)

    Larimer, Stanley J.; Lisec, Thomas R.; Spiessbach, Andrew J.; Waldron, Kenneth J.

    1990-01-01

    Proposed agile walking robot operates over rocky, sandy, and sloping terrain. Offers stability and climbing ability superior to other conceptual mobile robots. Equipped with six articulated legs like those of insect, continually feels ground under leg before applying weight to it. If leg sensed unexpected object or failed to make contact with ground at expected point, seeks alternative position within radius of 20 cm. Failing that, robot halts, examines area around foot in detail with laser ranging imager, and replans entire cycle of steps for all legs before proceeding.

  9. Autonomous mobile robot teams

    NASA Technical Reports Server (NTRS)

    Agah, Arvin; Bekey, George A.

    1994-01-01

    This paper describes autonomous mobile robot teams performing tasks in unstructured environments. The behavior and the intelligence of the group is distributed, and the system does not include a central command base or leader. The novel concept of the Tropism-Based Cognitive Architecture is introduced, which is used by the robots in order to produce behavior transforming their sensory information to proper action. The results of a number of simulation experiments are presented. These experiments include worlds where the robot teams must locate, decompose, and gather objects, and defend themselves against hostile predators, while navigating around stationary and mobile obstacles.

  10. Modelling robot construction systems

    NASA Technical Reports Server (NTRS)

    Grasso, Chris

    1990-01-01

    TROTER's are small, inexpensive robots that can work together to accomplish sophisticated construction tasks. To understand the issues involved in designing and operating a team of TROTER's, the robots and their components are being modeled. A TROTER system that features standardized component behavior is introduced. An object-oriented model implemented in the Smalltalk programming language is described and the advantages of the object-oriented approach for simulating robot and component interactions are discussed. The presentation includes preliminary results and a discussion of outstanding issues.

  11. Advanced mechanisms for robotics

    NASA Technical Reports Server (NTRS)

    Vranish, John M.

    1991-01-01

    An overview of applied research and development at the Goddard Space Flight Center (GSFC) on mechanisms and collision avoidance skin for robots is presented. The work on robot end effectors is outlined, followed by a brief discussion of robot-friendly payload latching mechanisms and compliant joints. This is followed by discussions of the collision avoidance/management skin and the GSFC research on magnetorestrictive direct drive motors. A new project, the artificial muscle, is introduced. Each of the devices is described sufficiently to permit a basic understanding of its purpose, capabilities, and operating fundamentals. The implications for commercialization are discussed.

  12. Robotics in shoulder rehabilitation

    PubMed Central

    Sicuri, Chiara; Porcellini, Giuseppe; Merolla, Giovanni

    2014-01-01

    Summary In the last few decades, several researches have been conducted in the field of robotic rehabilitation to meet the intensive, repetitive and task-oriented training, with the goal to recover the motor function. Up to now, robotic rehabilitation studies of the upper extremity have generally focused on stroke survivors leaving less explored the field of orthopaedic shoulder rehabilitation. In this review we analyse the present status of robotic technologies, in order to understand which are the current indications and which may be the future perspective for their application in both neurological and orthopaedic shoulder rehabilitation. PMID:25332937

  13. Robotics: An introduction

    SciTech Connect

    Mc Cloy, D.; Harris, D.

    1986-01-01

    This book is an account encompassing the entire range of disciplines involved in robotics: mechanical, electrical, electronic, and software design, as well as the related technologies of pick-and-place devices, walking machines, teleoperators, and prosthetics. The book explores the evolution of robotics and major trends in the field, and covers an array of robot configurations and mechanisms. It also looks at fundamentals such as actuation, control, measurement, computers, sensing and interaction with the environment, and pattern recognition. Important economic and financial aspects as well as safety and social implications are detailed.

  14. Robots and telechirs

    SciTech Connect

    Thring, M.W.

    1985-01-01

    This volume outlines an engineering approach and includes relevant social aspects of the impact of robotic automation. The book explains the basic principles and theory, discusses design and investigates current methods to produce practical, reliable robots. Specific topics include the theory and practice of mechanical arms, hands and legs. The use of robotics in industry and of telechirs in mines, underwater, and in such dangerous situations as handling explosives are also covered, as are the mechanisms of the human body in doing these tasks.

  15. Joint Robotics Program

    DTIC Science & Technology

    2008-04-23

    Åèìáëáíáçå= oÉëÉ~êÅÜ=póãéçëáìã= JOINT ROBOTICS PROGRAM Published: 23 April 2008 by Joel Brown and Paul Varian 5th Annual Acquisition Research...3. DATES COVERED 00-00-2008 to 00-00-2008 4. TITLE AND SUBTITLE Joint Robotics Program 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM...ëóåÉêÖó=Ñçê=áåÑçêãÉÇ=ÅÜ~åÖÉ=======- 464 - = = Joint Robotics Program Presenter: Joel Brown, Defense Acquisition University Author: Paul Varian

  16. Artificial Intelligence and Robotics.

    DTIC Science & Technology

    1982-09-20

    8217’AD-A122 414 ARTIFICIAL INTELLIGENCE AND ROBOTICS (.) ARMY SCIENCE 1/j 13OARD WA SH INGTON Od I C PEDEN ET AL. 20 SEP 82 UNCLASSIFIED F/G 15/3 NL LEE...AND ACQUISITION WASHINGTON, D. C. 20310 A RMY CIENCE BOARD AD HOC SUBGROUP REPORT ON ARTIFICIAL INTELLIGENCE AND ROBOTICS SEPTEMBER 1982 DTIC DEC 1 5...TITLE (aid Subtitle) S TYPE OF REPORT & PERIOD COVERED Army Science Board AHSG Report Final Artificial Intelligence and Robotics S. PERFORMING ORG

  17. Robots in astronomy

    NASA Astrophysics Data System (ADS)

    Baruch, John E. F.

    A development history and a development trends evaluation are presented for the growth of automation and robotics in industry and in observational astronomy, with a view to the distinctive problems of each field of application. Recent concepts concerning the astronomical use of robots as personal assistants are noted, and an effort is made to discern ways in which technology guides both methods and perceptions. Current programs for robotic and automated telescope development are noted, and it is argued that international standards should soon be formulated for this technology.

  18. MVACS Robotic Arm

    NASA Technical Reports Server (NTRS)

    Bonitz, R.; Slostad, J.; Bon, B.; Braun, D.; Brill, R.; Buck, C.; Fleischner, R.; Haldeman, A.; Herman, J.; Hertzel, M.; Noon, D.; Pixler, G.; Schenker, P.; Ton, T.; Tucker, C.; Zimmerman, W.

    2000-01-01

    The primary purpose of the Mars Volatiles and Climate Surveyor (MVACS) Robotic Arm is to support to the other MVACS science instruments by digging trenches in the Martian soil; acquiring and dumping soil samples into the thermal evolved gas analyzer (TEGA); positioning the Soil Temperature Probe (STP) in the soil: positioning the Robotic Arm Air Temperature Sensor (RAATS) at various heights above the surface, and positioning the Robotic Arm Camera (RAC) for taking images of the surface, trench, soil samples, magnetic targets and other objects of scientific interest within its workspace.

  19. Architecture for robot intelligence

    NASA Technical Reports Server (NTRS)

    Peters, II, Richard Alan (Inventor)

    2004-01-01

    An architecture for robot intelligence enables a robot to learn new behaviors and create new behavior sequences autonomously and interact with a dynamically changing environment. Sensory information is mapped onto a Sensory Ego-Sphere (SES) that rapidly identifies important changes in the environment and functions much like short term memory. Behaviors are stored in a DBAM that creates an active map from the robot's current state to a goal state and functions much like long term memory. A dream state converts recent activities stored in the SES and creates or modifies behaviors in the DBAM.

  20. Lack of effect of bilateral nephrectomy on the pharmacokinetics of /sup 14/C-indapamide (REV 2555) and its metabolites in the dog

    SciTech Connect

    Klunk, L.J.; Mangat, S.; Treitman, J.A.; Grebow, P.E.

    1983-11-01

    Renal impairment can affect the disposition of metabolites, as well as unchanged drug, especially when there is significant renal clearance of metabolites. The pharmacokinetics of indapamide, a highly metabolized drug, and total indapamide equivalents (as an indicator of metabolites plus unchanged drug) were determined in the anephric dog. An intravenous dose of /sup 14/C-indapamide was administered to dogs first after a sham-operation, and then following bilateral nephrectomy. The disposition of total indapamide equivalents, calculated from total radioactivity, was not substantially different after nephrectomy as compared to after sham-operation, with an increase after nephrectomy in the area under the blood level curve (+26.2%), and decreases in the elimination rate constant (-6.9%), volume of distribution (-12.7%) and total blood clearance (-21.9%). The only statistically significant change was the decrease in the volume of distribution. The elimination kinetics of unchanged drug were also qualitatively similar in both cases. After nephrectomy, a decrease was seen in the elimination rate constant (-10.9%) and the volume of distribution (-16.3%) while slight increases in the total blood clearance (+1.9%) and the area under the blood level curve (+4.8%) were noted. These findings could have important implications for advantageous use of indapamide in treatment of hypertensive patients with renal failure since these data suggest that metabolites as well as unchanged drug could still be effectively eliminated by an alternate, non-renal route, thus minimizing accumulation of these compounds.

  1. Robotic assisted adrenalectomy: Surgical techniques, feasibility, indications, oncological outcome and safety.

    PubMed

    Yiannakopoulou, Eugenia

    2016-04-01

    Nowadays robotic assisted adrenalectomy has become an alternative to conventional laparoscopic adrenalectomy. However, evidence on the possible advantages and drawbacks of robotic assisted adrenalectomy remains still limited. This manuscript aimed to review evidence on robotic assisted adrenalectomy in terms of surgical technique, feasibility, indications, oncological outcome and safety. Existing evidence, although limited, suggests that robotic assisted adrenalectomy is feasible and safe. However, the number of patients submitted to robotic assisted adrenalectomy is limited with the majority of them being operated for benign disease. There are only a few case reports of robotic assisted adrenalectomy performed for adrenocortical carcinoma, oncocytoma or metastasis. Partial adrenalectomy seems to be a promising application of robotic assisted adrenalectomy especially for the treatment of hereditary pheocromocytomas. Robotic assisted adrenalectomy overcoming the technical limitations of laparoscopic surgery could possibly elicit a mild surgical response instead of the well described surgical response. Surgical response affects surgical morbidity and mortality as well as oncological outcome of malignant disease. If this hypothesis is proved correct, robotic assisted adrenalectomy could be possibly indicated in the treatment of disease. In conclusion, robotic assisted adrenalectomy is feasible and safe. Further research is needed on the oncological outcome of this minimally invasive technique as well as on its effect on surgical stress response.

  2. Software Architecture for Planetary and Lunar Robotics

    NASA Technical Reports Server (NTRS)

    Utz, Hans; Fong, Teny; Nesnas, Iasa A. D.

    2006-01-01

    A viewgraph presentation on the role that software architecture plays in space and lunar robotics is shown. The topics include: 1) The Intelligent Robotics Group; 2) The Lunar Mission; 3) Lunar Robotics; and 4) Software Architecture for Space Robotics.

  3. Miniature in vivo robotics and novel robotic surgical platforms.

    PubMed

    Shah, Bhavin C; Buettner, Shelby L; Lehman, Amy C; Farritor, Shane M; Oleynikov, Dmitry

    2009-05-01

    Robotic surgical systems, such as the da Vinci Surgical System (Intuitive Surgical, Inc., Sunnyvale, California), have revolutionized laparoscopic surgery but are limited by large size, increased costs, and limitations in imaging. Miniature in vivo robots are being developed that are inserted entirely into the peritoneal cavity for laparoscopic and natural orifice transluminal endoscopic surgical (NOTES) procedures. In the future, miniature camera robots and microrobots should be able to provide a mobile viewing platform. This article discusses the current state of miniature robotics and novel robotic surgical platforms and the development of future robotic technology for general surgery and urology.

  4. Continuum limbed robots for locomotion

    NASA Astrophysics Data System (ADS)

    Mutlu, Alper

    This thesis focuses on continuum robots based on pneumatic muscle technology. We introduce a novel approach to use these muscles as limbs of lightweight legged robots. The flexibility of the continuum legs of these robots offers the potential to perform some duties that are not possible with classical rigid-link robots. Potential applications are as space robots in low gravity, and as cave explorer robots. The thesis covers the fabrication process of continuum pneumatic muscles and limbs. It also provides some new experimental data on this technology. Afterwards, the designs of two different novel continuum robots - one tripod, one quadruped - are introduced. Experimental data from tests using the robots is provided. The experimental results are the first published example of locomotion with tripod and quadruped continuum legged robots. Finally, discussion of the results and how far this technology can go forward is presented.

  5. Robotics and remote systems applications

    SciTech Connect

    Rabold, D.E.

    1996-05-01

    This article is a review of numerous remote inspection techniques in use at the Savannah River (and other) facilities. These include: (1) reactor tank inspection robot, (2) californium waste removal robot, (3) fuel rod lubrication robot, (4) cesium source manipulation robot, (5) tank 13 survey and decontamination robots, (6) hot gang valve corridor decontamination and junction box removal robots, (7) lead removal from deionizer vessels robot, (8) HB line cleanup robot, (9) remote operation of a front end loader at WIPP, (10) remote overhead video extendible robot, (11) semi-intelligent mobile observing navigator, (12) remote camera systems in the SRS canyons, (13) cameras and borescope for the DWPF, (14) Hanford waste tank camera system, (15) in-tank precipitation camera system, (16) F-area retention basin pipe crawler, (17) waste tank wall crawler and annulus camera, (18) duct inspection, and (19) deionizer resin sampling.

  6. Robotic follow system and method

    DOEpatents

    Bruemmer, David J [Idaho Falls, ID; Anderson, Matthew O [Idaho Falls, ID

    2007-05-01

    Robot platforms, methods, and computer media are disclosed. The robot platform includes perceptors, locomotors, and a system controller, which executes instructions for a robot to follow a target in its environment. The method includes receiving a target bearing and sensing whether the robot is blocked front. If the robot is blocked in front, then the robot's motion is adjusted to avoid the nearest obstacle in front. If the robot is not blocked in front, then the method senses whether the robot is blocked toward the target bearing and if so, sets the rotational direction opposite from the target bearing, and adjusts the rotational velocity and translational velocity. If the robot is not blocked toward the target bearing, then the rotational velocity is adjusted proportional to an angle of the target bearing and the translational velocity is adjusted proportional to a distance to the nearest obstacle in front.

  7. Robots on the Roof

    NASA Video Gallery

    The Aerosol Robotic Network (AERONET) is one of the first places that scientists turn when volcanoes, wildfires, pollution plumes, dust storms and many other phenomena—both natural and manmade—...

  8. DOE Robotics Project

    SciTech Connect

    Not Available

    1991-01-01

    This document provide the bimonthly progress reports on the Department of Energy (DOE) Robotics Project by the University of Michigan. Reports are provided for the time periods of December 90/January 91 through June 91/July 91. (FI)

  9. Biological Soft Robotics.

    PubMed

    Feinberg, Adam W

    2015-01-01

    In nature, nanometer-scale molecular motors are used to generate force within cells for diverse processes from transcription and transport to muscle contraction. This adaptability and scalability across wide temporal, spatial, and force regimes have spurred the development of biological soft robotic systems that seek to mimic and extend these capabilities. This review describes how molecular motors are hierarchically organized into larger-scale structures in order to provide a basic understanding of how these systems work in nature and the complexity and functionality we hope to replicate in biological soft robotics. These span the subcellular scale to macroscale, and this article focuses on the integration of biological components with synthetic materials, coupled with bioinspired robotic design. Key examples include nanoscale molecular motor-powered actuators, microscale bacteria-controlled devices, and macroscale muscle-powered robots that grasp, walk, and swim. Finally, the current challenges and future opportunities in the field are addressed.

  10. Operator roles in robotics

    SciTech Connect

    Lyman, J.; Madni, A.M.

    1984-01-01

    The authors suggest that operator roles in robotics can be classified under the categories of monitor, manager, and maintainer. With increasingly sophisticated applications of machine intelligence, however, these roles will require explicit and continuing reassessment. 5 references.

  11. Microprocessors, Robotics, and Work.

    ERIC Educational Resources Information Center

    DeVore, Paul W.

    1982-01-01

    The author explores several recent technological developments which will have an impact on future technical education. These developments include the revolution in information services, robotics, job changes and eliminations, changing role of the worker, and quality of life. (CT)

  12. Rolling friction robot fingers

    NASA Technical Reports Server (NTRS)

    Vranish, John M. (Inventor)

    1992-01-01

    A low friction, object guidance, and gripping finger device for a robotic end effector on a robotic arm is disclosed, having a pair of robotic fingers each having a finger shaft slideably located on a gripper housing attached to the end effector. Each of the robotic fingers has a roller housing attached to the finger shaft. The roller housing has a ball bearing mounted centering roller located at the center, and a pair of ball bearing mounted clamping rollers located on either side of the centering roller. The object has a recess to engage the centering roller and a number of seating ramps for engaging the clamping rollers. The centering roller acts to position and hold the object symmetrically about the centering roller with respect to the X axis and the clamping rollers act to position and hold the object with respect to the Y and Z axis.

  13. Robotic aortic surgery.

    PubMed

    Duran, Cassidy; Kashef, Elika; El-Sayed, Hosam F; Bismuth, Jean

    2011-01-01

    Surgical robotics was first utilized to facilitate neurosurgical biopsies in 1985, and it has since found application in orthopedics, urology, gynecology, and cardiothoracic, general, and vascular surgery. Surgical assistance systems provide intelligent, versatile tools that augment the physician's ability to treat patients by eliminating hand tremor and enabling dexterous operation inside the patient's body. Surgical robotics systems have enabled surgeons to treat otherwise untreatable conditions while also reducing morbidity and error rates, shortening operative times, reducing radiation exposure, and improving overall workflow. These capabilities have begun to be realized in two important realms of aortic vascular surgery, namely, flexible robotics for exclusion of complex aortic aneurysms using branched endografts, and robot-assisted laparoscopic aortic surgery for occlusive and aneurysmal disease.

  14. Robotics in urologic oncology

    PubMed Central

    Jain, Saurabh; Gautam, Gagan

    2015-01-01

    Robotic surgery was initially developed to overcome problems faced during conventional laparoscopic surgeries and to perform telesurgery at distant locations. It has now established itself as the epitome of minimally invasive surgery (MIS). It is one of the most significant advances in MIS in recent years and is considered by many as a revolutionary technology, capable of influencing the future of surgery. After its introduction to urology, robotic surgery has redefined the management of urological malignancies. It promises to make difficult urological surgeries easier, safer and more acceptable to both the surgeon and the patient. Robotic surgery is slowly, but surely establishing itself in India. In this article, we provide an overview of the advantages, disadvantages, current status, and future applications of robotic surgery for urologic cancers in the context of the Indian scenario. PMID:25598598

  15. K-10 Robots

    NASA Video Gallery

    Robots, scientists, engineers and flight controllers from NASA's Ames Research Center at Moffett Field, Calif., and NASA's Johnson Space Center in Houston, gathered at NASA Ames to perform a series...

  16. Robots in operating theatres.

    PubMed Central

    Buckingham, R. A.; Buckingham, R. O.

    1995-01-01

    Robots designed for surgery have three main advantages over humans. They have greater three dimensional spatial accuracy, are more reliable, and can achieve much greater precision. Although few surgical robots are yet in clinical trials one or two have advanced to the stage of seeking approval from the UK's Medical Devices Agency and the US Federal Drug Administration. Safety is a key concern. A robotic device can be designed in an intrinsically safe way by restricting its range of movement to an area where it can do no damage. Furthermore, safety can be increased by making it passive, guided at all times by a surgeon. Nevertheless, some of the most promising developments may come from robots that are active (monitored rather than controlled by the surgeon) and not limited to intrinsically safe motion. Images Fig 1 Fig 3 Fig 4 PMID:8520340

  17. FIRST Robotics Kickoff

    NASA Technical Reports Server (NTRS)

    2007-01-01

    NASA engineers Scott Olive (left) and Bo Clarke answer questions during the 2007 FIRST (For Inspiration and Recognition of Science and Technology) Robotics Competition regional kickoff event held Saturday, Jan. 6, 2007, at StenniSphere, the visitor center at NASA Stennis Space Center near Bay St. Louis, Miss. The SSC employees and FIRST Robotics volunteer mentors are standing near a mock-up of the playing field for the FIRST Robotics' 2007 `Rack n' Roll' challenge. Roughly 300 students and adult volunteers - representing 29 high schools from four states - attended the kickoff to hear the rules of `Rack n' Roll.' The teams will spend the next six weeks building and programming robots from parts kits they received Saturday, then battle their creations at regional spring competitions in New Orleans, Houston, Atlanta and other cities around the nation. FIRST aims to inspire students in the pursuit of engineering and technology studies and careers.

  18. Robotics in Colorectal Surgery

    PubMed Central

    Weaver, Allison; Steele, Scott

    2016-01-01

    Over the past few decades, robotic surgery has developed from a futuristic dream to a real, widely used technology. Today, robotic platforms are used for a range of procedures and have added a new facet to the development and implementation of minimally invasive surgeries. The potential advantages are enormous, but the current progress is impeded by high costs and limited technology. However, recent advances in haptic feedback systems and single-port surgical techniques demonstrate a clear role for robotics and are likely to improve surgical outcomes. Although robotic surgeries have become the gold standard for a number of procedures, the research in colorectal surgery is not definitive and more work needs to be done to prove its safety and efficacy to both surgeons and patients. PMID:27746895

  19. Wheeled hopping robot

    DOEpatents

    Fischer, Gary J.

    2010-08-17

    The present invention provides robotic vehicles having wheeled and hopping mobilities that are capable of traversing (e.g. by hopping over) obstacles that are large in size relative to the robot and, are capable of operation in unpredictable terrain over long range. The present invention further provides combustion powered linear actuators, which can include latching mechanisms to facilitate pressurized fueling of the actuators, as can be used to provide wheeled vehicles with a hopping mobility.

  20. Military Space Robotics

    DTIC Science & Technology

    1987-04-30

    space will need to be designed for service by autonomous robots. Objects in space will have to be hardened for protection against directed- energy ...weapons, kinetic- energy weapons, and natural radiation. Extraterrestrial m~itrials (ETM) will be preferable as a lower-cost alternative to earth-launched...RESOURCES IN ORBIT ROBOTS IN ORBIT ABILITY TO UTILIZE ETM TO CONSTRUCT ABILITY TO CONSTRUCT LARGE ORBITAL RESOURCES STRUCTURES IN ORBIT . ABILITY TO FORM

  1. Robotics and general surgery.

    PubMed

    Jacob, Brian P; Gagner, Michel

    2003-12-01

    Robotics are now being used in all surgical fields, including general surgery. By increasing intra-abdominal articulations while operating through small incisions, robotics are increasingly being used for a large number of visceral and solid organ operations, including those for the gallbladder, esophagus, stomach, intestines, colon, and rectum, as well as for the endocrine organs. Robotics and general surgery are blending for the first time in history and as a specialty field should continue to grow for many years to come. We continuously demand solutions to questions and limitations that are experienced in our daily work. Laparoscopy is laden with limitations such as fixed axis points at the trocar insertion sites, two-dimensional video monitors, limited dexterity at the instrument tips, lack of haptic sensation, and in some cases poor ergonomics. The creation of a surgical robot system with 3D visual capacity seems to deal with most of these limitations. Although some in the surgical community continue to test the feasibility of these surgical robots and to question the necessity of such an expensive venture, others are already postulating how to improve the next generation of telemanipulators, and in so doing are looking beyond today's horizon to find simpler solutions. As the robotic era enters the world of the general surgeon, more and more complex procedures will be able to be approached through small incisions. As technology catches up with our imaginations, robotic instruments (as opposed to robots) and 3D monitoring will become routine and continue to improve patient care by providing surgeons with the most precise, least traumatic ways of treating surgical disease.

  2. Modularity in robotic systems

    NASA Technical Reports Server (NTRS)

    Tesar, Delbert; Butler, Michael S.

    1989-01-01

    Most robotic systems today are designed one at a time, at a high cost of time and money. This wasteful approach has been necessary because the industry has not established a foundation for the continued evolution of intelligent machines. The next generation of robots will have to be generic, versatile machines capable of absorbing new technology rapidly and economically. This approach is demonstrated in the success of the personal computer, which can be upgraded or expanded with new software and hardware at virtually every level. Modularity is perceived as a major opportunity to reduce the 6 to 7 year design cycle time now required for new robotic manipulators, greatly increasing the breadth and speed of diffusion of robotic systems in manufacturing. Modularity and its crucial role in the next generation of intelligent machines are the focus of interest. The main advantages that modularity provides are examined; types of modules needed to create a generic robot are discussed. Structural modules designed by the robotics group at the University of Texas at Austin are examined to demonstrate the advantages of modular design.

  3. Robot goniophotometry at PTB

    NASA Astrophysics Data System (ADS)

    Lindemann, M.; Maass, R.; Sauter, G.

    2015-04-01

    The total luminous flux of a light source is the complete integration of its spectral radiance distribution weighted with the photopic observer and taken over all parts of its surface and over the full solid angle of emittance. The spatial distributions are measured with various types of goniophotometers and the PTB robot goniophotometer is a new type with many unique features. It is built as an arrangement of three robots with arms of more than 6 m in length and with 7 degrees of freedom each. The extreme flexibility of the robots allows computer controlled tracks with variable radii and speeds up to 3 m and 1 m s-1, respectively. One robot aligns the light source and the two other robots move photometers and array spectrometers in their hemispheres simultaneously measuring planar illuminance and the related relative spectral distribution. The robot goniophotometer is optimized for the realisation of the luminous flux unit, the lumen and it is completely characterized in this report. The relevant properties and correction factors are explained, as well as the implementation of techniques for synchronisation and stabilisation of spatially resolved or integrated photometric and colorimetric quantities. Finally, all contributions are combined in the model of evaluation for the (total) luminous flux value and the measurement uncertainty associated with that value is evaluated in the presented uncertainty budget. The goniophotometric determination of the values for colorimetric quantities is explained for the total luminous flux and the spatially distributed radiant power.

  4. Robotic surgery in gynecology

    PubMed Central

    Sinha, Rooma; Sanjay, Madhumati; Rupa, B.; Kumari, Samita

    2015-01-01

    FDA approved Da Vinci Surgical System in 2005 for gynecological surgery. It has been rapidly adopted and it has already assumed an important position at various centers where this is available. It comprises of three components: A surgeon's console, a patient-side cart with four robotic arms and a high-definition three-dimensional (3D) vision system. In this review we have discussed various robotic-assisted laparoscopic benign gynecological procedures like myomectomy, hysterectomy, endometriosis, tubal anastomosis and sacrocolpopexy. A PubMed search was done and relevant published studies were reviewed. Surgeries that can have future applications are also mentioned. At present most studies do not give significant advantage over conventional laparoscopic surgery in benign gynecological disease. However robotics do give an edge in more complex surgeries. The conversion rate to open surgery is lesser with robotic assistance when compared to laparoscopy. For myomectomy surgery, Endo wrist movement of robotic instrument allows better and precise suturing than conventional straight stick laparoscopy. The robotic platform is a logical step forward to laparoscopy and if cost considerations are addressed may become popular among gynecological surgeons world over. PMID:25598600

  5. Application of robots in space.

    NASA Technical Reports Server (NTRS)

    Johnsen, E. G.

    1971-01-01

    Robots are defined as electromechanical systems (with local computers) receiving inputs from sensors, and in turn, controlling motors and effectors to do tasks requiring some measure of intelligence and permitting the whole system to interact with the real world. Robot systems for space applications are categorized into three general groups consisting of roving exploration robots, spacecraft robots, and planet development robots. The functions of systems in each category are defined in terms of intended applications, and requirements for operating and decision making are outlined. Further developments which must be achieved in robot technology are summarized.

  6. Robotic hand with modular extensions

    DOEpatents

    Salisbury, Curt Michael; Quigley, Morgan

    2015-01-20

    A robotic device is described herein. The robotic device includes a frame that comprises a plurality of receiving regions that are configured to receive a respective plurality of modular robotic extensions. The modular robotic extensions are removably attachable to the frame at the respective receiving regions by way of respective mechanical fuses. Each mechanical fuse is configured to trip when a respective modular robotic extension experiences a predefined load condition, such that the respective modular robotic extension detaches from the frame when the load condition is met.

  7. Metastasis of renal cell carcinoma to the parathyroid gland 16 years after radical nephrectomy: A case report

    PubMed Central

    Torregrossa, Liborio; Rotondo, Maria Isabella; Insilla, Andrea Cacciato; Galleri, David; Guidoccio, Federica; Miccoli, Paolo; Livolsi, Virginia A.; Basolo, Fulvio

    2016-01-01

    Renal cell carcinoma (RCC) has a high metastatic potential, and most commonly metastasizes via the bloodstream, although lymphatic metastases also occur. RCC is well-known for its propensity to metastasize to unusual sites, and late metastasis, even after a number of years, is common. The occurrence of RCC metastasis to the head and neck region is uncommon, and occurs primarily in the thyroid gland and in patients with widespread dissemination. Involvement of the parathyroid gland in metastatic carcinoma is extremely rare. In the present report, a case of metastasis confined to the parathyroid gland is described, likely with intrathyroidal localization, arising from a RCC that occurred 16 years after nephrectomy. A 66-year-old man was referred to the Department of Surgery of the University Hospital of Pisa (Pisa, Italy) with a preoperative fine-needle aspiration diagnosis of a follicular lesion in the context of nodular goiter of the thyroid gland. The previous medical history of the patient included a right nephrectomy for the treatment of clear cell RCC in February 1997. No other distant metastases were identified as of the latest follow-up in March 2014. At the time of thyroid surgery, the thyroid and parathyroid function tests were normal. The gross appearance of the surgical specimen was a multinodular goiter with a solid nodule measuring 33 mm on the left lobe of the thyroid gland. Microscopic examination revealed a completely encapsulated lesion consisting of clear cells arranged in a solid pattern and intermixed with fragments of parathyroid tissue. Following immunohistochemical examination, the clear cell lesion was negative for thyroid transcription factor-1 and thyroglobulin and strongly positive for epithelial membrane antigen, cluster of differentiation 10 and vimentin. To the best of our knowledge, this is the second case of metastasis to the parathyroid gland from a RCC reported in the literature. PMID:27899986

  8. Renal accumulation and intrarenal distribution of inorganic mercury in the rabbit: Effect of unilateral nephrectomy and dose of mercuric chloride

    SciTech Connect

    Zalups, R.K. )

    1991-06-01

    The effects of unilateral nephrectomy and dose of mercuric chloride on the short-term renal accumulation and intrarenal distribution of inorganic mercury were studied in the rabbit. The renal accumulation of inorganic mercury, on a per gram basis, was increased in uninephrectomized (NPX) rabbits compared with that in sham-operated (SO) rabbits 24 h after the animals received either a nontoxic 2.0 mumol/kg or nephrotoxic 4.0 mumol/kg dose of mercuric chloride. In the NPX rabbits given the 2.0 mumol/kg dose of mercuric chloride, the increased accumulation of inorganic mercury was due to increased accumulation of mercury in the outer stripe of the outer medulla. In the NPX rabbits given the 4.0 mumol/kg dose of mercuric chloride, the increased renal accumulation of mercury appeared to be due to increased accumulation of mercury in both the renal cortex and outer stripe of the outer medulla. Interestingly, no differences in the renal accumulation of inorganic mercury were found between NPX and SO rabbits given a low nontoxic 0.5 mumol/kg dose of mercuric chloride. As the dose of mercuric chloride was increased from 0.5 to 4.0 mumol/kg, the percent of the administered dose of mercury that accumulated in each gram of renal tissue decreased substantially. The findings in the present study indicate that the renal accumulation of inorganic mercury increases after unilateral nephrectomy when certain nontoxic and nephrotoxic doses of mercuric chloride are administered. In addition, they indicate that the percent of the administered dose of mercury that accumulates in the renal tissue of both NPX and SO rabbits decreases as the dose of mercuric chloride is increased.

  9. An overview of artificial intelligence and robotics. Volume 2: Robotics

    NASA Technical Reports Server (NTRS)

    Gevarter, W. B.

    1982-01-01

    This report provides an overview of the rapidly changing field of robotics. The report incorporates definitions of the various types of robots, a summary of the basic concepts, utilized in each of the many technical areas, review of the state of the art and statistics of robot manufacture and usage. Particular attention is paid to the status of robot development, the organizations involved, their activities, and their funding.

  10. A history of robots: from science fiction to surgical robotics.

    PubMed

    Hockstein, N G; Gourin, C G; Faust, R A; Terris, D J

    2007-01-01

    Surgical robotics is an evolving field with great advances having been made over the last decade. The origin of robotics was in the science-fiction literature and from there industrial applications, and more recently commercially available, surgical robotic devices have been realized. In this review, we examine the field of robotics from its roots in literature to its development for clinical surgical use. Surgical mills and telerobotic devices are discussed, as are potential future developments.

  11. Deployer: A Robot-Deploying Robot

    DTIC Science & Technology

    2003-04-01

    6: Bandicoot 11 Figure 7: Deployer mast in a.) retracted, b.) extending, and c.) fully extended positions. 13 Figure 8: Wombat climbing stairs with...mast in a.) retracted, b.)extending, and c.) fully extended positions. 13 Deploy er Outfitting - Wombat The second Urban Robot, Wombat (Fig.8), was...equipped with a single, rear-mounted ISIS transceiver and a Swarm Radio to communicate with all of the Joeys. In addition, Wombat was equipped with

  12. Socially intelligent robots: dimensions of human-robot interaction.

    PubMed

    Dautenhahn, Kerstin

    2007-04-29

    Social intelligence in robots has a quite recent history in artificial intelligence and robotics. However, it has become increasingly apparent that social and interactive skills are necessary requirements in many application areas and contexts where robots need to interact and collaborate with other robots or humans. Research on human-robot interaction (HRI) poses many challenges regarding the nature of interactivity and 'social behaviour' in robot and humans. The first part of this paper addresses dimensions of HRI, discussing requirements on social skills for robots and introducing the conceptual space of HRI studies. In order to illustrate these concepts, two examples of HRI research are presented. First, research is surveyed which investigates the development of a cognitive robot companion. The aim of this work is to develop social rules for robot behaviour (a 'robotiquette') that is comfortable and acceptable to humans. Second, robots are discussed as possible educational or therapeutic toys for children with autism. The concept of interactive emergence in human-child interactions is highlighted. Different types of play among children are discussed in the light of their potential investigation in human-robot experiments. The paper concludes by examining different paradigms regarding 'social relationships' of robots and people interacting with them.

  13. Supersmart Robots: The Next Generation of Robots Has Evolutionary Capabilities

    ERIC Educational Resources Information Center

    Simkins, Michael

    2008-01-01

    Robots that can learn new behaviors. Robots that can reproduce themselves. Science fiction? Not anymore. Roboticists at Cornell's Computational Synthesis Lab have developed just such engineered creatures that offer interesting implications for education. The team, headed by Hod Lipson, was intrigued by the question, "How can you get robots to be…

  14. Partial (focal) seizure

    MedlinePlus

    ... Jacksonian seizure; Seizure - partial (focal); Temporal lobe seizure; Epilepsy - partial seizures ... Abou-Khalil BW, Gallagher MJ, Macdonald RL. Epilepsies. In: Daroff ... Practice . 7th ed. Philadelphia, PA: Elsevier; 2016:chap 101. ...

  15. Partial tooth gear bearings

    NASA Technical Reports Server (NTRS)

    Vranish, John M. (Inventor)

    2010-01-01

    A partial gear bearing including an upper half, comprising peak partial teeth, and a lower, or bottom, half, comprising valley partial teeth. The upper half also has an integrated roller section between each of the peak partial teeth with a radius equal to the gear pitch radius of the radially outwardly extending peak partial teeth. Conversely, the lower half has an integrated roller section between each of the valley half teeth with a radius also equal to the gear pitch radius of the peak partial teeth. The valley partial teeth extend radially inwardly from its roller section. The peak and valley partial teeth are exactly out of phase with each other, as are the roller sections of the upper and lower halves. Essentially, the end roller bearing of the typical gear bearing has been integrated into the normal gear tooth pattern.

  16. Robots for Astrobiology!

    NASA Technical Reports Server (NTRS)

    Boston, Penelope J.

    2016-01-01

    The search for life and its study is known as astrobiology. Conducting that search on other planets in our Solar System is a major goal of NASA and other space agencies, and a driving passion of the community of scientists and engineers around the world. We practice for that search in many ways, from exploring and studying extreme environments on Earth, to developing robots to go to other planets and help us look for any possible life that may be there or may have been there in the past. The unique challenges of space exploration make collaborations between robots and humans essential. The products of those collaborations will be novel and driven by the features of wholly new environments. For space and planetary environments that are intolerable for humans or where humans present an unacceptable risk to possible biologically sensitive sites, autonomous robots or telepresence offer excellent choices. The search for life signs on Mars fits within this category, especially in advance of human landed missions there, but also as assistants and tools once humans reach the Red Planet. For planetary destinations where we do not envision humans ever going in person, like bitterly cold icy moons, or ocean worlds with thick ice roofs that essentially make them planetary-sized ice caves, we will rely on robots alone to visit those environments for us and enable us to explore and understand any life that we may find there. Current generation robots are not quite ready for some of the tasks that we need them to do, so there are many opportunities for roboticists of the future to advance novel types of mobility, autonomy, and bio-inspired robotic designs to help us accomplish our astrobiological goals. We see an exciting partnership between robotics and astrobiology continually strengthening as we jointly pursue the quest to find extraterrestrial life.

  17. ISS Update: Robotic Refueling Mission

    NASA Video Gallery

    NASA Public Affairs Officer Dan Huot interviews Alex Janas, robotics operator from the Goddard Space Flight Center, about the Robotic Refueling Mission that has been taking place on the space stati...

  18. Artificial intelligence: Robots with instincts

    NASA Astrophysics Data System (ADS)

    Adami, Christoph

    2015-05-01

    An evolutionary algorithm has been developed that allows robots to adapt to unforeseen change. The robots learn behaviours quickly and instinctively by mining the memory of their past achievements. See Letter p.503

  19. Industrial Robots on the Line.

    ERIC Educational Resources Information Center

    Ayres, Robert; Miller, Steve

    1982-01-01

    Explores the history of robotics and its effects upon the manufacturing industry. Topics include robots' capabilities and limitations, the factory of the future, displacement of the workforce, and implications for management and labor. (SK)

  20. Basic Operational Robotics Instructional System

    NASA Technical Reports Server (NTRS)

    Todd, Brian Keith; Fischer, James; Falgout, Jane; Schweers, John

    2013-01-01

    The Basic Operational Robotics Instructional System (BORIS) is a six-degree-of-freedom rotational robotic manipulator system simulation used for training of fundamental robotics concepts, with in-line shoulder, offset elbow, and offset wrist. BORIS is used to provide generic robotics training to aerospace professionals including flight crews, flight controllers, and robotics instructors. It uses forward kinematic and inverse kinematic algorithms to simulate joint and end-effector motion, combined with a multibody dynamics model, moving-object contact model, and X-Windows based graphical user interfaces, coordinated in the Trick Simulation modeling environment. The motivation for development of BORIS was the need for a generic system for basic robotics training. Before BORIS, introductory robotics training was done with either the SRMS (Shuttle Remote Manipulator System) or SSRMS (Space Station Remote Manipulator System) simulations. The unique construction of each of these systems required some specialized training that distracted students from the ideas and goals of the basic robotics instruction.

  1. Robots Aboard International Space Station

    NASA Video Gallery

    Ames Research Center, MIT and Johnson Space Center have two new robotics projects aboard the International Space Station (ISS). Robonaut 2, a two-armed humanoid robot with astronaut-like dexterity,...

  2. Pediatric robotic urologic surgery-2014.

    PubMed

    Kearns, James T; Gundeti, Mohan S

    2014-07-01

    We seek to provide a background of the current state of pediatric urologic surgery including a brief history, procedural outcomes, cost considerations, future directions, and the state of robotic surgery in India. Pediatric robotic urology has been shown to be safe and effective in cases ranging from pyeloplasty to bladder augmentation with continent urinary diversion. Complication rates are in line with other methods of performing the same procedures. The cost of robotic surgery continues to decrease, but setting up pediatric robotic urology programs can be costly in terms of both monetary investment and the training of robotic surgeons. The future directions of robot surgery include instrument and system refinements, augmented reality and haptics, and telesurgery. Given the large number of children in India, there is huge potential for growth of pediatric robotic urology in India. Pediatric robotic urologic surgery has been established as safe and effective, and it will be an important tool in the future of pediatric urologic surgery worldwide.

  3. Remote Education Based on Robot Edutainment

    NASA Astrophysics Data System (ADS)

    Yorita, Akihiro; Hashimoto, Takuya; Kobayashi, Hiroshi; Kubota, Naoyuki

    This paper discusses the role of robots in remote education. There are three different aims of robot edutainment, i.e., Learning on Robots, Learning through Robots, and Learning with Robots. The last is to apply human-friendly robots instead of personal computers for computer-assisted instruction. Especially, natural communication capability is required to educational robots in the learning with robots. In this paper, we apply human-friendly robots to remote education and discuss the requirements and specifications of robots for the remote education.

  4. The Northwest Indiana Robotic Telescope

    NASA Astrophysics Data System (ADS)

    Slavin, Shawn D.; Rengstorf, A. W.; Aros, J. C.; Segally, W. B.

    2011-01-01

    The Northwest Indiana Robotic (NIRo) Telescope is a remote, automated observing facility recently built by Purdue University Calumet (PUC) at a site in Lowell, IN, approximately 30 miles from the PUC campus. The recently dedicated observatory will be used for broadband and narrowband optical observations by PUC students and faculty, as well as pre-college students through the implementation of standards-based, middle-school modules developed by PUC astronomers and education faculty. The NIRo observatory and its web portal are the central technical elements of a project to improve astronomy education at Purdue Calumet and, more broadly, to improve science education in middle schools of the surrounding region. The NIRo Telescope is a 0.5-meter (20-inch) Ritchey-Chrétien design on a Paramount ME robotic mount, featuring a seven-position filter wheel (UBVRI, Hα, Clear), Peltier (thermoelectrically) cooled CCD camera with 3056 x 3056, square, 12 μm pixels, and off-axis guiding. It provides a coma-free imaging field of 0.5 degrees square, with a plate scale of 0.6 arcseconds per pixel. The observatory has a wireless internet connection, local weather station which publishes data to an internet weather site, and a suite of CCTV security cameras on an IP-based, networked video server. Control of power to every piece of instrumentation is maintained via internet-accessible power distribution units. The telescope can be controlled on-site, or off-site in an attended fashion via an internet connection, but will be used primarily in an unattended mode of automated observation, where queued observations will be scheduled daily from a database of requests. Completed observational data from queued operation will be stored on a campus-based server, which also runs the web portal and observation database. Partial support for this work was provided by the National Science Foundation's Course, Curriculum, and Laboratory Improvement (CCLI) program under Award No. 0736592.

  5. Aerial Explorers and Robotic Ecosystems

    NASA Technical Reports Server (NTRS)

    Young, Larry A.; Pisanich, Greg

    2004-01-01

    A unique bio-inspired approach to autonomous aerial vehicle, a.k.a. aerial explorer technology is discussed. The work is focused on defining and studying aerial explorer mission concepts, both as an individual robotic system and as a member of a small robotic "ecosystem." Members of this robotic ecosystem include the aerial explorer, air-deployed sensors and robotic symbiotes, and other assets such as rovers, landers, and orbiters.

  6. Cooperative Autonomous Robots for Reconnaissance

    DTIC Science & Technology

    2009-03-06

    REPORT Cooperative Autonomous Robots for Reconnaissance 14. ABSTRACT 16. SECURITY CLASSIFICATION OF: Collaborating mobile robots equipped with WiFi ...Cooperative Autonomous Robots for Reconnaissance Report Title ABSTRACT Collaborating mobile robots equipped with WiFi transceivers are configured as a mobile...equipped with WiFi transceivers are configured as a mobile ad-hoc network. Algorithms are developed to take advantage of the distributed processing

  7. Higher Order Languages for Robots,

    DTIC Science & Technology

    1986-10-01

    and procedures for math, I/O, character manipula- 4; tion, robot motion , and line tracking give pre-defined methods for real world control, which...and Shin (5) describe five levels of robot programming: task- " oriented, structured programming, primitive motion , point-to-point, and micro...spray painting robot the programmer (usually a shop floor operator) leads the robot through all of the motions for locating, moving, and orienting the

  8. Teen Sized Humanoid Robot: Archie

    NASA Astrophysics Data System (ADS)

    Baltes, Jacky; Byagowi, Ahmad; Anderson, John; Kopacek, Peter

    This paper describes our first teen sized humanoid robot Archie. This robot has been developed in conjunction with Prof. Kopacek’s lab from the Technical University of Vienna. Archie uses brushless motors and harmonic gears with a novel approach to position encoding. Based on our previous experience with small humanoid robots, we developed software to create, store, and play back motions as well as control methods which automatically balance the robot using feedback from an internal measurement unit (IMU).

  9. Investigating the Implementation of Robotics.

    DTIC Science & Technology

    1984-02-01

    igating the Implementation of Robotics j Linda Argote and Paul S. Goodman I CML-RI-TRS84-9I Investigating the Implementation of Robotics #Linda...Argote and Paul S. Goodman CMU-RI-TR-84-9 The Robotics Institute Carnegie-Mellon University Pittsburgh, Pennsylvania 15213 Fecbruary 1984 JUN~jg 4...Copyright ®1984 Carnegie-Mellon UniversityA UA Support for this research was provided by the Graduate School of Industrial Administration, thc Robotics

  10. US Army TARDEC: Robotics Overview

    DTIC Science & Technology

    2010-03-25

    unclassified US ARMY TARDEC Robotics Overview Bernard Theisen, Joint Center for Robotics 25 March 2010 Reference herein to any specific commercial...4. TITLE AND SUBTITLE US ARMY TARDEC Robotics Overview 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Bernard... Robotics Industry Partnerships Academia PartnershipsGovernment Partnerships TRADOC Community Outreach • S&T Support to the RS-JPO • Develops and Fosters

  11. ICAM Robotics Application Guide (RAG)

    DTIC Science & Technology

    1980-04-01

    ROBOTICS APPLICATION MB GENERAL DYNAMICS CORPORATION FORT WORTH DIVISION FORT WORTH, TEXAS 76101 APRIL 1980 TECHNICAL REPORT AFWAL-TR-80-4042...DOCUMENTATION PAGE AyvJAijfTR-so-AOA^vnntnuFri ’ AT)(-ß05O CTXZ/, l. GOVT ACCESSION NO Ull’i ICAM Robotics Application Guide (RAG) m . vlJ L...Effector Flexible Automation Industrial Robot Manipulator Robotics Work Volume 20. ABSTRACT (Continue on reverse erde II necessary end

  12. Quantum robots plus environments.

    SciTech Connect

    Benioff, P.

    1998-07-23

    A quantum robot is a mobile quantum system, including an on board quantum computer and needed ancillary systems, that interacts with an environment of quantum systems. Quantum robots carry out tasks whose goals include making specified changes in the state of the environment or carrying out measurements on the environment. The environments considered so far, oracles, data bases, and quantum registers, are seen to be special cases of environments considered here. It is also seen that a quantum robot should include a quantum computer and cannot be simply a multistate head. A model of quantum robots and their interactions is discussed in which each task, as a sequence of alternating computation and action phases,is described by a unitary single time step operator T {approx} T{sub a} + T{sub c} (discrete space and time are assumed). The overall system dynamics is described as a sum over paths of completed computation (T{sub c}) and action (T{sub a}) phases. A simple example of a task, measuring the distance between the quantum robot and a particle on a 1D lattice with quantum phase path dispersion present, is analyzed. A decision diagram for the task is presented and analyzed.

  13. Robotics, Ethics, and Nanotechnology

    NASA Astrophysics Data System (ADS)

    Ganascia, Jean-Gabriel

    It may seem out of character to find a chapter on robotics in a book about nanotechnology, and even more so a chapter on the application of ethics to robots. Indeed, as we shall see, the questions look quite different in these two fields, i.e., in robotics and nanoscience. In short, in the case of robots, we are dealing with artificial beings endowed with higher cognitive faculties, such as language, reasoning, action, and perception, whereas in the case of nano-objects, we are talking about invisible macromolecules which act, move, and duplicate unseen to us. In one case, we find ourselves confronted by a possibly evil double of ourselves, and in the other, a creeping and intangible nebula assails us from all sides. In one case, we are faced with an alter ego which, although unknown, is clearly perceptible, while in the other, an unspeakable ooze, the notorious grey goo, whose properties are both mysterious and sinister, enters and immerses us. This leads to a shift in the ethical problem situation: the notion of responsibility can no longer be worded in the same terms because, despite its otherness, the robot can always be located somewhere, while in the case of nanotechnologies, myriad nanometric objects permeate everywhere, disseminating uncontrollably.

  14. Robotic microsurgery optimization.

    PubMed

    Brahmbhatt, Jamin V; Gudeloglu, Ahmet; Liverneaux, Philippe; Parekattil, Sijo J

    2014-05-01

    The increased application of the da Vinci robotic platform (Intuitive Surgical Inc.) for microsurgery has led to the development of new adjunctive surgical instrumentation. In microsurgery, the robotic platform can provide high definition 12×-15× digital magnification, broader range of motion, fine instrument handling with decreased tremor, reduced surgeon fatigue, and improved surgical productivity. This paper presents novel adjunctive tools that provide enhanced optical magnification, micro-Doppler sensing of vessels down to a 1-mm size, vein mapping capabilities, hydro-dissection, micro-ablation technology (with minimal thermal spread-CO2 laser technology), and confocal microscopy to provide imaging at a cellular level. Microsurgical outcomes from the use of these tools in the management of patients with infertility and chronic groin and testicular pain are reviewed. All these instruments have been adapted for the robotic console and enhance the robot-assisted microsurgery experience. As the popularity of robot-assisted microsurgery grows, so will its breadth of instrumentation.

  15. Biologically inspired intelligent robots

    NASA Astrophysics Data System (ADS)

    Bar-Cohen, Yoseph; Breazeal, Cynthia

    2003-07-01

    Humans throughout history have always sought to mimic the appearance, mobility, functionality, intelligent operation, and thinking process of biological creatures. This field of biologically inspired technology, having the moniker biomimetics, has evolved from making static copies of human and animals in the form of statues to the emergence of robots that operate with realistic behavior. Imagine a person walking towards you where suddenly you notice something weird about him--he is not real but rather he is a robot. Your reaction would probably be "I can't believe it but this robot looks very real" just as you would react to an artificial flower that is a good imitation. You may even proceed and touch the robot to check if your assessment is correct but, as oppose to the flower case, the robot may be programmed to respond physical and verbally. This science fiction scenario could become a reality as the current trend continues in developing biologically inspired technologies. Technology evolution led to such fields as artificial muscles, artificial intelligence, and artificial vision as well as biomimetic capabilities in materials science, mechanics, electronics, computing science, information technology and many others. This paper will review the state of the art and challenges to biologically-inspired technologies and the role that EAP is expected to play as the technology evolves.

  16. Engineering robust intelligent robots

    NASA Astrophysics Data System (ADS)

    Hall, E. L.; Ali, S. M. Alhaj; Ghaffari, M.; Liao, X.; Cao, M.

    2010-01-01

    The purpose of this paper is to discuss the challenge of engineering robust intelligent robots. Robust intelligent robots may be considered as ones that not only work in one environment but rather in all types of situations and conditions. Our past work has described sensors for intelligent robots that permit adaptation to changes in the environment. We have also described the combination of these sensors with a "creative controller" that permits adaptive critic, neural network learning, and a dynamic database that permits task selection and criteria adjustment. However, the emphasis of this paper is on engineering solutions which are designed for robust operations and worst case situations such as day night cameras or rain and snow solutions. This ideal model may be compared to various approaches that have been implemented on "production vehicles and equipment" using Ethernet, CAN Bus and JAUS architectures and to modern, embedded, mobile computing architectures. Many prototype intelligent robots have been developed and demonstrated in terms of scientific feasibility but few have reached the stage of a robust engineering solution. Continual innovation and improvement are still required. The significance of this comparison is that it provides some insights that may be useful in designing future robots for various manufacturing, medical, and defense applications where robust and reliable performance is essential.

  17. Surgery with cooperative robots.

    PubMed

    Lehman, Amy C; Berg, Kyle A; Dumpert, Jason; Wood, Nathan A; Visty, Abigail Q; Rentschler, Mark E; Platt, Stephen R; Farritor, Shane M; Oleynikov, Dmitry

    2008-03-01

    Advances in endoscopic techniques for abdominal procedures continue to reduce the invasiveness of surgery. Gaining access to the peritoneal cavity through small incisions prompted the first significant shift in general surgery. The complete elimination of external incisions through natural orifice access is potentially the next step in reducing patient trauma. While minimally invasive techniques offer significant patient advantages, the procedures are surgically challenging. Robotic surgical systems are being developed that address the visualization and manipulation limitations, but many of these systems remain constrained by the entry incisions. Alternatively, miniature in vivo robots are being developed that are completely inserted into the peritoneal cavity for laparoscopic and natural orifice procedures. These robots can provide vision and task assistance without the constraints of the entry incision, and can reduce the number of incisions required for laparoscopic procedures. In this study, a series of minimally invasive animal-model surgeries were performed using multiple miniature in vivo robots in cooperation with existing laparoscopy and endoscopy tools as well as the da Vinci Surgical System. These procedures demonstrate that miniature in vivo robots can address the visualization constraints of minimally invasive surgery by providing video feedback and task assistance from arbitrary orientations within the peritoneal cavity.

  18. The problem with multiple robots

    NASA Technical Reports Server (NTRS)

    Huber, Marcus J.; Kenny, Patrick G.

    1994-01-01

    The issues that can arise in research associated with multiple, robotic agents are discussed. Two particular multi-robot projects are presented as examples. This paper was written in the hope that it might ease the transition from single to multiple robot research.

  19. Robotics and Intelligent Systems Program

    SciTech Connect

    Not Available

    1987-06-01

    This report gives brief descriptions of the projects associated with the Robotics and Intelligent Systems Program (RISP). Projects included in the report are (1) Remote Operations Demonstration Facility; (2) M-2 Servomanipulator; (3) The Advanced Servomanipulator; (4) Hostile Environment Robotic Machine Intelligence Experiment Series robots); and (5) Telerobotic Concepts. These devices have application in nuclear industry and space environments. (JDH)

  20. Heterogeneous Multi-Robot Cooperation

    DTIC Science & Technology

    1994-02-01

    the objects the robots manipulate are hazardous waste. I have not actually applied the robots to reA toxic waste spills, since they are simply small...1993] Bruce Randall Donald, James Jennings, and Daniela Rus. To- wards a theory of information invariants for cooperating autonomous mobile robots

  1. Adaptive Language Games with Robots

    NASA Astrophysics Data System (ADS)

    Steels, Luc

    2010-11-01

    This paper surveys recent research into language evolution using computer simulations and robotic experiments. This field has made tremendous progress in the past decade going from simple simulations of lexicon formation with animallike cybernetic robots to sophisticated grammatical experiments with humanoid robots.

  2. Humans and Robots. Educational Brief.

    ERIC Educational Resources Information Center

    National Aeronautics and Space Administration, Washington, DC.

    This brief discusses human movement and robotic human movement simulators. The activity for students in grades 5-12 provides a history of robotic movement and includes making an End Effector for the robotic arms used on the Space Shuttle and the International Space Station (ISS). (MVL)

  3. KC-135 materials handling robotics

    NASA Technical Reports Server (NTRS)

    Workman, Gary L.

    1991-01-01

    Robot dynamics and control will become an important issue for implementing productive platforms in space. Robotic operations will become necessary for man-tended stations and for efficient performance of routine operations in a manned platform. The current constraints on the use of robotic devices in a microgravity environment appears to be due to an anticipated increase in acceleration levels due to manipulator motion and for safety concerns. The objective of this study will be to provide baseline data to meet that need. Most texts and papers dealing with the kinematics and dynamics of robots assume that the manipulator is composed of joints separated by rigid links. However, in recent years several groups have begun to study the dynamics of flexible manipulators, primarily for applying robots in space and for improving the efficiency and precision of robotic systems. Robotic systems which are being planned for implementation in space have a number of constraints to overcome. Additional concepts which have to be worked out in any robotic implementation for a space platform include teleoperation and degree of autonomous control. Some significant results in developing a robotic workcell for performing robotics research on the KC-135 aircraft in preperation for space-based robotics applications in the future were generated. In addition, it was shown that TREETOPS can be used to simulate the dynamics of robot manipulators for both space and ground-based applications.

  4. Robotic Design for the Classroom

    NASA Technical Reports Server (NTRS)

    Culbert, Chris; Burns, Kaylynn

    2001-01-01

    This slide presentation reviews the use of robotic design to interest students in science and engineering. It describes one program, BEST, and resources that area available to design and create a robot. BEST is a competition for sixth and seventh graders that is designed to engage gifted and talented students. A couple of scenarios involving the use of a robot are outlined.

  5. Robot Technology: Implications for Education.

    ERIC Educational Resources Information Center

    Post, Paul E.; And Others

    1988-01-01

    Provides an introduction to robotic technology, and describes current robot models. Three ways of using robots in education are discussed--as exemplars of other processes, as objects of instruction, and as prosthetic aids--and selection criteria are outlined. (17 references) (CLB)

  6. Future perspectives in robotic surgery.

    PubMed

    Wedmid, Alexei; Llukani, Elton; Lee, David I

    2011-09-01

    Robotics of the current day have advanced significantly from early computer-aided design/manufacturing systems to modern master-slave robotic systems that replicate the surgeon's exact movements onto robotic instruments in the patient. • Globally >300,000 robotic procedures were completed in 2010, including ≈98,000 robot-assisted radical prostatectomies. • Broadening applications of robotics for urological procedures are being investigated in both adult and paediatric urology. • The use of the current robotic system continues to be further refined. Increasing experience has optimized port placement reducing arm collisions to allow for more expedient surgery. Improved three-dimensional camera magnification provides improved intraoperative identification of structures. • Robotics has probably improved the learning curve of laparoscopic surgery while still maintaining its patient recovery advantages and outcomes. • The future of robotic surgery will take this current platform forward by improving haptic (touch) feedback, improving vision beyond even the magnified eye, improving robot accessibility with a reduction of entry ports and miniaturizing the slave robot. • Here, we focus on the possible advancements that may change the future landscape of robotic surgery.

  7. Robotic extended pyelolithotomy for complete staghorn calculus.

    PubMed

    Sotelo, Rene; Astigueta, Juan Carlos; Giedelman, Camilo; de Andrade, Robert; Carmona, Oswaldo; Ramirez, Daniel; Clavijo, Rafael

    2010-08-01

    Staghorn stones represent a therapeutic challenge to urologists. We present our experience with laparoscopic extended pyelolithotomy for treatment of staghorn and complex renal calculi in highly selected cases. This approach provides the principles of open surgery with the advantages of minimally invasive surgery. We describe our experience with robot-assisted extended pyelolithotomy for complex coralliform calculi. Since January 2007, robotic extended pyelolithotomy has been performed by transperitoneal approach in two patients with complete coralliform lithiasis (calculi average size 8 cm). One patient had history of percutaneous nephrolithotomy. Demographic and operative data were collected. All procedures were technically successful without need for open conversion. Mean estimated blood loss was 175 ml (range 50-300 ml), and mean operative time was 150 min (range 120-150 min). A perinephric drain was employed in one patient with duration of 5 days. Postoperative imaging confirmed complete stone clearance. Robotic extended pyelolithotomy is a feasible and reproducible procedure for removal of complete and partial staghorn calculi in selected patients with complex nephrolithiasis. This approach might limit the role of open surgery for these calculi, but further publications with more cases are necessary to further define its utility.

  8. Is robotic mitral valve surgery more expensive than its conventional counterpart?

    PubMed

    Canale, Leonardo Secchin; Colafranceschi, Alexandre Siciliano

    2015-06-01

    A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was 'Is robotic mitral valve surgery more expensive than its conventional counterpart?' Altogether 19 papers were found using the reported search, of which 5 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. There is a general impression in the surgical community that robotic operations might incur prohibitive additional costs. There is a paucity of data in the literature regarding cost analysis in cardiac robotic surgery. From the five studies, four were single institution experiences and one was a database inquiry study. These four studies showed that operational costs are higher for robotic cases but this was partially (one study) or completely (three studies) offset by lower postoperative costs. Overall hospital costs were similar between the two approaches in three studies and one study showed higher costs in the robotic group. Higher operating theatre (OT) costs were driven mainly by use of robotic instruments (approximately US$1500 per case) and longer OT times. Savings in postoperative care were driven by shorter length of hospital stay (on average 2 days fewer in robotic cases) and lower morbidity. If amortization cost, that is, the value of the initial capital investment on the robotic system divided by all operations performed, is included in this analysis, robotic approach becomes significantly more expensive by approximately US$3400 per case. The fifth study was a large national database inquiry in which robotic approach was found to be more expensive by US$600 per case excluding amortization cost and by US$3700 if amortization is included. We conclude that the total hospital cost of robotic mitral valve surgery is slightly higher than conventional sternotomy surgery. If

  9. Human-Robot Interaction

    NASA Technical Reports Server (NTRS)

    Rochlis-Zumbado, Jennifer; Sandor, Aniko; Ezer, Neta

    2012-01-01

    Risk of Inadequate Design of Human and Automation/Robotic Integration (HARI) is a new Human Research Program (HRP) risk. HRI is a research area that seeks to understand the complex relationship among variables that affect the way humans and robots work together to accomplish goals. The DRP addresses three major HRI study areas that will provide appropriate information for navigation guidance to a teleoperator of a robot system, and contribute to the closure of currently identified HRP gaps: (1) Overlays -- Use of overlays for teleoperation to augment the information available on the video feed (2) Camera views -- Type and arrangement of camera views for better task performance and awareness of surroundings (3) Command modalities -- Development of gesture and voice command vocabularies

  10. Transoral Robotic Surgery.

    PubMed

    Yee, Shokjean

    2017-01-01

    Transoral robotic surgery (TORS) is a technique used to treat oral, throat, and skull base cancers using a minimally invasive robotic approach through the mouth and throat. The TORS procedure allows deeper access and dissection of suspicious lesions and neoplastic growths in the oral cavity and those that extend from the throat to the base of the skull. Robotic surgery allows the surgeon to operate in tight spaces without a large open incision. This article discusses symptoms and risk factors of oral, throat, and skull base cancers; types of procedures that can be performed using the TORS approach; specialized instrumentation; patient selection; surgical advantages and disadvantages; patient benefits; and the role of the surgical team in preparing to intraoperatively care for the TORS patient.

  11. Advanced mechanisms for robotics

    NASA Technical Reports Server (NTRS)

    Vranish, John M.

    1992-01-01

    An overview of applied research and development at NASA-Goddard (GSFC) on mechanisms and the collision avoidance skin for robots is presented. First the work on robot end effectors is outlined, followed by a brief discussion on robot-friendly payload latching mechanisms and compliant joints. This, in turn, is followed by the collision avoidance/management skin and the GSFC research on magnetostrictive direct drive motors. Finally, a new project, the artificial muscle, is introduced. Each of the devices is described in sufficient detail to permit a basic understanding of its purpose, fundamental principles of operation, and capabilities. In addition, the development status of each is reported along with descriptions of breadboards and prototypes and their test results. In each case, the implications of the research for commercialization is discussed. The chronology of the presentation will give a clear idea of both the evolution of the R&D in recent years and its likely direction in the future.

  12. The universal robot

    NASA Technical Reports Server (NTRS)

    Moravec, Hans

    1993-01-01

    Our artifacts are getting smarter, and a loose parallel with the evolution of animal intelligence suggests one future course for them. Computerless industrial machinery exhibits the behavioral flexibility of single-celled organisms. Today's best computer-controlled robots are like the simpler invertebrates. A thousand-fold increase in computer power in the next decade should make possible machines with reptile-like sensory and motor competence. Properly configured, such robots could do in the physical world what personal computers now do in the world of data - act on our behalf as literal-minded slaves. Growing computer power over the next half-century will allow this reptile stage to be surpassed, in stages producing robots that learn like mammals, model their world like primates, and eventually reason like humans. Depending on your point of view, humanity will then have produced a worthy successor, or transcended some of its inherited limitations and so transformed itself into something quite new.

  13. ISS Robotic Student Programming

    NASA Technical Reports Server (NTRS)

    Barlow, J.; Benavides, J.; Hanson, R.; Cortez, J.; Le Vasseur, D.; Soloway, D.; Oyadomari, K.

    2016-01-01

    The SPHERES facility is a set of three free-flying satellites launched in 2006. In addition to scientists and engineering, middle- and high-school students program the SPHERES during the annual Zero Robotics programming competition. Zero Robotics conducts virtual competitions via simulator and on SPHERES aboard the ISS, with students doing the programming. A web interface allows teams to submit code, receive results, collaborate, and compete in simulator-based initial rounds and semi-final rounds. The final round of each competition is conducted with SPHERES aboard the ISS. At the end of 2017 a new robotic platform called Astrobee will launch, providing new game elements and new ground support for even more student interaction.

  14. The universal robot

    NASA Astrophysics Data System (ADS)

    Moravec, Hans

    1993-12-01

    Our artifacts are getting smarter, and a loose parallel with the evolution of animal intelligence suggests one future course for them. Computerless industrial machinery exhibits the behavioral flexibility of single-celled organisms. Today's best computer-controlled robots are like the simpler invertebrates. A thousand-fold increase in computer power in the next decade should make possible machines with reptile-like sensory and motor competence. Properly configured, such robots could do in the physical world what personal computers now do in the world of data - act on our behalf as literal-minded slaves. Growing computer power over the next half-century will allow this reptile stage to be surpassed, in stages producing robots that learn like mammals, model their world like primates, and eventually reason like humans. Depending on your point of view, humanity will then have produced a worthy successor, or transcended some of its inherited limitations and so transformed itself into something quite new.

  15. FIRST robots compete

    NASA Technical Reports Server (NTRS)

    2000-01-01

    FIRST teams and their robots work to go through the right motions at the FIRST competition. Students from all over the country are at the KSC Visitor Complex for the FIRST (For Inspiration and Recognition of Science and Technology) Southeast Regional competition March 9-11 in the Rocket Garden. Teams of high school students are testing the limits of their imagination using robots they have designed, with the support of business and engineering professionals and corporate sponsors, to compete in a technological battle against other schools' robots. Of the 30 high school teams competing, 16 are Florida teams co-sponsored by NASA and KSC contractors. Local high schools participating are Astronaut, Bayside, Cocoa Beach, Eau Gallie, Melbourne, Melbourne Central Catholic, Palm Bay, Rockledge, Satellite, and Titusville.

  16. Partial porcine kidney resection in vivo using a 1.92 μm fiber laser system

    NASA Astrophysics Data System (ADS)

    Theisen-Kunde, Dirk; Tedsen, Sönke; Danicke, Veit; Brinkmann, Ralf

    2009-07-01

    A cw Laser system (Medical Laser Centre Lübeck GmbH, Germany) emitting a wavelength at 1.92μm and a laser power up to 50 W was used for partial porcine renal parenchyma resection and hemi nephrectomy. Laser radiation (30 Watt) was transmitted via 365μm fiber with polished distal fiber tip which was fixed in a stainless steel tube. Power density at the distal fiber tip was 28.6 kW/cm2. On 3 kidneys a partial renal parenchyma resection without opening of the renal pelvis was performed (Group A). On 8 kidneys a hemi nephrectomy with opening of the renal pelvis was performed (Group B). Total resection time including haemostasis of the remaining tissue was 501 +/- 103 s in group "A" and 730 +/- 415 s in group "B". Blood lost was 28 +/- 3 ml in group "A" and 98 +/- 73 ml in group "B". The ischemic time for the kidneys in group "B" was 157 s in average, while for group "A" no ligation was necessary at all. Healing process was observed over 3 weeks, survival rate was 100 %, no inflammation or renal fistulas were found. In conclusion, the first experiments show that the 1.92 μm Laser-System is a very promising device for bloodless and fast kidney resection.

  17. Put Your Robot In, Put Your Robot Out: Sequencing through Programming Robots in Early Childhood

    ERIC Educational Resources Information Center

    Kazakoff, Elizabeth R.; Bers, Marina Umaschi

    2014-01-01

    This article examines the impact of programming robots on sequencing ability in early childhood. Thirty-four children (ages 4.5-6.5 years) participated in computer programming activities with a developmentally appropriate tool, CHERP, specifically designed to program a robot's behaviors. The children learned to build and program robots over three…

  18. Mobile robot trajectory tracking using noisy RSS measurements: an RFID approach.

    PubMed

    Miah, M Suruz; Gueaieb, Wail

    2014-03-01

    Most RF beacons-based mobile robot navigation techniques rely on approximating line-of-sight (LOS) distances between the beacons and the robot. This is mostly performed using the robot's received signal strength (RSS) measurements from the beacons. However, accurate mapping between the RSS measurements and the LOS distance is almost impossible to achieve in reverberant environments. This paper presents a partially-observed feedback controller for a wheeled mobile robot where the feedback signal is in the form of noisy RSS measurements emitted from radio frequency identification (RFID) tags. The proposed controller requires neither an accurate mapping between the LOS distance and the RSS measurements, nor the linearization of the robot model. The controller performance is demonstrated through numerical simulations and real-time experiments.

  19. Embedding knowledge in robot controllers

    SciTech Connect

    Puttre, M.

    1994-06-01

    This article reports that finding the right robot for a task and programming it remain key issues facing the industry. Developers, meanwhile, are striving to embed more applications knowledge in robot controllers using high-level languages and autonomy. Although robot components such as motors, arms, and sensors have become highly advanced, the control software and systems integration necessary to support rapidly configurable factory settings have been slow to emerge. The requirements for industrial robots currently are geared more toward performance than autonomy. However, as agile manufacturing issues gain importance, robot flexibility will also become an important requirement.

  20. Robust Software Architecture for Robots

    NASA Technical Reports Server (NTRS)

    Aghazanian, Hrand; Baumgartner, Eric; Garrett, Michael

    2009-01-01

    Robust Real-Time Reconfigurable Robotics Software Architecture (R4SA) is the name of both a software architecture and software that embodies the architecture. The architecture was conceived in the spirit of current practice in designing modular, hard, realtime aerospace systems. The architecture facilitates the integration of new sensory, motor, and control software modules into the software of a given robotic system. R4SA was developed for initial application aboard exploratory mobile robots on Mars, but is adaptable to terrestrial robotic systems, real-time embedded computing systems in general, and robotic toys.