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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. Robotic partial nephrectomy: current technique and outcomes.

    PubMed

    Wang, Liang; Lee, Benjamin R

    2013-09-01

    Over the past decade, management of the T1 renal mass has focused on nephron-sparing surgery. Robotic partial nephrectomy has played an increasing role in the technique of preserving renal function by decreasing warm ischemia time, as well as optimizing outcomes of hemorrhage and fistula. Robot-assisted partial nephrectomy is designed to provide a minimally-invasive nephron-sparing surgical option utilizing reconstructive capability, decreasing intracorporeal suturing time, technical feasibility and safety. Ultimately, its benefits are resulting in its dissemination across institutions. Articulated instrumentation and three-dimensional vision facilitate resection, collecting system reconstruction and renorrhaphy, leading to decreased warm ischemia time while preserving oncological outcomes. The aim of the present review was to present our surgical sequence and technique, as well as review the current status of robot-assisted partial nephrectomy.

  3. Is robotic partial nephrectomy convenient for solitary kidney?

    PubMed

    Kaouk, Jihad H; Malkoç, Ercan

    2016-09-01

    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

  4. 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

  5. Robot-assisted laparoscopic partial nephrectomy during pregnancy.

    PubMed

    Park, Sung Yul; Ham, Won Sik; Jung, Hyun Jin; Jeong, Wooju; Kim, Won Tae; Rha, Koon Ho

    2008-09-01

    We present a case of a 36-year-old pregnant woman with renal cell carcinoma who underwent a successful robot-assisted laparoscopic partial nephrectomy (RLPN) at 14 weeks gestational age. The operative time, including da Vinci™ setup, was 165 min. The warm ischemic time was 28 min, and the estimated blood loss was 100 ml. The final pathologic evaluation was conventional-type renal cell carcinoma with Fuhrman nuclear grade 3, stage T1a disease with a negative margin. The remainder of the pregnancy was uneventful. Although previous cases of laparoscopic nephrectomy performed during pregnancy have been reported, this is the first case in which it has been performed using robotics. RLPN during pregnancy can be a safe and feasible alternative to open and laparoscopic surgery. PMID:27628260

  6. Robotic partial nephrectomy: a multi-institutional analysis.

    PubMed

    Rogers, C G; Menon, M; Weise, E S; Gettman, M T; Frank, I; Shephard, D L; Abrahams, H M; Green, J M; Savatta, D J; Bhayani, S B

    2008-09-01

    Laparoscopic partial nephrectomy for kidney tumors has demonstrated durable oncologic and functional outcomes. The feasibility of robotic partial nephrectomy (RPN) has been demonstrated in several small, single-institution studies. We performed a large, multi-institutional analysis to determine early oncologic results and perioperative outcomes after RPN. Between October, 2002 and September, 2007, 148 patients underwent RPN at six different centers by nine different primary surgeons for localized renal tumors. Medical and operative records were reviewed for clinical characteristics, pathologic findings, and follow-up information. A total of 148 patients underwent RPN. Mean tumor size was 2.8 cm. Renal hilar clamping was utilized in 120 patients, with a mean warm ischemia time of 27.8 min. Positive surgical margins were identified in six patients (4%), of which two had cautery artifact obscuring the margin after off-clamp cautery excision and one underwent completion radical nephrectomy with no evidence of cancer. There is no evidence of tumor recurrence at mean follow-up of 7.2 months (range 2-54 months) overall, and mean follow-up of 18 months (range 12-23 months) for patients with positive surgical margin. Complications occurred in nine patients (6.1%), including hematoma requiring drainage (n = 1), prolonged ileus (n = 3), pulmonary embolus (n = 2), prolonged urine leak (n = 2), and rhabdomyolysis (n = 1). Two patients underwent open conversion for failure to progress, one patient with morbid obesity and one patient with adhesions from prior ureterolithotomy. Mean hospital stay was 1.9 days. In this multi-institutional series of surgeons beginning their initial experience in RPN, the procedure is a feasible option for minimally invasive, nephron-sparing surgery, with immediate oncologic results and perioperative outcomes comparable with more mature laparoscopic series. PMID:27628250

  7. A Single Surgeon's Experience with Open, Laparoscopic, and Robotic Partial Nephrectomy.

    PubMed

    Klaassen, Zachary; Kohut, Robert M; Patel, Dhruti; Terris, Martha K; Madi, Rabii

    2014-01-01

    Objective. To report the perioperative outcomes of patients treated with partial nephrectomy by a single surgeon using three surgical modalities-open, laparoscopic, and robotic. Methods. Between August 2006 and February 2012, 106 consecutive patients underwent open partial nephrectomy (OPN) (n = 23), laparoscopic partial nephrectomy (LPN) (n = 48), and robotic partial nephrectomy (RPN) (n = 35) by a single surgeon. Clinical variables, operative parameters, and renal functional outcomes were analyzed. Results. Preoperative patient characteristics were similar except for baseline glomerular filtration rate (GFR), which was highest in the RPN group (P = 0.004). Surgery time was longest in the RPN group (244 minutes) and shortest in the OPN group (163 minutes, P < 0.0001). Patients who had OPN had the highest incidence of 30-day complications (30%), while the RPN approach had the lowest (14%, P = 0.008). Conclusions. When performed by a single surgeon, robotic partial nephrectomy appears to be associated with fewer complications than both open and laparoscopic partial nephrectomy. Kidney function was not affected by surgical approach.

  8. The Effect of the Diffusion of the Surgical Robot on the Hospital-level Utilization of Partial Nephrectomy

    PubMed Central

    Sivarajan, Ganesh; Taksler, Glen B.; Walter, Dawn; Gross, Cary P.; Sosa, Raul E.; Makarov, Danil V.

    2015-01-01

    Introduction The rapid diffusion of the surgical robot has been controversial because of the technology’s high costs and its disputed marginal benefit. Some, however, have suggested that adoption of the robot may have improved care for patients with renal malignancy by facilitating partial nephrectomy, an underutilized, technically challenging procedure believed to be less morbid than radical nephrectomy. We sought to determine whether institutional acquisition of the robot was associated with increased utilization of partial nephrectomy. Methods We used all payer data from 7 states to identify 21,569 nephrectomies. These patient-level records were aggregated to the hospital-level then merged with the American Hospital Association Annual Survey and publicly available data on timing of robot acquisition. We used a multivariable difference-in-difference model to assess at the hospital-level whether robot acquisition was associated with an increase in the proportion of partial nephrectomy, adjusting for hospital nephrectomy volume, year of surgery, and several additional hospital-level factors. Results In the multivariable-adjusted differences-in-differences model, hospitals acquiring a robot between 2001 and 2004 performed a greater proportion of partial nephrectomy in both 2005 (29.9% increase) and 2008 (34.9% increase). Hospitals acquiring a robot between 2005 and 2008 also demonstrated a greater proportion of partial nephrectomy in 2008 (15.5% increase). In addition, hospital nephrectomy volume and urban location were also significantly associated with increased proportion of partial nephrectomy. Conclusions Hospital acquisition of the surgical robot is associated with greater proportion of partial nephrectomy, an underutilized, guideline-encouraged procedure. This is one of the few studies to suggest robot acquisition is associated with improvement in quality of patient care. PMID:25494234

  9. 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.

  10. Auto localization and segmentation of occluded vessels in robot-assisted partial nephrectomy.

    PubMed

    Amir-Khalili, Alborz; Peyrat, Jean-Marc; Abinahed, Julien; Al-Alao, Osama; Al-Ansari, Abdulla; Hamarneh, Ghassan; Abugharbieh, Rafeef

    2014-01-01

    Hilar dissection is an important and delicate stage in partial nephrectomy during which surgeons remove connective tissue surrounding renal vasculature. Potentially serious complications arise when vessels occluded by fat are missed in the endoscopic view and are not appropriately clamped. To aid in vessel discovery, we propose an automatic method to localize and label occluded vasculature. Our segmentation technique is adapted from phase-based video magnification, in which we measure subtle motion from periodic changes in local phase information albeit for labeling rather than magnification. We measure local phase through spatial decomposition of each frame of the endoscopic video using complex wavelet pairs. We then assign segmentation labels based on identifying responses of regions exhibiting temporal local phase changes matching the heart rate frequency. Our method is evaluated with a retrospective study of eight real robot-assisted partial nephrectomies demonstrating utility for surgical guidance that could potentially reduce operation times and complication rates.

  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. Robotic versus Open Partial Nephrectomy: A Systematic Review and Meta-Analysis

    PubMed Central

    Cai, Chen; Ye, Huamao; Lv, Chen; Yang, Qing; Sheng, Jing; Song, Shangqing; Qu, Le; Xiao, Liang; Sun, Yinghao; Wang, Linhui

    2014-01-01

    Objectives To critically review the currently available evidence of studies comparing robotic partial nephrectomy (RPN) and open partial nephrectomy (OPN). Materials and Methods A comprehensive review of the literature from Pubmed, Web of Science and Scopus was performed in October 2013. All relevant studies comparing RPN with OPN were included for further screening. A cumulative meta-analysis of all comparative studies was performed and publication bias was assessed by a funnel plot. Results Eight studies were included for the analysis, including a total of 3418 patients (757 patients in the robotic group and 2661 patients in the open group). Although RPN procedures had a longer operative time (weighted mean difference [WMD]: 40.89; 95% confidence interval [CI], 14.39–67.40; p = 0.002), patients in this group benefited from a lower perioperative complication rate (19.3% for RPN and 29.5% for OPN; odds ratio [OR]: 0.53; 95%CI, 0.42–0.67; p<0.00001), shorter hospital stay (WMD: −2.78; 95%CI, −3.36 to −1.92; p<0.00001), less estimated blood loss(WMD: −106.83; 95%CI, −176.4 to −37.27; p = 0.003). Transfusions, conversion to radical nephrectomy, ischemia time and estimated GFR change, margin status, and overall cost were comparable between the two techniques. The main limitation of the present meta-analysis is the non-randomization of all included studies. Conclusions RPN appears to be an efficient alternative to OPN with the advantages of a lower rate of perioperative complications, shorter length of hospital stay and less blood loss. Nevertheless, high quality prospective randomized studies with longer follow-up period are needed to confirm these findings. PMID:24740259

  13. Robotic partial nephrectomy for caliceal diverticulum: a single-center case series.

    PubMed

    Akca, Oktay; Zargar, Homayoun; Autorino, Riccardo; Brandao, Luis Felipe; Laydner, Humberto; Samarasekera, Dinesh; Krishnan, Jayram; Noble, Mark; Haber, George-Pascal; Kaouk, Jihad H; Stein, Robert J

    2014-08-01

    The aim of this study is to examine the role of robotic partial nephrectomy (RPN) in the management of caliceal diverticula by assessing our single-center outcomes. Between July 2007 and July 2013, 7 of 670 patients underwent RPN procedures as a reason of caliceal diverticula. The indications for RPN in all cases were recurrent urinary tract infection and pain attributed to the diverticulum in addition to failed management by endourologic or extracorporeal shockwave lithotripsy (SWL) treatments. One patient with a calcified diverticulum and another with an unsuccessful SWL treatment underwent RPN without further endourologic intervention. The other five patients had a history of unsuccessful percutaneous nephrolithotomy (one case), ureteroscopy (URS) (two cases), and a combination of SWL+URS (two cases). No intraoperative or postoperative complications were observed. No patient was readmitted postoperatively. Unique features of the robotic platform facilitate the excision of diverticulum and subsequent kidney reconstruction for this benign, but complex pathology.

  14. The role of the assistant during robot-assisted partial nephrectomy: does experience matter?

    PubMed

    Potretzke, Aaron M; Knight, Brent A; Brockman, John A; Vetter, Joel; Figenshau, Robert S; Bhayani, Sam B; Benway, Brian M

    2016-06-01

    The objective of this study was to evaluate surgical outcomes with respect to the experience level of the bedside assistant during robot-assisted partial nephrectomy. A retrospective review was conducted of a prospectively maintained database of 414 consecutive robot-assisted laparoscopic partial nephrectomies performed by experienced robotic surgeons at our institution from April 2011 to September 2014. A senior-level assistant was defined as a resident in his or her post-graduate year (PGY) 4 or 5, or a fellow. Junior-level assistants were considered to be PGY-2, PGY-3, or a nurse first assistant. Multivariate analyses were performed using linear, Poisson, and logistic regression models. There were 115 junior-level cases and 299 senior-level cases. On univariate analysis, the experience level of the assistant had no impact on operative time (168 for junior level vs. 163 min for senior level, p = 0.656). Likewise, there were no differences between the junior- and senior-level groups with regard to warm ischemia time (21.3 vs. 20.9 min, p = 0.843), negative margin status (111/115 (96.5 %) vs. 280/299 (93.6 %), p = 0.340), or postoperative complications (17/115 (14.8 %) vs. 35/299 (11.7 %), p = 0.408). After multivariate analysis, operative time was associated with increased body mass index and tumor size (both p < 0.001), but not with resident experience level (p = 0.051). Estimated blood loss and postoperative complications were also not associated with the PGY of the assistant (p = 0.488 and p = 0.916, respectively). Despite common concern, the PGY status of a physician trainee serving as the bedside assistant does not appear to influence the outcomes of robot-assisted partial nephrectomy at a high-volume center. PMID:27039192

  15. Robot-assisted partial nephrectomy: analysis of the first 100 cases from a single institution.

    PubMed

    Tobis, Scott; Venigalla, Sriram; Knopf, Joy K; Scosyrev, Emelian; Erturk, Erdal N; Golijanin, Dragan J; Joseph, Jean V; Rashid, Hani; Wu, Guan

    2012-06-01

    Robot-assisted partial nephrectomy (RAPN) is an alternative to open and laparoscopic partial nephrectomy for small renal tumors. Our objectives were to report our experience and short-term outcomes from the first 100 cases of robot-assisted partial nephrectomy (RAPN) performed at a single institution, as well as to evaluate the effect of the learning curve and identify any factors associated with adverse perioperative outcomes. Patient records of the first 100 RAPN cases performed by three surgeons between October 2007 and March 2010 were retrospectively reviewed. The cases were divided into two groups to analyze a possible learning curve effect. Group 1 consisted of the first half (chronologically) of the cases performed by each surgeon, and Group 2 consisted of the second half. For the entire series, the median warm ischemia time was 24 min (range 11-49), mean length of follow-up was 13.4 months, and the median postoperative change in glomerular filtration rate (GFR) was -6.6 mL/min/1.73 m(2). Three patients had microscopically positive margins on final pathology, three intraoperative complications occurred, and 13 postoperative complications were recorded (10 Clavien grade IIIa or less). Median operative time was significantly longer in Group 1 (193 min) than in Group 2 (165 min, P = 0.003). Multivariate analysis identified male gender and cases done in Group 1 to be associated with increased operative time, while male gender and higher nephrometry scores were associated with increased blood loss. Tumor characteristics associated with greater reductions in GFR included higher nephrometry scores, endophytic tumors, and hilar tumors. In conclusion, RAPN appears to be safe and the major effect of the learning curve appears to be on operative time. Warm ischemia times are sufficiently low to prevent significant renal impairment, while male gender and higher nephrometry scores may be predictors of longer operative times and more intraoperative blood loss

  16. Simultaneous bilateral robotic partial nephrectomy: Case report and critical evaluation of the technique.

    PubMed

    Giberti, Claudio; Gallo, Fabrizio; Schenone, Maurizio; Cortese, Pierluigi

    2014-06-16

    We report our first simultaneous bilateral robot assisted partial nephrectomy (RAPN) in order to show and critically discuss the feasibility of this procedure. Materials and methods A 69-year-old male patient visited our department due to incidental finding of bilateral mesorenal small masses (2.5 cm on the right and 3.5 cm on the left) suspicious for malignancy. We started from the right side with patient in flank position. Port placement: 12-mm periumbilical camera port, two 8-mm robotic ports in wide ''V''configuration, additional 12 mm assistant port on the midline between the umbilicus and symphysis pubis. A right unclamping RAPN with sliding clip renorrhaphy was performed. The trocars were removed and the robot undocked. Without interrupting the anesthesiological procedures, the patient was reported in supine position and, after 180 degrees rotation of the surgical bed, was newly placed in contralateral flank position. Using both the previous periumbilical and midline ports, two other 8-mm robotic trocars were placed. The robot was then redocked and RAPN was also performed on the left side using the same previously reported technique. Results Total time: 285 min. Estimated blood losses: 150 cc. Postoperative period: uneventful. Pathological examination: bilateral renal cell carcinoma, negative surgical margins. Conclusions Our experience was encouraging and confirmed the feasibility and safety of this procedure. The planning of our technique was time and cost effective with cosmetic benefit for the patient. However, we think that an appropriate selection of the patients and a skill in robotic renal surgery are advisable before approaching this type of surgery.

  17. The Washington University Renorrhaphy for robotic partial nephrectomy: a detailed description of the technique displayed at the 2008 World Robotic Urologic Symposium.

    PubMed

    Bhayani, Sam B; Figenshau, Robert S

    2008-09-01

    Robotic partial nephrectomy is an emerging procedure. The Washington University Renorrhaphy involves robotic assistance, rapid closure of the collecting system, and renorrhaphy with sliding nonabsorbable clips. Bolsters are rarely used. Preliminary results have shown very short ischemic times with few complications. This communication offers a short video describing the renorrhaphy. PMID:27628249

  18. 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.

  19. Partial nephrectomy in a patient with dwarfism.

    PubMed

    Farber, Nicholas J; Dubin, Justin; Parihar, Jaspreet; Han, Chris; Lasser, Michael S

    2016-08-01

    We describe the case of a 50-year-old male with achondroplastic dwarfism who presents with a renal mass in his left kidney concerning for renal cell carcinoma. The patient successfully underwent a robotic partial nephrectomy, which revealed a T1a renal cell carcinoma. The tumor was excised successfully without any intraoperative complications demonstrating that a robotic partial nephrectomy is technically both safe and effective in patients with achondroplastic dwarfism. PMID:27544562

  20. 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

  1. Can selective arterial clamping with fluorescence imaging preserve kidney function during robotic partial nephrectomy?

    PubMed Central

    McClintock, Tyler R.; Bjurlin, Marc A.; Wysock, James S.; Borofsky, Michael S.; Marien, Tracy P.; Okoro, Chinonyerem; Stifelman, Michael D.

    2015-01-01

    Objectives To compare renal functional outcomes in robotic partial nephrectomy (RPN) with selective arterial clamping guided by near infrared fluorescence (NIRF) imaging to a matched cohort of patients who underwent RPN without selective arterial clamping and NIRF imaging. Methods From April 2011 to December 2012, NIRF imaging-enhanced RPN with selective clamping was utilized in 42 cases. Functional outcomes of successful cases were compared with a cohort of patients, matched by tumor size, preoperative eGFR, functional kidney status, age, sex, body mass index, and American Society of Anesthesiologists score, who underwent RPN without selective clamping and NIRF imaging. Results In matched-pair analysis, selective clamping with NIRF was associated with superior kidney function at discharge, as demonstrated by postoperative eGFR (78.2 vs 68.5 ml/min per 1.73m2; P=0.04), absolute reduction of eGFR (−2.5 vs −14.0 ml/min per 1.73m2; P<0.01) and percent change in eGFR (−1.9% vs −16.8%, P<0.01). Similar trends were noted at three month follow up but these differences became non-significant (P[eGFR]=0.07], P[absolute reduction of eGFR]=0.10, and P[percent change in eGFR]=0.07). In the selective clamping group, a total of four perioperative complications occurred in three patients, all of which were Clavien I-III. Conclusion Utilization of NIRF imaging was associated with improved short-term renal functional outcomes when compared to RPN without selective arterial clamping and NIRF imaging. With this effect attenuated at later follow-up, randomized prospective studies and long-term assessment of kidney-specific functional outcomes are needed to further assess the benefits of this technology. PMID:24909960

  2. [Laparoscopic robot-assisted partial nephrectomy with total ureterectomy in a symptomatic complete duplicated system: advantages of transperitoneal approach].

    PubMed

    Tostivint, V; Doumerc, N; Roumiguie, M; Beauval, J-B; Rischmann, P; Soulie, M; Galinier, P; Bouali, O

    2014-10-01

    We report the case of a laparoscopic robot assisted left upper polar partial nephrectomy with total ureterectomy performed in a teenager. A 14 year-old girl was referred to our institution for stress urinary incontinence. The morphological assessment (ultrasound scan and uro-MRI) showed a double collecting system with a complete ureteral duplication complicated by a dysplasia of the upper moiety of the duplex left kidney and a mega ureter. The surgery started on a lateral decubitus position by the upper polar partial nephrectomy and the ureter section behind superior polar renal vessels. The patient was placed in a supine position and the mega ureter was released and sectioned at the level of the distal adynamic segment in the left uterine parameter. The transperitoneal route was chosen as it provides a large workspace and allows the dissection of the ureters into their pelvic portion by a simple repositioning of the robot ports without additional incision and without any modification of the operative field. No intraoperative and postoperative complication was noticed. Laparoscopic robotic assisted surgery in pediatric urology is increasing, and to our knowledge, we reported this technique and surgery for the first time in France and in children. In the reported case, we showed that the robotic minimally invasive surgery in children is an innovative and safe technique for the treatment of symptomatic upper urinary tract malformations. PMID:25176144

  3. Comparison of the Width of Peritumoral Surgical Margin in Open and Robotic Partial Nephrectomy: A Propensity Score Matched Analysis

    PubMed Central

    Oh, Jong Jin; Lee, Jung Keun; Kim, Kwangmo; Byun, Seok-Soo; Lee, Sang Eun

    2016-01-01

    Background To compare the surgical margin status after open partial nephrectomy (OPN) and robotic partial nephrectomy (RPN) performed in patients with T1a renal cell carcinoma (RCC). Methods This was a propensity score-matched study including 702 patients with cT1a RCC treated with partial nephrectomy (PN) between May 2003 and July 2015. Perioperative parameters, including surgical margin width after PN, were compared between two surgical methods. After determining propensity score for tumor size and location, the width of peritumoral surgical margin was investigated. Multivariate logistic analysis to predict peritumoral surgical margin less than 1mm was analyzed. Results The mean width of peritumoral surgical margin was 2.61 ± 2.15 mm in OPN group (n = 385), significantly wider than the 2.29 ± 2.00 mm of RPN group (n = 317) (p = 0.042). The multivariate analysis showed surgical methods was significant factors to narrow surgical margin less than 1mm (p = 0.031). After propensity score matching, the surgical margin width was significantly longer in OPN (2.67 ± 2.14 mm) group than RPN (2.25 ± 2.03 mm) group (p = 0.016). A positive resection margin occurred in 7 (1.8%) patients in the OPN group and 4 (1.3%) in the RPN group. During the median follow-up of 48.3 months, two patients who underwent OPN had tumor bed recurrence. Conclusions RPN may result in a narrower peritumoral surgical margin than OPN. Further investigation on the potential impact of such a phenomenon should be performed in a larger-scale study. PMID:27336438

  4. Using a Harmonic Scalpel “Drilling and Clamping” Method to Implement Zero Ischemic Robotic-assisted Partial Nephrectomy

    PubMed Central

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

    2016-01-01

    Abstract 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. PMID:26817867

  5. 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

  6. [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.

  7. Partial nephrectomy: an option in calculus disease?

    PubMed

    Timoney, A G; Payne, S R; Walmsley, B H; Vinnicombe, J; Abercrombie, G F

    1988-12-01

    Thirty-seven patients treated by partial nephrectomy for calculus disease between 1971 and 1986 were reviewed retrospectively. Of the 25 patients available for analysis, 20% developed immediate surgical complications, 20% had residual post-operative stone and 33% developed true ipsilateral stone recurrence during the period of follow-up. Our results from partial nephrectomy for calculus disease are compared with the results of treatment by percutaneous nephrolithotomy and extracorporeal shockwave lithotripsy. It was concluded that partial nephrectomy should be reserved for situations where stone disease is associated with anatomical abnormalities which cannot be treated by the newer modalities of stone management.

  8. 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. PMID:26817867

  9. Achieving zero ischemia in minimally invasive partial nephrectomy surgery.

    PubMed

    Hou, Weibin; Ji, Zhigang

    2015-06-01

    Widespread application of the minimally invasive partial nephrectomy (MIPN) techniques like laparoscopic and robotic partial nephrectomy, has been limited by concerns about prolonged warm ischemia. So techniques aiming at performing have been actively explored. A systemic review of literatures on the MIPN without hilar clamping was performed and related methods were summarized. There are mainly seven methods including selective/segmental renal artery clamping technique, selective renal parenchymal clamping technique, targeted renal blood flow interruption technique, laser supported MIPN, radio frequency assisted MIPN, hydro-jet assisted MIPN, and sequential preplaced suture renorrhaphy technique that have been undergoing enthusiastic investigation for achieving MINP without hilar clamping. All of these emerging techniques represent the exploring work to achieve a zero ischemia MIPN for small renal tumors of different characteristics. Though not perfect for any of the technique, they deserve a further assessment during their future experimental and clinical applications.

  10. Laparoscopic partial nephrectomy and wedge resection.

    PubMed

    Kozlowski, P M; Winfield, H N

    2000-12-01

    Partial nephrectomy is a more challenging operation than radical or simple nephrectomy, primarily because of the risk of complications such as bleeding. This problem is even more troublesome with minimally invasive approaches because of the dearth of effective hemostatic instruments and supplies. The location of the lesion determines whether a transperitoneal or a retroperitoneal route will be employed. Centrally located or anterior renal lesions generally are approached transperitoneally whereas peripheral lateral or posterior lesions are accessed by retroperitoneoscopy. The Harmonic Scalpel with slow cutting and high coagulation settings is useful for incising the renal capsule and parenchyma. The argon beam coagulator is helpful to stop any persistent bleeding. The few reported series of laparoscopic partial nephrectomy indicate considerably longer operative times than are needed for open surgery and hospitalization of upwards of 5 days, largely to monitor drainage and urine leakage. It is hoped that this advanced laparoscopic technique will become more user friendly with further developments in techniques and instrumentation to provide patients with the expected benefits of minimally invasive surgery.

  11. Temporary Targeted Hemostasis to Facilitate Bloodless Partial Nephrectomy

    PubMed Central

    Harty, Niall J; Moinzadeh, Alireza; Flacke, Sebastian; Pettit, Jeffrey; Benn, James A.; Libertino, John A; Madras, Peter N

    2011-01-01

    Purpose Lumagel™, a non-toxic polymer may be administered intra-arterially under fluoroscopy to obtain a bloodless operative field during partial nephrectomy while maintaining normal circulation to uninvolved renal tissue. We extend previous robotic assisted techniques developed in the swine model to studies of laparoscopic and open partial nephrectomy conducted in pigs and calves, designed to encompass vessel diameters similar to those encountered in humans. Materials and Methods 10 Animals (7 pigs, 3 calves) underwent flow interruption to the kidney, 2 with cross-clamping of the main renal artery, the remaining with Lumagel. Other than the first pig and calf, all animals then underwent partial nephrectomy. Results and Conclusions Using Lumagel, targeted blood flow interruption was achieved while circulation to uninvolved renal tissue was maintained. Hemostasis lasted for 30 minutes or more. Surgical resection averaged 11 minutes (range 10–13) and 23.3 (range 9–40) in the open and laparoscopic groups, respectively. Estimated blood loss was negligible with the exception of two cases, one in which an error in angiographic assessment lead to an unoccluded vessel near the resection site and a second case where a guide wire was inadvertently passed through a vessel. Time to complete flow return as determined by direct visualization of the kidney and its corresponding angiogram averaged 7 and 2.5 minutes for Lumagel and arterial clamping, respectively. Lumagel provides reliable and reproducible intraluminal blood flow interruption and flow restoration in both main and segmental renal arteries. By providing blood free resection, techniques described may facilitate partial nephrectomy without global renal ischemia. PMID:22137714

  12. Laparoscopic partial nephrectomy in a horseshoe kidney.

    PubMed

    Molina, Wilson R; Gill, Inderbir S

    2003-12-01

    A 68-year-old man with an incidentally found 2-cm complex enhancing cystic right renal mass in the right moiety of a horseshoe kidney was treated with a three-port retroperitoneal laparoscopic approach. The tumor was completely excised with cold Endoshears, and Surgicel bolsters were tightly buttressed into the resection bed with 0 Vicryl sutures. The warm ischemia time was 31 minutes. To our knowledge, this is the initial case of retroperitoneal laparoscopic partial nephrectomy in a horseshoe kidney. Three-dimensional CT with volume rendering in a video format provides the necessary information about the number, location, and extrarenal anatomy of the renal artery and vein.

  13. 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.

  14. Ex vivo partial nephrectomy and autotransplantation for renal cell cancer after laparoscopic renal harvest.

    PubMed

    Sokoloff, Mitchell H; Chien, Gary W; Thistlewaite, J Richard; Harland, Robert; Shalhav, Arieh L

    2004-06-01

    Laparoscopic partial nephrectomy is an alternative to the open approach. For centrally located tumors, open extracorporeal partial nephrectomy has been used. We report 2 cases of laparoscopic nephrectomy for the purpose of extracorporeal partial nephrectomy and autotransplantation for renal cell cancer.

  15. Conservative management of renal artery pseudoaneurysm following partial nephrectomy

    PubMed Central

    Dukic, I; Ali, Z; Shackley, D

    2014-01-01

    A bleeding renal artery pseudoaneurysm is a recognised complication occurring after partial nephrectomy. The bleeding is usually suspected when a patient presents with haematuria following the procedure and the reported management is with radiologically guided embolisation. We report a case of renal artery pseudoaneurysm successfully managed conservatively, giving another potential management option in non-torrential haemorrhage. PMID:24780659

  16. 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

  17. Risk Factors for Postoperative Hemorrhage After Partial Nephrectomy

    PubMed Central

    Jung, Saebin; Min, Gyeong Eun; Chung, Benjamin I.

    2014-01-01

    Purpose To evaluate the frequency and clinical characteristics of postoperative hemorrhage as a complication of partial nephrectomy. Materials and Methods The demographics, physical statistics, tumor size, R.E.N.A.L. nephrometry score, operative method, warm ischemic time, and presence of postoperative hemorrhage and its severity and method of intervention were examined in 300 partial nephrectomy patients in two medical centers (Stanford Medical Center and Kyung Hee University Medical Center) between March 2000 and March 2012. Results Of the 300 subjects, 13 (4.3%) experienced postoperative hemorrhage severe enough to require intervention more invasive than transfusion (Clavien grade III or higher). Univariate analysis of the bleeding and nonbleeding groups showed that whereas age, ischemic time, tumor size and stage, body mass index, American Society of Anesthesiologists class, and operative method did not differ significantly, the exophyticity (E) score was significantly higher for severe postoperative hemorrhage (p=0.04). However, multivariate analysis showed none of the factors to differ significantly. In most of the cases requiring intervention, selective embolization was sufficient, but in one case explorative laparotomy and nephrectomy were required. Clinical characteristics varied significantly among severe hemorrhage cases, with time of onset ranging from the first to the 30th postoperative day and symptoms presenting in a diverse manner, such as gross hematuria and pleuritic chest pain. Computed tomography and angiographic findings were consistent with either arteriovenous fistula or pseudoaneurysms. Conclusions Severe hemorrhage after partial nephrectomy is rare. Nonetheless, with the great variability in presenting symptoms and time of onset after surgery, surgeons should exercise great vigilance during the postoperative care of partial nephrectomy patients. PMID:24466392

  18. Renal transposition during minimally invasive partial nephrectomy: a safe technique for excision of upper pole tumors.

    PubMed

    Kaplan, Joshua R; Chang, Peter; Percy, Andrew G; Wagner, Andrew A

    2013-09-01

    Minimally invasive partial nephrectomy (MIPN) for upper pole masses, particularly for those located posteriorly, is challenging because of difficult visualization during tumor resection and renorrhaphy. Complete renal transposition facilitates access to and excision of upper pole renal masses during MIPN. Sixteen patients with upper pole renal masses underwent laparoscopic or robot-assisted partial nephrectomy with renal transposition from October 2009 to March 2012 with a mean follow-up of 22 months. Mean operative time was 242.6 minutes, and mean warm ischemic time was 14.7 minutes. No patient needed an intraoperative or postoperative blood transfusion. Five (31%) patients had a postoperative complication (four Clavien grade I, one Clavien grade II). There were no delayed complications, positive surgical margins, or tumor recurrences. Mean postoperative eGFR change within 3 months was -9.4%. These results show that complete renal transposition can be safely used to facilitate excision of upper pole tumors. PMID:23750561

  19. Energy sources for laparoscopic partial nephrectomy--critical appraisal.

    PubMed

    Rubinstein, Mauricio; Moinzadeh, Alireza; Colombo, Jose R; Favorito, Luciano A; Sampaio, Francisco J; Gill, Inderbir S

    2007-01-01

    Laparoscopic partial nephrectomy (LPN) has emerged as a viable alternative for the conventional open nephron-sparing surgery (NSS). So far, an adequate renal parenchymal cutting and hemostasis, as well as caliceal repair remains technically challenging. Numerous investigators have developed techniques using different energy sources to simplify the technically demanding LPN. Herein we review these energy sources, discussing perceived advantages and disadvantages of each technique.

  20. Laparoscopic Partial Nephrectomy for Renal-Cell Carcinoma During Pregnancy

    PubMed Central

    Yuruk, Emrah; Ucpinar, Burak; Binbay, Zerrin; Colakerol, Aykut; Muslumanoglu, Ahmet Yaser

    2016-01-01

    Abstract Background: The incidence of renal-cell carcinoma (RCC) is low during pregnancy. There are different approaches for timing of surgery and treatment modalities for RCC in pregnant women in the literature. To our knowledge, this is the first laparoscopic partial nephrectomy case in a pregnant woman. Case Presentation: Herein, we present a 34-year-old woman with a renal mass at her 14th gestational week. She was admitted to our clinic after a right renal mass was incidentally diagnosed during routine antenatal ultrasonography. MRI revealed a completely endophytic tumor of 6 × 6.5 × 6.5 cm, located in the upper half of the right kidney. We performed laparoscopic partial nephrectomy in our patient and the postoperative course was uneventful. Conclusion: This is the first presented laparoscopic partial nephrectomy case in a pregnant patient. Nephron-sparing surgeries can be performed laparoscopically in appropriate sized renal tumors in suitable pregnant patients. PMID:27579405

  1. 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

  2. Description of a novel technique for suture ligation of the renal vessels during robotic nephrectomy.

    PubMed

    Patel, Manish N; Laungani, Rajesh; Shrivastava, Alok; Bhandari, Akshay; Spencer Krane, L; Menon, Mani; Rogers, Craig G

    2009-03-01

    Minimally invasive techniques are frequently used for surgical treatment of suspected malignant renal masses. We previously reported on our experience with robotic nephrectomy and the feasibility of performing suture ligation of the renal vessels using robotic needle drivers. We describe a novel technique for suture ligation of the renal vessels during robotic nephrectomy utilizing the robotic hook and a suture with loops at each end. Our technique for suture ligation of the renal vessels recapitulates the open technique without the need for exchanging the robotic working instruments for robotic needle drivers and without the need for endovascular staplers. PMID:27628449

  3. Open Mini-Flank Partial Nephrectomy: An Essential Contemporary Operation

    PubMed Central

    Mano, Roy

    2014-01-01

    Secondary to the widespread use of the modern imaging techniques of computed tomography, magnetic resonance imaging, and ultrasound, 70% of renal tumors today are detected incidentally with a median tumor size of less than 4 cm. Twenty years ago, all renal tumors, regardless of size were treated with radical nephrectomy (RN). Elective partial nephrectomy (PN) has emerged as the treatment of choice for small renal tumors. The basis of this paradigm shift is three major factors: (1) cancer specific survival is equivalent for T1 tumors (7 cm or less) whether treated by PN or RN; (2) approximately 45% of renal tumors have indolent or benign pathology; and (3) PN prevents or delays the onset of chronic kidney disease, a condition associated with increased cardiovascular morbidity and mortality. Although PN can be technically demanding and associated with potential complications of bleeding, infection, and urinary fistula, the patient derived benefits of this operation far outweigh the risks. We have developed a "mini-flank" open surgical approach that is highly effective and, coupled with rapid recovery postoperative care pathways associated with a 2-day length of hospital stay. PMID:25237456

  4. Clinical results of renal artery embolization to control postoperative hemorrhage after partial nephrectomy

    PubMed Central

    Jeon, Chang Ho; Yoon, Chang Jin; Byun, Seok-Soo; Lee, Sang Eun

    2016-01-01

    Background With the wider application of nephron-sparing surgery, there has been an increase in the occurrence of postoperative hemorrhage. However, despite such an increase, there are only a limited number of reports regarding renal artery embolization (RAE) for the management of postoperative bleeding after nephron-sparing surgery, especially after robot-assisted laparoscopic partial nephrectomy (RALPN). Purpose To evaluate the safety and clinical efficacy of transcatheter RAE for postoperative hemorrhage after open partial nephrectomy (OPN) and RALPN. Material and Methods A total of 29 patients (17 men, 12 women; age range, 31–70 years) who were referred to our hospital for postoperative hemorrhage after partial nephrectomy, between December 2003 and December 2014, were selected. We retrospectively reviewed patients’ clinical data, angiographic findings, embolization details, and clinical outcomes. Results Embolization was performed in patients who underwent OPN (25/29) and RALPN (4/29). The angiographic findings were as follows: renal artery pseudoaneurysm (n = 18), contrast extravasation (n = 8), and arteriovenous fistula (n = 3). Fiber-coated microcoil and n-butyl-2-cyanoacrylate (NBCA) was administered to the targeted bleeding renal arteries in 12 and 11 patients, respectively. In six patients, fiber-coated microcoil and NBCA were used concurrently. Technical and clinical successes were achieved in all patients (100%). Bleeding cessation was achieved in all patients, and no further relevant surgeries or interventions were required for hemorrhage control. There were no episodes of hemorrhagic recurrence during the follow-up period (median, 20 days; range, 7–108 days). Conclusion Angiography and RAE identified the origin of bleeding and could successfully preserve the residual renal function. PMID:27570638

  5. Dietary protein alters tubular iron accumulation after partial nephrectomy.

    PubMed

    Nankivell, B J; Tay, Y C; Boadle, R A; Harris, D C

    1994-04-01

    Reactive oxygen species (ROS) have been implicated in progression of disease in the rat remnant kidney (RK) model of chronic renal failure. Substantial amounts of iron accumulate in proximal tubular lysosomes of RK and could damage tubules by ROS generation. The effect of dietary protein intake on ROS, tubular damage and iron accumulation assessed by energy dispersive analysis was determined in RK (5/6 nephrectomy, N = 12) and sham-operated kidneys (SO, N = 10). In RK, mean lysosomal iron concentration, urinary iron and protein excretion and morphological damage were increased and GFR decreased. Dietary protein loading (40% vs. 12%) increased the number of iron-containing lysosomes (P < 0.05) and the mean lysosomal iron (P < 0.02) in proximal tubular cells after four weeks. In RK, high protein diet increased renal weight (P < 0.01), numerical density of iron-containing lysosomes and tubular damage (both P < 0.05). ROS generation, assessed by tissue and plasma malondialdehyde (MDA), was also increased (both P < 0.05). Plasma MDA correlated with tubular iron accumulation (r = 0.75). In RK fed a high protein diet (N = 18) treatment with the iron-chelator desferrioxamine reduced serum iron, urinary volume, and tubular iron accumulation and damage compared to controls (P < 0.01). In summary, in RK dietary protein manipulation altered urinary iron and protein excretion, proximal tubular iron accumulation, renal cortical ROS generation and ultrastructural damage. Desferrioxamine treatment reduced tubular lysosomal iron and ultrastructural damage. These results suggest a role for tubular iron as a determinant of tubular injury associated with dietary protein loading in rats with partial nephrectomy.

  6. 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.

  7. A 3D-elastography-guided system for laparoscopic partial nephrectomies

    NASA Astrophysics Data System (ADS)

    Stolka, Philipp J.; Keil, Matthias; Sakas, Georgios; McVeigh, Elliot; Allaf, Mohamad E.; Taylor, Russell H.; Boctor, Emad M.

    2010-02-01

    We present an image-guided intervention system based on tracked 3D elasticity imaging (EI) to provide a novel interventional modality for registration with pre-operative CT. The system can be integrated in both laparoscopic and robotic partial nephrectomies scenarios, where this new use of EI makes exact intra-operative execution of pre-operative planning possible. Quick acquisition and registration of 3D-B-Mode and 3D-EI volume data allows intra-operative registration with CT and thus with pre-defined target and critical regions (e.g. tumors and vasculature). Their real-time location information is then overlaid onto a tracked endoscopic video stream to help the surgeon avoid vessel damage and still completely resect tumors including safety boundaries. The presented system promises to increase the success rate for partial nephrectomies and potentially for a wide range of other laparoscopic and robotic soft tissue interventions. This is enabled by the three components of robust real-time elastography, fast 3D-EI/CT registration, and intra-operative tracking. With high quality, robust strain imaging (through a combination of parallelized 2D-EI, optimal frame pair selection, and optimized palpation motions), kidney tumors that were previously unregistrable or sometimes even considered isoechoic with conventional B-mode ultrasound can now be imaged reliably in interventional settings. Furthermore, this allows the transformation of planning CT data of kidney ROIs to the intra-operative setting with a markerless mutual-information-based registration, using EM sensors for intraoperative motion tracking. Overall, we present a complete procedure and its development, including new phantom models - both ex vivo and synthetic - to validate image-guided technology and training, tracked elasticity imaging, real-time EI frame selection, registration of CT with EI, and finally a real-time, distributed software architecture. Together, the system allows the surgeon to concentrate

  8. The renal tumor morphological characteristics that affect surgical planning for laparoscopic or open partial nephrectomy.

    PubMed

    Funahashi, Yasuhito; Murotani, Kenta; Yoshino, Yasushi; Sassa, Naoto; Ishida, Shohei; Gotoh, Momokazu

    2015-02-01

    The purpose of this study is to investigate the morphological characteristics of renal tumors which affect the surgeons' decision-making for the selection of open or laparoscopic partial nephrectomy. We included 147 patients who underwent partial nephrectomy for renal masses with elective indications in this study. Laparoscopic partial nephrectomy (LPN) and open partial nephrectomy (OPN) were performed in 72 and 75 patients, respectively. Preoperative trans-sectional images were used to assess tumor characteristics such as tumor size, endophyticity, distance from the sinus, distance from the kidney equator, hilar designation, inside designation, and R.E.N.A.L. nephrometry score. Univariate logistic regression analyses demonstrated that tumor size, endophyticity, distance from the sinus, hilar designation, inside designation, and R.E.N.A.L. nephrometry score were associated with decision of laparoscopic partial nephrectomy. Among these factors, multiple regression analyses showed that endophyticity (odds ratio = 0.92, p = 0.007) and distance from the sinus (odds ratio = 1.201, p < 0.001) had statistically significant associations with the type of operation performed. ROC analyses demonstrated cut-off values of 16 mm for endophyticity (sensitivity 69%, specificity 77%) and of 4 mm for distance from the sinus (sensitivity 79%, specificity 65%) for predicting the selection of laparoscopic surgery. In conclusion, this study revealed that endophyticity and distance from the sinus were important for the surgical planning of partial nephrectomy.

  9. Laparoscopic Partial Nephrectomy with Diode Laser: A Promising Technique

    PubMed Central

    Knezevic, Nikola; Maric, Marjan; Grkovic, Marija Topalovic; Krhen, Ivan; Kastelan, Zeljko

    2014-01-01

    Abstract Objective: The aim of this study was to evaluate application of diode laser in laparoscopic partial nephrectomy (LPN), and to question this technique in terms of ease of tumor excision and reduction of warm ischemia time (WIT). Background data: LPN is the standard operative method for small renal masses. The benefits of LPN are numerous, including preserving renal function and prolonging overall survival. However, reduction of WIT remains main challenge in this operation. In order to shorten WIT, many techniques have been developed, with variable results. Patients and methods: We performed a prospective collection and analysis of health records for patients who were operated on between March 2011 and August 2012. Inclusion criteria were single tumor ≤4 cm, predominant exophytic growth and intraparenchymal depth ≤1.5 cm, with a minimum distance of 5 mm from the urinary collecting system. Results: We operated on 17 patients. Median operative time was 170 min. In all but two patients, we had to perform hilar clamping. Median duration of WIT was 16 min. Pathohistological evaluation revealed clear cell renal cancer and confirmed margins negative for tumor in all cases. Median size of the tumor was 3 cm. Median postoperative hospitalization was 5 days. Average follow up was 11.5 months. There were no intraoperative complications. One postoperative complication was noted: perirenal hematoma. Conclusions: Laser LPN is feasible, and offers the benefit of shorter WIT, with effective tissue coagulation and hemostasis. With operative experience and technical advances, WIT will be reduced or even eliminated, and a solution to some technical difficulties, such as significant smoke production, will be found. PMID:24460067

  10. Hand-assisted robotic right donor nephrectomy in patient with total sinus inversus: A case report

    PubMed Central

    Gonzalez-Heredia, Raquel; Garcia-Roca, Raquel; Benedetti, Enrico

    2016-01-01

    Total situs inversus” is an infrequent congenital condition. The robot has been already proved as a safe and attractive approach for living donor neprectomies. We report here the first right donor nephrectomy in a patient with total sinus inversus that is performed using the Da Vinci platform. PMID:27085108

  11. 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

  12. Robotic nephrectomy for central renal tumors with intraoperative evaluation of tumor histology.

    PubMed

    Lieberman, Leedor; Barod, Ravi; Tapper, Alex; Kumar, Ramesh; Rogers, Craig

    2016-09-01

    Patients undergoing nephrectomy for central renal tumors suspicious for renal cell carcinoma (RCC) may carry a small risk of having transitional cell carcinoma (TCC) on final pathology, even in the absence of filling defects or abnormal cytology. We describe outcomes in such patients undergoing robotic nephrectomy for suspected RCC, with intraoperative specimen assessment to guide completion ureterectomy if TCC is present. Between September 2010 and August 2015, ten patients had central renal masses suspicious for RCC, which were not amenable to nephron-sparing surgery. Patients underwent a four-arm robotic nephrectomy technique using a GelPOINT(®) access port. Following hilar ligation, the ureter was divided between adjacent hem-o-lok clips, placed in an endocatch bag, and extracted through the GelPOINT incision for the frozen section analysis. If intraoperative assessment confirmed TCC, a robotic completion ureterectomy and a bladder cuff excision were performed. Of the ten patients with central tumors who underwent robotic nephrectomy for suspected RCC, four (40 %) had TCC on the frozen section analysis and underwent completion ureterectomy. Five patients had RCC, and one patient had an oncocytoma. Mean age was 63.1 years (49-76) and mean tumor size was 4.0 cm (1.9-7.6). Mean operating time was 246 min (135-328). All patients had negative margins. Mean length of stay was 2.5 days. No recurrences were documented at median 8.5 months follow-up. For patients undergoing robotic nephrectomy for central renal tumors, intraoperative specimen evaluation can help determine the need for minimally invasive completion ureterectomy. PMID:27146858

  13. Postrenal transplant urinary leakage caused by segmental infarction of a renal allograft treated by partial nephrectomy.

    PubMed

    Salehipour, Mehdi; Roozbeh, Jamshid; Eshraghian, Ahad; Nikeghbalian, Saman; Salahi, Heshmatollah; Bahador, Ali; Malek-hosseini, Seyed Ali

    2011-04-01

    Kidney transplant is the final treatment for patients with end-stage renal disease. Urinary leakage is the most-common surgical complication early after transplant. Another complication in the early posttransplant period is segmental allograft infarction. We report a kidney recipient who developed urinary leakage secondary to a segmental infarction of the upper pole of the transplanted kidney 2 months after transplant. The patient was treated successfully by a partial nephrectomy of the infracted upper lobe of the kidney. Three months after the partial nephrectomy of the allograft, serum blood urea nitrogen and creatinine were normal, and the patient was able to partake in her daily activities. Partial nephrectomy in the context of infarction of a kidney allograft is safe and can be used in similar cases.

  14. 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

  15. Gender differences in the development of uremic cardiomyopathy following partial nephrectomy: Role of progesterone.

    PubMed

    Drummond, Christopher A; Buddny, George; Haller, Steven T; Liu, Jiang; Yan, Yanling; Xie, Zijian; Malhotra, Deepak; Shapiro, Joseph I; Tian, Jiang

    2013-01-31

    Gender difference has been suggested as a risk factor for developing cardiovascular and renal diseases in humans and experimental animals. As a major sex hormone, progesterone was reported to compete with cardiotonic steroid binding to Na/K-ATPase. Our previous publication demonstrated that cardiotonic steroids (e.g., marinobufagenin) play an important role in the development of experimental uremic cardiomyopathy. We also observed that the putative mineralocorticoid antagonists, spironolactone and its major metabolite canrenone, antagonize binding of cardiotonic steroids to Na/K-ATPase in a competitive manner and also ameliorate experimental uremic cardiomyopathy induced by partial nephrectomy. In the following studies, we noted that progesterone displayed competitive inhibition of cardiotonic steroid binding to Na/K-ATPase and partially inhibited collagen synthesis induced by marinobufagenin in cultured cardiac fibroblasts. Therefore, we sought to examine whether female rats displayed less uremic cardiomyopathy than male rats when subjected to partial nephrectomy. Although partial nephrectomy caused the induction of smaller increases in blood pressure of female rats, they appeared to be similarly susceptible to cardiac remodeling induced by partial nephrectomy in terms of hypertrophy and fibrosis as age-matched male rats. The possible explanations for our findings are therefore discussed. PMID:24404431

  16. Gender differences in the development of uremic cardiomyopathy following partial nephrectomy: Role of progesterone

    PubMed Central

    Drummond, Christopher A; Buddny, George; Haller, Steven T; Liu, Jiang; Yan, Yanling; Xie, Zijian; Malhotra, Deepak; Shapiro, Joseph I; Tian, Jiang

    2013-01-01

    Gender difference has been suggested as a risk factor for developing cardiovascular and renal diseases in humans and experimental animals. As a major sex hormone, progesterone was reported to compete with cardiotonic steroid binding to Na/K-ATPase. Our previous publication demonstrated that cardiotonic steroids (e.g., marinobufagenin) play an important role in the development of experimental uremic cardiomyopathy. We also observed that the putative mineralocorticoid antagonists, spironolactone and its major metabolite canrenone, antagonize binding of cardiotonic steroids to Na/K-ATPase in a competitive manner and also ameliorate experimental uremic cardiomyopathy induced by partial nephrectomy. In the following studies, we noted that progesterone displayed competitive inhibition of cardiotonic steroid binding to Na/K-ATPase and partially inhibited collagen synthesis induced by marinobufagenin in cultured cardiac fibroblasts. Therefore, we sought to examine whether female rats displayed less uremic cardiomyopathy than male rats when subjected to partial nephrectomy. Although partial nephrectomy caused the induction of smaller increases in blood pressure of female rats, they appeared to be similarly susceptible to cardiac remodeling induced by partial nephrectomy in terms of hypertrophy and fibrosis as age-matched male rats. The possible explanations for our findings are therefore discussed. PMID:24404431

  17. [Retroperitoneal laparoscopic partial nephrectomy for treatment of cystic nephroma: one case report].

    PubMed

    Qiu, Min; Lu, Jian; Ma, Lu-lin; Yan, Ye; Zhang, Shu-dong

    2014-08-18

    The clinical features and pathologic findings of one case of cystic nephroma was reported,and the safety of treatment by retroperitoneal laparoscopic partial nephrectomy evaluated. The patient was a 20-year-old woman, and found left renal cyst for 1 year with pain in her left flank one month ago. The patient was diagnosed as complex renal cyst, then underwent retroperitoneal laparoscopic partial nephrectomy. In the operation, the tumor was located in the middle and lower part of her left kidney, with a number of small sample masses, and a solid mass near the renal parenchymal part. The operation time was 224 min, and the artery occlusion time was about 17 min. The blood loss was 20 mL, with no blood transfusion. The pathology was cystic nephroma. No operation complication was seen, nor was recurrence after a short-term follow-up. Cystic nephroma is a relatively rare benign lesion of the kidney. Retroperitoneal laparoscopic partial nephrectomy is a safe and effective way to treat cystic nephroma.

  18. 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

  19. Survival advantage of partial over radical nephrectomy in patients presenting with localized renal cell carcinoma

    PubMed Central

    2014-01-01

    Background Partial nephrectomy (PN) preserves renal function and has become the standard approach for T1a renal cell carcinoma (RCC). However, there is still an ongoing debate as to which patients will actually derive greater benefit from partial than from radical nephrectomy (RN). The aim of this study was to retrospectively evaluate the impact of the type of surgery on overall survival (OS) in patients with localized RCC. Methods Renal surgery was performed in 4326 patients with localized RCC (pT ≤ 3a N/M0) at six German tertiary care centers from 1980 to 2010: RN in 2955 cases (68.3%), elective (ePN) in 1108 (25.6%), and imperative partial nephrectomy (iPN) in 263 (6.1%) cases. The median follow-up for all patients was 63 months. Kaplan-Meier and Cox regression analyses were carried out to identify prognosticators for OS. Results PN was performed significantly more often than RN in patients presenting with lower tumor stages, higher RCC differentiation, and non-clear cell histology. Accordingly, the calculated 5 (10)-year OS rates were 90.0 (74.6)% for ePN, 83.9 (57.5)% for iPN, and 81.2 (64.7)% for RN (p < 0.001). However, multivariate analysis including age, sex, tumor diameter and differentiation, histological subtype, and the year of surgery showed that ePN compared to RN still qualified as an independent factor for improved OS (HR 0.79, 95% CI 0.66-0.94, p = 0.008). Conclusion Even allowing for the weaknesses of this retrospective analysis, our multicenter study indicates that in patients with localized RCC, PN appears to be associated with better OS than RN irrespective of age or tumor size. PMID:24885955

  20. 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

  1. Application of Long-Acting VLHL PAI-1 during Sutureless Partial Nephrectomy in Mice Reduces Bleeding

    PubMed Central

    Shahrour, Khaled; Keck, Rick; Jankun, Jerzy

    2015-01-01

    PAI-1 prevents lysis of blood clot by inhibiting the urokinase and tPA induced conversion of plasminogen to plasmin. VLHL PAI-1 protein mutant was created to extend half-life over 700 hours. The objective of this paper was to test VLHL PAI-1 effects on bleeding during partial nephrectomy in mice. All animals had a left partial nephrectomy after intravenous infusion of saline or tPA. The animals were divided into four groups. Group 1 was infused with saline and kidney was exposed to saline too; Group 2 was infused with saline and kidney was exposed to PAI-1. Group 3 was infused with tPA and kidney was exposed to saline, while Group 4 was infused with tPA and kidney was exposed to PAI-1. Preweighed gauze containing PAI-1 or saline was then applied to the kidney for 30 minutes. The gauze was afterward weighed and blood loss was measured by subtracting the preweight of gauze from the final weight. We have observed a statistically significant (P ≤ 0.05) reduction of bleeding in PAI-1-treated group in comparison to saline and tPA-treated groups. Based on these results we propose that VLHL PAI-1 can be used therapeutically in limiting the flow of blood from renal wounds. PMID:25883959

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. Partial blockade of neurotensin-induced hypotension in rats by nephrectomy captopril and saralasin. Possible mechanisms.

    PubMed

    Kérouac, R; St-Pierre, S; Manning, M; Rioux, F

    1983-04-01

    We have assessed the influence of acute bilateral nephrectomy, of captopril and saralasin, on the hypotensive activity of neurotensin (NT) and of various hypotensive drugs in pentobarbital-anesthetized rats. The results show that the hypotensive activity of NT and of compound 48/80 (C48/80), in contrast to that of histamine, of 5-hydroxytryptamine and of hexamethonium, is markedly reduced, especially for NT, in nephrectomized as compared to sham operated rats. The pretreatment of rats with captopril (10 mg kg-1, i.v.) or with saralasin (20 micrograms kg-1 min-1, i.v.) was found to inhibit significantly the hypotensive activity of NT and of C48/80. Adrenalectomy restored partially the hypotensive activity of NT in nephrectomized rats. The potent vasopressin antagonist [d(CH2)5 Tyr(Me)AVP] did not alter the refractoriness of nephrectomized rats to the hypotensive activity of NT. Neither nephrectomy nor saralasin were found to interfere with the ability of NT or of C48/80 to evoke an increase of plasma histamine level or of the hematocrit. The results were interpreted as an indication that NT produces part of its hypotensive effect in anesthetized rats by reducing the activity of the renin angiotensin system. The results also suggest that part of the refractoriness of nephrectomized rats to the hypotensive activity of NT could be due to the release of catecholamines from adrenal glands by NT. Endogenous vasopressin does not appear to contribute to the refractoriness of nephrectomized rats to the hypotensive action of NT.

  7. Isolated omental metastasis of renal cell carcinoma after extraperitoneal open partial nephrectomy: A case report

    PubMed Central

    Acar, Ömer; Mut, Tuna; Sağlıcan, Yeşim; Sag, Alan Alper; Falay, Okan; Selcukbiricik, Fatih; Tabak, Levent; Esen, Tarık

    2016-01-01

    Introduction Metachronous metastatic spread of clinically localized renal cell carcinoma (RCC) affects almost 1/3 of the patients. They occur most frequently in lung, liver, bone and brain. Isolated omental metastasis of RCC has not been reported so far. Case presentation A 62-year-old patient previously diagnosed and treated due to pulmonary sarcoidosis has developed an omental metastatic lesion 13 years after having undergone open extraperitoneal partial nephrectomy for T1 clear-cell RCC. Constitutional symptoms and imaging findings that were attributed to the presence of a sarcomatoid paraneoplastic syndrome triggered by the development this metastatic focus complicated the diagnostic work-up. Biopsy of the [18F]-fluorodeoxyglucose (+) lesions confirmed the diagnosis of metastatic RCC and the patient was managed by the resection of the omental mass via near-total omentectomy followed by targeted therapy with a tyrosine kinase inhibitor. Discussion Late recurrence of RCC has been reported to occur in 10–20% of the patients within 20 years. Therefore lifelong follow up of RCC has been advocated by some authors. Diffuse peritoneal metastases have been reported in certain RCC subtypes with adverse histopathological features. However, isolated omental metastasis without any sign of peritoneal involvement is an extremely rare condition. Conclusion To our knowledge, this is the first reported case of metachronously developed, isolated omental metastasis of an initially T1 clear-cell RCC. Constitutional symptoms, despite a long interval since nephrectomy, should raise the possibility of a paraneoplastic syndrome being associated with metastatic RCC. Morphological and molecular imaging studies together with histopathological documentation will be diagnostic. PMID:26874583

  8. 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.

  9. Factors Predicting Adhesion between Renal Capsule and Perinephric Adipose Tissue in Partial Nephrectomy.

    PubMed

    Kobayashi, Yasuyuki; Kurahashi, Hiroaki; Matsumoto, Yuko; Wada, Koichiro; Sasaki, Katsumi; Araki, Motoo; Ebara, Shin; Watanabe, Toyohiko; Nasu, Yasutomo

    2016-01-01

    In minimally invasive partial nephrectomy (MIPN), it is important to preoperatively predict the degree of difficulty of tumor resection. When severe adhesions occur between the renal capsule and perinephric adipose tissue, detachment can be difficult. Preoperative prediction of adhesion is thought to be useful in the selection of surgical procedure. Subjects were 63 patients of a single surgeon who had received MIPN between April 2008 and August 2013 at Okayama University Hospital. Of these patients, this study followed 47 in whom the presence or absence of adhesions between the renal capsule and perinephric adipose tissue was confirmed using intraoperative videos. Data collected included: sex, BMI, CT finding (presence of fi broids in perinephric adipose tissue), comorbidities and lifestyle. Adhesion was observed in 7 patients (14.9%). The mean operative time was 291.6 min in the adhesion group, and 226.3 min in the group without. The increased time in the adhesions group was significant (p<0.05). Predictive factors were a positive CT finding for fibroid structure and comorbidity of hypertension (p<0.05). In MIPN, difficulty of surgery can be affected by the presence of adhesion of the perinephric adipose tissue. Predicting such adhesion from preoperative CT is thus important.

  10. 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.

  11. 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

  12. 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

  13. Intraoperative Monitoring of Pulmonary Artery Physiology With Transesophageal Echocardiography in a Patient With an Extensive Pulmonary Aneurysm Undergoing Partial Nephrectomy.

    PubMed

    Plakke, Michael J; Maxwell, Cory D; Bottiger, Brandi A

    2016-09-01

    Surgical patients with pulmonary hypertension present a significant challenge to the anesthesiologist. Continuous perioperative monitoring of pulmonary artery (PA) pressure is recommended and most often accomplished with a PA catheter. Placement of a PA catheter may be difficult or contraindicated, and in these cases, transesophageal echocardiography is a useful alternative to monitor dynamic PA physiology. In this case, we used intraoperative transesophageal echocardiography to detect changes in peak PA pressure and guide clinical treatment in a patient with pulmonary hypertension and an extensive PA aneurysm undergoing partial nephrectomy. PMID:27580409

  14. [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.

  15. 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

  16. An 80-Year-Old Man With Dyspnea and Bilateral Pleural Effusions After Partial Nephrectomy for Renal Cell Carcinoma.

    PubMed

    Gupta, Anupam; Farokhi, Mahsan; Shah, Sapna; McGarry, Terence; Warshawsky, Martin; Epelbaum, Oleg

    2016-05-01

    An 80-year-old man presented because of superficial head trauma sustained after falling from bed. On review of systems, he reported worsening dyspnea on exertion, nonproductive cough, and weight loss over the preceding 2 to 3 months. There was no report of chest pain or leg swelling. He had a past medical history of hypertension, coronary artery disease, subclinical hypothyroidism, and renal cell carcinoma treated with partial right nephrectomy approximately 1 year before this presentation. Two months earlier he had been evaluated in the dermatology clinic for painful, dystrophic fingernails. At that time he was diagnosed with acropachy with onycholysis and suspected superinfection, and after failing to improve with vinegar soaks and topical antimicrobials, he underwent surgical nail removal on the second and fourth digits of the right hand. Histological examination of the operative specimens revealed dystrophic nails with negative fungal stains. His medications included levothyroxine, hydrochlorothiazide, and clopidogrel. He had never smoked and had done clerical work until retirement. He was originally from Colombia. PMID:27157230

  17. Long-term effect of partial nephrectomy on biological parameters, kidney histology, and guanidino compound levels in mice.

    PubMed

    Al Banchaabouchi, M; Marescau, B; Van Marck, E; D'hooge, R; De Deyn, P P

    2001-12-01

    The long-term adverse consequences of early renal mass reduction in mice have not yet been investigated. The effects of partial surgical nephrectomy (NX) in 2-month-old mice on some biological parameters, on histopathologic and morphometric features of the kidney, and on urea and guanidino compound (GC) levels in plasma, urine, and brain were examined at 10 days, and 1, 2, 4, and 12 months postsurgery. Body weight, urinary volume, and plasma urea were most affected at 10 days and 12 months post-NX. NX-induced changes in the remaining renal tissue (including hypertrophy, glomerular mesangial expansion, and presence of protein casts) increased with age. As in human renal insufficiency, NX mice showed significantly higher plasma guanidinosuccinic acid (GSA) and creatinine (CTN) levels at all studied periods. The same tendency could be seen for most other plasma GCs examined, except for arginine (Arg), guanidinoacetic acid (GAA), and homoarginine (HA). As seen in human pathobiochemistry, the latter 2 compounds tended to be lower in NX mice in our follow-up study. Remarkably, and also similar to humans, NX mice excreted less GAA and more GSA than controls during the entire follow-up study. During the follow-up, excretion levels of GAA were unchanged in NX and sham-operated mice. In brain, GAA and gamma-guanidinobutyric acid (GBA) levels were always higher in NX mice with a tendency to respectively increase or decrease over time in NX as well as sham-operated mice. Although urea and GC metabolism were influenced by time post-NX and aging, the model was confirmed to display a mild stable chronic impairment of renal function. Histopathologic and morphometric changes of the kidney increased with age.

  18. Robotic-assisted laparoscopic radical nephrectomy using the Da Vinci Si system: how to improve surgeon autonomy. Our step-by-step technique.

    PubMed

    Davila, Hugo H; Storey, Raul E; Rose, Marc C

    2016-09-01

    Herein, we describe several steps to improve surgeon autonomy during a Left Robotic-Assisted Laparoscopic Radical Nephrectomy (RALRN), using the Da Vinci Si system. Our kidney cancer program is based on 2 community hospitals. We use the Da Vinci Si system. Access is obtained with the following trocars: Two 8 mm robotic, one 8 mm robotic, bariatric length (arm 3), 15 mm for the assistant and 12 mm for the camera. We use curved monopolar scissors in robotic arm 1, Bipolar Maryland in arm 2, Prograsp Forceps in arm 3, and we alternate throughout the surgery with EndoWrist clip appliers and the vessel sealer. Here, we described three steps and the use of 3 robotic instruments to improve surgeon autonomy. Step 1: the lower pole of the kidney was dissected and this was retracted upwards and laterally. This maneuver was performed using the 3rd robotic arm with the Prograsp Forceps. Step 2: the monopolar scissors was replaced (robotic arm 1) with the robotic EndoWrist clip applier, 10 mm Hem-o-Lok. The renal artery and vein were controlled and transected by the main surgeon. Step 3: the superior, posterolateral dissection and all bleeders were carefully coagulated by the surgeon with the EndoWrist one vessel sealer. We have now performed 15 RALRN following these steps. Our results were: blood loss 300 cc, console time 140 min, operating room time 200 min, anesthesia time 180 min, hospital stay 2.5 days, 1 incisional hernia, pathology: (13) RCC clear cell, (1) chromophobe and (1) papillary type 1. Tumor Stage: (5) T1b, (8) T2a, (2) T2b. We provide a concise, step-by-step technique for radical nephrectomy (RN) using the Da Vinci Si robotic system that may provide more autonomy to the surgeon, while maintaining surgical outcome equivalent to standard laparoscopic RN.

  19. 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.

  20. Radiofrequency Ablation Versus Partial Nephrectomy in Treating Small Renal Tumors: A Systematic Review and Meta-Analysis.

    PubMed

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

    2015-12-01

    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

  1. Spontaneous regression of multiple pulmonary nodules in a patient with unclassified renal cell carcinoma following laparoscopic partial nephrectomy: A case report

    PubMed Central

    UEDA, KOSUKE; SUEKANE, SHIGETAKA; MITANI, TOMOTARO; CHIKUI, KATSUAKI; EJIMA, KAZUHISA; SUYAMA, SHUNSUKE; NAKIRI, MAKOTO; NISHIHARA, KIYOAKI; MATSUO, MITSUNORI; IGAWA, TSUKASA

    2016-01-01

    Spontaneous regression of metastatic renal cell carcinoma (RCC) is rare, but well-documented in clear cell RCC. However, there are no reports on spontaneous regression of unclassified RCC. Since the radiological findings of pulmonary infarcts and inflammatory pseudotumors are similar to those of metastases from RCC, a definitive diagnosis is difficult without performing a histological examination. A 56-year-old woman underwent medical examination by a physician. An abdominal computed tomography (CT) scan revealed a 22-mm mass with a cystic area in the right kidney, as well as multiple enlarged lymph nodes in the common iliac, external iliac and groin areas, bilaterally. A chest CT revealed multiple pulmonary nodules bilaterally, the largest measuring 15 mm. Since the right renal tumor was suspected to be an RCC, laparoscopic partial nephrectomy was performed. The final pathological diagnosis of the renal tumor was unclassified RCC. One month following surgery, a CT scan revealed spontaneous regression of the pulmonary nodules. We herein present a rare case of spontaneous regression of pulmonary nodules in a patient with unclassified RCC following laparoscopic partial nephrectomy. To the best of our knowledge, this is the first case of spontaneous regression in unclassified RCC. PMID:27330764

  2. Transoral robotic supracricoid partial laryngectomy with cartilaginous framework preservation.

    PubMed

    Vural, Emre; Tulunay-Ugur, Ozlem E; Suen, James Y

    2012-12-01

    To report the technical feasibility of performing transoral robotic supracricoid partial laryngectomy with preservation of the thyroid cartilage. This is a case report from a tertiary-care academic institution. A patient with recurrent T2 glottic squamous cell carcinoma of the larynx underwent supracricoid partial laryngectomy with negative margins and preservation of the laryngeal framework using transoral robotic surgery, where an adequate exposure to the endolarynx was obtained by using a Feyh-Kastenbauer retractor. The patient was successfully decannulated in postoperative week 4, and his gastrostomy tube was removed in postoperative week 6. Transoral robotic surgery may be feasible in select glottic/subglottic laryngeal lesions, if adequate exposure is obtained. PMID:27628480

  3. 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

  4. 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 Central

    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. PMID:23509463

  5. 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. PMID:23509463

  6. The use of Haemostatic Agents does not impact the rate of hemorrhagic complications in patients undergoing partial nephrectomy for renal masses

    PubMed Central

    Abu-Ghanem, Yasmin; Dotan, Zohar; Kaver, Issac; Zilberman, Dorit E.; Ramon, Jacob

    2016-01-01

    Hemostatic agents(HAs) have gained increasing popularity as interventions to improve perioperative haemostasis and diminish the need for allogeneic red cell transfusion(PBT) despite a paucity of data supporting the practice. The aim of the current study is to examine the efficacy of HAs in reducing the rate of hemorrhagic complications during partial nephrectomy(PN). Data on 657 patients, who underwent elective PN between 2004–2013, were analyzed. The impact of HAs and SURGICEL was evaluated by comparing four sequential groups of patients: Group1 = Sutures alone, Group2 = sutures and HA, Group3 = sutures and SURGICEL, Group4 = both HA and SURGICEL. Complications included post-operative urinary leak(UL), PBT rate, delayed bleeding and post-operative renal failure. Results showed that the use of HAs did not engender a statistically significant difference in overall complications rate. Specifically, the addition of HAs did not reduce the rate of PBT, delayed bleeding or UL. Further analysis revealed that patients who received SURGICEL had significantly higher PBT rate and higher prevalence of UL cases. Addition of HAs to SURGICEL had no effect on the rate of these complications. In the current study, the use of HAs during open and laparoscopic PN did not reduce the rate of negative outcomes. Adequate suture renorrhaphy may be sufficient to prevent hemorrhagic complications. PMID:27572274

  7. Open Partial Nephrectomy for High-Risk Renal Masses Is Associated with Renal Pseudoaneurysms: Assessment of a Severe Procedure-Related Complication

    PubMed Central

    Kriegmair, M. C.; Mandel, P.; Rathmann, N.; Diehl, S. J.; Pfalzgraf, D.; Ritter, M.

    2015-01-01

    Objectives. A symptomatic renal pseudoaneurysm (RPA) is a severe complication after open partial nephrectomy (OPN). The aim of our study was to assess incidence and risk factors for RPA formation. Furthermore, we present our management strategy. Patients and Methods. Clinical records of consecutive patients undergoing OPN were assessed for surgical outcome and postoperative complications. Renal masses were risk stratified for tumor complexity according to the PADUA score. Uni- and multivariate analysis for symptomatic RPAs were performed using the t-tests and logistic regression. Results. We identified 233 patients treated with OPN. Symptomatic RPAs were observed in 13 (5.6%) patients, on average 14 (4–42) days after surgery. Uni- and multivariate analysis identified tumor complexity to be an independent predictor for symptomatic RPAs (p = 0.004). There was a significant correlation between RPAs and transfusion and the duration of stay (p < 0.001 and p = 0.021). Symptomatic RPAs were diagnosed with CT scans and successfully treated with arterial embolization. Discussion. Symptomatic RPAs are not uncommon after OPN for high-risk renal masses. A high nephrometry score is a predictor for this severe complication and may enable a risk-stratified followup. RPAs can successfully be located by CT angiography, which enables targeted angiographic treatment. PMID:26539549

  8. Retroperitoneal robotic renal surgery: technique and early results.

    PubMed

    Patel, Manish N; Kaul, Sanjeev A; Laungani, Rajesh; Eun, Daniel; Bhandari, Mahendra; Menon, Mani; Rogers, Craig G

    2009-03-01

    We describe a robotic retroperitoneal approach to renal surgery, optimized in porcine and cadaveric models, and applied to human patients. A retroperitoneal approach for robotic kidney surgery was developed in nonsurvival porcine and a fresh cadaver models, and then utilized in ten patients (three partial nephrectomy, three radical nephrectomy, two simple nephrectomy, one pyeloplasty, one cryoablation). Retroperitoneal access was successfully achieved for robotic renal procedures in six pigs and a human cadaver. Ten human patients (mean age 56 years, range 36-72 years) then underwent a successful retroperitoneal approach for robotic renal surgery. Mean console time was 166 (120-300) min. Mean blood loss was 82 (50-100) ml and average hospital stay was 2.6 (1-5) days. Pathology demonstrated clear cell renal cell carcinoma (four), papillary renal cell carcinoma (two), and xanthogranulomatous pyelonephritis (two). One patient with xanthogranulomatous pyelonephritis required open conversion for failure to progress due to dense adhesions. A retroperitoneal approach is a safe and feasible alternative to a transperitoneal approach for robotic renal surgery, including radical nephrectomy, partial nephrectomy, pyeloplasty, and cryoablation. PMID:27628446

  9. Transplant nephrectomy

    PubMed Central

    Akoh, Jacob A

    2011-01-01

    About 10% of all renal allografts fail during the first year of transplantation and thereafter approximately 3%-5% yearly. Given that approximately 69 400 renal transplants are performed worldwide annually, the number of patients returning to dialysis following allograft failure is increasing. A failed transplant kidney, whether maintained by low dose immunosuppression or not, elicits an inflammatory response and is associated with increased morbidity and mortality. The risk for transplant nephrectomy (TN) is increased in patients who experienced multiple acute rejections prior to graft failure, develop chronic graft intolerance, sepsis, vascular complications and early graft failure. TN for late graft failure is associated with greater morbidity and mortality, bleeding being the leading cause of morbidity and infection the main cause of mortality. TN appears to be beneficial for survival on dialysis but detrimental to the outcome of subsequent transplantation by virtue of increased level of antibodies to mismatched antigens, increased rate of primary non function and delayed graft function. Many of the studies are characterized by a retrospective and univariate analysis of small numbers of patients. The lack of randomization in many studies introduced a selection bias and conclusions drawn from such studies should be applied with caution. Pending a randomised controlled trial on the role of TN in the management of transplant failure patients, it is prudent to remove failed symptomatic allografts and all grafts failing within 3 mo of transplantation, monitor inflammatory markers in patients with retained failed allografts and remove the allograft in the event of a significant increase in levels. PMID:24175187

  10. 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...

  11. Robotic-assisted partial cystectomy for recurrent extra-adrenal pheochromocytoma.

    PubMed

    Jayram, G; Msezane, L E; Angelos, P; Eggener, S E

    2009-03-01

    A 27-year-old male experienced a bladder metastasis of a malignant extra-adrenal retroperitoneal pheochromocytoma 10 months after surgical resection of the primary tumor. This recurrence was managed successfully utilizing a robotic-assisted partial cystectomy with minimal morbidity and negative surgical margins. This is the first published report of robotic-assisted management of bladder pheochromocytoma. PMID:27628452

  12. 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. PMID:25341557

  13. Robotic nephron-sparing surgery for renal tumors: Current status.

    PubMed

    Azhar, Raed A; Gill, Inderbir S; Aron, Monish

    2014-07-01

    There have been a number of advances in robotic partial nephrectomy (RPN) for renal masses. We reviewed these advances with emphasis on the evolution of technique and outcomes as well as the expanding indications for RPN. Literature in the English language was reviewed using the National Library of Medicine database. Relevant articles were extracted, and their citations were utilized to broaden our search. The identified articles were reviewed and summarized with a focus on novel developments. RPN is an evolving procedure and is an emerging viable alternative to laparoscopic partial nephrectomy and open partial nephrectomy with favorable outcomes. The contemporary techniques used for RPN demonstrate excellent perioperative outcomes. The short-term oncologic outcomes are comparable to those of laparoscopic and open surgical approaches. Further studies are needed to assess long-term oncologic control.

  14. Robot-assisted surgery for kidney cancer increased access to a procedure that can reduce mortality and renal failure.

    PubMed

    Chandra, Amitabh; Snider, Julia Thornton; Wu, Yanyu; Jena, Anupam; Goldman, Dana P

    2015-02-01

    Surgeons increasingly use robot-assisted minimally invasive surgery for a variety of medical conditions. For hospitals, the acquisition and maintenance of a robot requires a significant investment, but financial returns are not linked to any improvement in long-term patient outcomes in the current reimbursement environment. Kidney cancer provides a useful case study for evaluating the long-term value that this innovation can provide. Kidney cancer is generally treated through partial or radical nephrectomy, with evidence favoring the former procedure for appropriate patients. We found that robot-assisted surgery increased access to partial nephrectomy and that partial nephrectomy reduced mortality and renal failure. The value of the benefits of robot-assisted minimally invasive surgery to patients, in terms of quality-adjusted life-years gained, outweighed the health care and surgical costs to patients and payers by a ratio of five to one. In addition, we found no evidence that the availability of robot-assisted minimally invasive surgery increased the likelihood that inappropriate patients received partial nephrectomy. PMID:25646101

  15. Reward-Modulated Hebbian Plasticity as Leverage for Partially Embodied Control in Compliant Robotics.

    PubMed

    Burms, Jeroen; Caluwaerts, Ken; Dambre, Joni

    2015-01-01

    In embodied computation (or morphological computation), part of the complexity of motor control is offloaded to the body dynamics. We demonstrate that a simple Hebbian-like learning rule can be used to train systems with (partial) embodiment, and can be extended outside of the scope of traditional neural networks. To this end, we apply the learning rule to optimize the connection weights of recurrent neural networks with different topologies and for various tasks. We then apply this learning rule to a simulated compliant tensegrity robot by optimizing static feedback controllers that directly exploit the dynamics of the robot body. This leads to partially embodied controllers, i.e., hybrid controllers that naturally integrate the computations that are performed by the robot body into a neural network architecture. Our results demonstrate the universal applicability of reward-modulated Hebbian learning. Furthermore, they demonstrate the robustness of systems trained with the learning rule. This study strengthens our belief that compliant robots should or can be seen as computational units, instead of dumb hardware that needs a complex controller. This link between compliant robotics and neural networks is also the main reason for our search for simple universal learning rules for both neural networks and robotics. PMID:26347645

  16. Reward-Modulated Hebbian Plasticity as Leverage for Partially Embodied Control in Compliant Robotics

    PubMed Central

    Burms, Jeroen; Caluwaerts, Ken; Dambre, Joni

    2015-01-01

    In embodied computation (or morphological computation), part of the complexity of motor control is offloaded to the body dynamics. We demonstrate that a simple Hebbian-like learning rule can be used to train systems with (partial) embodiment, and can be extended outside of the scope of traditional neural networks. To this end, we apply the learning rule to optimize the connection weights of recurrent neural networks with different topologies and for various tasks. We then apply this learning rule to a simulated compliant tensegrity robot by optimizing static feedback controllers that directly exploit the dynamics of the robot body. This leads to partially embodied controllers, i.e., hybrid controllers that naturally integrate the computations that are performed by the robot body into a neural network architecture. Our results demonstrate the universal applicability of reward-modulated Hebbian learning. Furthermore, they demonstrate the robustness of systems trained with the learning rule. This study strengthens our belief that compliant robots should or can be seen as computational units, instead of dumb hardware that needs a complex controller. This link between compliant robotics and neural networks is also the main reason for our search for simple universal learning rules for both neural networks and robotics. PMID:26347645

  17. Robotic-assisted partial cystectomy with en bloc excision of the urachus and the umbilicus for urachal adenocarcinoma.

    PubMed

    Correa, Jose J; Hakky, Tariq S; Spiess, Philippe E; Chuang, Tian; Sexton, Wade J

    2010-01-01

    We report two cases of urachal adenocarcinoma managed with robotic-assisted partial cystectomy. A detailed description of the robotic technique including methods used to resect the tumor, urachus, and umbilicus en bloc is described. A review of the management of urachal adenocarcinoma is presented. The robotic approach is technically feasible and safe, and is an attractive alternative to traditional open or laparoscopic-assisted partial cystectomy for this uncommon genitourinary malignancy. PMID:27628636

  18. Robot-Assisted Laparoscopic Partial Colpectomy and Intracorporeal Ileal Conduit Urinary Diversion (Bricker) for Cervical Adenocarcinoma Recurrence

    PubMed Central

    Uzan, Jennifer; Cornou, Caroline; Bensaid, Chérazade; Audenet, François; Ngô, Charlotte; Bats, Anne-Sophie; Lecuru, Fabrice

    2015-01-01

    Ileal conduit urinary diversion (Bricker) is a standard surgical open procedure. The Da Vinci robot allowed precision for this surgical procedure, especially for intracorporeal suturing. Meanwhile, few reports of robot-assisted laparoscopic ileal conduit diversion (Bricker) are described in the literature. We report the case of a 69-year-old patient with a vaginal recurrence of cervical adenocarcinoma associated with vesicovaginal fistula treated by robot-assisted laparoscopic partial colpectomy and ileal conduit urinary diversion (Bricker). The robot-assisted laparoscopic procedure followed all surgical steps of the open procedure. Postoperative period was free of complications. PMID:26634161

  19. Renal cancer from laparoscopic to robotic: How to proceed.

    PubMed

    Silva-Waissbluth, Andrés; Vidal-Mora, Ivar; Castillo, Octavio A

    2013-01-01

    The benefits laparoscopic surgery brings to the table are well established in the literature. In our environment however, still most of the reconstructive/oncologic procedures are performed as open surgery. This can be explained by the multiple challenges this technique involves, as well as a demanding learning curve. Technology has provided means to improve precision and usefulness of laparoscopy, as well as broaden its use amongst the medical community by shortening its learning curve. Renal tumors have been managed by laparoscopic approach for the past 20 years. During this time, many studies appeared in the literature comparing this procedure with open surgery. In the vast majority, laparoscopic surgery has the upper hand in regards of perioperative events. A number of series are available regarding the feasibility of robotic radical nephrectomy, however there is no literature available that demonstrates better outcome of robotic radical nephrectomy compared to standard laparoscopy. Laparoscopic partial nephrectomy is technically difficult, which has prevented its massive spread through the urologist community, even amongst trained laparoscopists. Current reports are starting to favor robotic partial nephrectomy over standard laparoscopy regarding perioperative outcomes, with similar oncologic results. More studies have to be performed in order to elucidate the importance of NOTES and LESS in the treatment on localized renal cancer, but the use of the robot will lower their learning curve and probably make them attractive in the short term. Even though this technology has brought laparoscopy closer to a greater number of surgeons, physicians should become familiar and proficient in conventional laparoscopic procedures before embarking into robotics.

  20. Living donor nephrectomy.

    PubMed

    Jacobs, S C; Flowers, J L; Dunkin, B; Sklar, G N; Cho, E

    1999-03-01

    The need for more organs for kidney transplantation is increasing. Cadaver sources for these organs are stable, therefore living donation must increase if the need is to be met. Less perfect kidneys are now being transplanted. The pool of potential donors is being expanded. The process of kidney donation is being made easier in an effort to increase the number of donors. The donor work-up is being streamlined. Laparoscopic donor nephrectomy has been introduced, and appears to be promising as a technique of lessening donor pain and suffering, while maintaining excellent graft results.

  1. Unilateral Partial Nephrectomy with Warm Ischemia Results in Acute Hypoxia Inducible Factor 1-Alpha (HIF-1α) and Toll-Like Receptor 4 (TLR4) Overexpression in a Porcine Model

    PubMed Central

    Zhang, Zhiyong; Haimovich, Beatrice; Kwon, Young Suk; Lu, Tyler; Fyfe-Kirschner, Billie; Olweny, Ephrem Odoy

    2016-01-01

    Purpose Ischemia/reperfusion (I/R) during partial nephrectomy (PN) contributes to acute kidney injury (AKI), which is inaccurately assessed using existent clinical markers of renal function. We evaluated I/R-related changes in expression in hypoxia inducible factor 1α (HIF-1α) and toll-like receptor 4 (TLR4), within kidney tissue and peripheral blood leukocytes (PBL) in a porcine model of PN. Materials and Methods Three adult pigs each underwent unilateral renal hilar cross clamping for 180 min followed by a 15 min reperfusion. The contralateral kidney served as control. Biopsies of clamped kidneys were obtained at baseline (time 0), every 60 min during the hypoxic phase, and post-reperfusion. Control kidneys were biopsied once at 180 min. Peripheral blood was sampled at time 0, every 30 min during the hypoxic phase, and post-reperfusion. HIF-1α and TLR4 expression in kidney tissue and PBL were analyzed by Western blotting. I/R-related histological changes were assessed. Results Expression of HIF-1α in clamped kidneys and PBL was below detection level at baseline, rising to detectable levels after 60 min of hypoxia, and continuing to rise throughout the hypoxic and reperfusion phases. Expression of TLR-4 in clamped kidneys followed a similar trend with initial detection after 30–60 min of hypoxia. Control kidneys exhibited no change in HIF-1α or TLR-4 expression. I/R-related histologic changes were minimal, primarily mild tubular dilatation. Conclusions In a porcine model of PN, HIF-1α and TLR4 exhibited robust, I/R-related increases in expression in kidney tissue and PBL. Further studies investigating these molecules as potential markers of AKI are warranted. PMID:27149666

  2. Renal artery injury during robot-assisted renal surgery.

    PubMed

    Lee, Jae Won; Yoon, Young Eun; Kim, Dae Keun; Park, Sung Yul; Moon, Hong Sang; Lee, Tchun Yong

    2010-07-01

    Laparoscopic partial nephrectomy (LPN) is becoming the standard of care for incidentally diagnosed, small renal tumors. With its seven degrees of freedom and three-dimensional vision, the DaVinci robotic surgical system has been used to assist in LPNs. The main disadvantage of robot-assisted surgery, however, is the lack of tactile feedback. We present a case of renal artery injury during robot-assisted renal surgery. Robot-assisted partial nephrectomy (RPN) was planned for 47-year-old man with a 3.5-cm right renal mass. After standard bowel mobilization, renal hilar dissection was performed. In the attempt to complete the dissection posteriorly, however, there was sudden profuse bleeding. The intraperitoneal pressure immediately increased to 20 mm Hg, and an additional suction device was inserted through the 5-mm liver retractor port. On inspection, there was an injury at the takeoff of the posterior segmental artery. A decision was made to convert to robot-assisted laparoscopic radical nephrectomy. The main renal artery and renal vein were controlled with Hem-o-Lok clips. The estimated blood loss was 2,000 mL. Four units of packed red blood cells were transfused intraoperatively. The post-transfusion hemoglobin level was 12.6 g/dL. There were no other perioperative complications. The surgeon should keep in mind that the robotic arms are very powerful and can easily injure major vessels because of lack of tactile feedback. A competent and experienced tableside surgeon is very important in robot-assisted surgery because the unsterile console surgeon cannot immediately react to intraoperative complications.

  3. 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. PMID:16754618

  4. 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)

  5. 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

  6. Body mass index and comorbidity are associated with postoperative renal function after nephrectomy

    PubMed Central

    Reinstatler, Lael; Klaassen, Zachary; Barrett, Brittani; Terris, Martha K.; Moses, Kelvin A.

    2015-01-01

    ABSTRACT Purpose: To explore the association of body mass index (BMI) and comorbidity with renal function after nephrectomy. Materials and Methods: We retrospectively analyzed 263 patients submitted to partial or radical nephrectomy from 2000-2013. Variables assessed included BMI, Charlson Comorbidity Index (CCI), race, tobacco use, tumor histology, surgical approach, Fuhrman nuclear grade, and tumor (T) classification. Glomerular filtration rate (GFR) was estimated using the Cockroft-Gault equation, adjusted for gender. Logistic regression was performed and included all interaction terms. Results: Median follow-up was 19.6 months (IQR 5.2, 53.7). Median preoperative GFR was 86.2mL/min/1.73m2 and median postoperative GFR was 68.4mL/min/1.73m2. BMI (OR 1.07, 95%CI 1.02-1.11), CCI (OR 1.19, 95%CI 1.04-1.37), and radical nephrectomy (OR 3.09, 95%CI 1.51-6.33) were significantly associated with a decline in renal function of ≥25%. Conclusion: BMI and CCI are associated with postoperative decline in renal function after nephrectomy. Additionally, radical nephrectomy is significantly associated with decreasing renal function compared to partial nephrectomy. These findings highlight the importance of assessing patient comorbidity in the decision making process for patients presenting with a renal mass. PMID:26401862

  7. Patient positioning and port placement for robot-assisted surgery.

    PubMed

    Chang, Charles; Steinberg, Zoe; Shah, Anup; Gundeti, Mohan S

    2014-06-01

    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.

  8. 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

  9. 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

  10. The emergence of surgeon-controlled robotic surgery in urologic oncology.

    PubMed

    Patel, Timil H; Babbar, Paurush; Hemal, Ashok K

    2012-06-01

    The rise of robotic surgery is transforming medicine. In many ways, urology has taken charge in pioneering a new era of minimally invasive surgery with the emergence of the robot. The unprecedented dissecting precision and the dynamic three-dimensional, high definition view of the surgical field are undoubtedly revolutionizing the field of urology. These unique attributes of robotic surgery confer enormous advantages in dealing with uro-oncological surgery. The robotic revolution began nearly a decade ago with surgeon-controlled robotic radical prostatectomy and has since expanded to include radical cystectomies and partial nephrectomies. There have been numerous landmark studies published showing that robotic surgery provides comparable oncological and functional outcomes against traditional open or laparoscopic surgery. As a result, it becomes exceedingly imperative that urologists and the oncological community remain up-to-date regarding these developments and appreciate the oncological outcomes of surgeon-controlled robotic surgery. This review will assess the impact surgeon-controlled robotic surgery has had in the field of urologic oncology.

  11. Two-year outcomes after robotic renal surgery: a single surgeon's experience.

    PubMed

    Uffort, Ekong E; Jensen, James C

    2010-12-01

    The purpose of this study is to validate the feasibility of the robotic technology for various types of renal surgery and to outline the 2-year clinical and pathological outcomes post surgery. In a retrospective chart review with IRB approval of 55 robotic renal surgeries, clinical data and pathological outcomes were recorded, including estimated glomerular filtration rate (eGFR), serum creatinine, radiological surveillance of tumor recurrences and overall quality of life on pre- and postoperative visits at 6, 12, 18 and 24 months. There were 26 robotic partial nephrectomy (RPN), 23 radical nephrectomy (RRN), 3 simple nephrectomy (RSN), and 3 radical nephroureterectomy (RNU) procedures. Twelve patients in the RPN group, 17 in the RRN group and all in the RSN and RNU groups had eGFR <60 ml/min/1.73 m(2) and one or more risk factors for chronic kidney disease (CKD) preoperatively. Mean serum creatinine was 1.2, 1.3, 1.2, and 1.8, and eGFR was 66.4, 61.2, 55.8, and 41.0, respectively. There were two distant metastasis and four local recurrences in the RRN group, and two local recurrences in the RNU group. Serum creatinine and changes in eGFR were statistically similar in all groups postoperatively. Cancer-specific survival was 100% for RPN, 83% for RRN, and 100% for RNU while overall survival was 100% for RPN, 76% for RRN, 100% for RSN, and 100% for RNU at 2 years. Robotic renal surgery is a feasible, minimally invasive alternative with promising outcomes in our short-term follow-up. Long-term and comparative studies with open or conventional laparoscopic approaches are needed. PMID:27627946

  12. Cytoreductive nephrectomy for metastatic renal cell carcinoma.

    PubMed

    Chery, Lisly J; Karam, Jose A; Wood, Christopher G

    2016-09-01

    The incidence of renal cell carcinoma is increasing, with up to one-third of patients presenting with metastatic disease. Combination therapy is used to prolong survival in patients with metastatic renal cell carcinoma, which carries a poor prognosis. Although two pivotal phase 3 trials have demonstrated the efficacy of immunotherapy after cytoreductive nephrectomy for metastatic disease, for now, targeted therapy has replaced immunotherapy as the preferred systemic treatment in these patients. Two ongoing phase 3 trials are evaluating the role of cytoreductive nephrectomy prior to targeted therapy. Proper patient selection is paramount in achieving successful outcomes. PMID:27673288

  13. 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

  14. Hand-assisted laparoscopic living-donor nephrectomy as an alternative to traditional laparoscopic living-donor nephrectomy.

    PubMed

    Buell, Joseph F; Hanaway, Michael J; Potter, Steven R; Cronin, David C; Yoshida, Atsushi; Munda, Rino; Alexander, J Wesley; Newell, Kenneth A; Bruce, David S; Woodle, E Steve

    2002-11-01

    The benefits of laparoscopic living-donor nephrectomy (LDN) are well described, while similar data on hand-assisted laparoscopic living-donor nephrectomy (HALDN) are lacking. We compare hand-assisted laparoscopic living-donor nephrectomy with open donor nephrectomy. One hundred consecutive hand-assisted laparoscopic living-donor nephrectomy (10/98-8/01) donor/recipient pairs were compared to 50 open donor nephrectomy pairs (8/97-1/00). Mean donor weights were similar (179.6 +/- 40.8 vs. 167.4 +/- 30.3 lb; p = NS), while donor age was greater among hand-assisted laparoscopic living-donor nephrectomy (38.2 +/- 9.5 vs. 31.2 +/- 7.8 year; p < 0.01). Right nephrectomies was fewer in hand-assisted laparoscopic living-donor nephrectomy [17/100 (17%) vs. 22/50 (44%); p < 0.05]. Operative time for hand-assisted laparoscopic living-donor nephrectomy (3.9 +/- 0.7 vs. 2.9 +/- 0.5 h; p < 0.01) was longer; however, return to diet (6.9 +/- 2.8 vs. 25.6 +/- 6.1 h; p < 0.01), narcotics requirement (17.9 +/- 6.3 vs. 56.3 +/- 6.4h; p < 0.01) and length of stay (51.7 +/- 22.2 vs. 129.6 +/- 65.7 h; p < 0.01) were less than open donor nephrectomy. Costs were similar ($11072 vs. 10840). Graft function and 1-week Cr of 1.4 +/- 0.9 vs. 1.6 +/- 1.1 g/dL (p = NS) were similar. With the introduction of HALDN, our laparoscopic living-donor nephrectomy program has increased by 20%. Thus, similar to traditional laparoscopic donor nephrectomy, hand-assisted laparoscopic living-donor nephrectomy provides advantages over open donor nephrectomy without increasing costs. PMID:12482153

  15. 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.

  16. 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

  17. 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.

  18. Toward robot-assisted neurosurgical lasers.

    PubMed

    Motkoski, Jason W; Yang, Fang Wei; Lwu, Shelly H H; Sutherland, Garnette R

    2013-04-01

    Despite the potential increase in precision and accuracy, laser technology is not widely used in neurological surgery. This in part relates to challenges associated with the early introduction of lasers into neurosurgery. Considerable advances in laser technology have occurred, which together with robotic technology could create an ideal platform for neurosurgical application. In this study, a 980-nm contact diode laser was integrated with neuroArm. Preclinical evaluation involved partial hepatectomy, bilateral nephrectomy, splenectomy, and bilateral submandibular gland excision in a Sprague-Dawley rat model (n = 50). Total surgical time, blood loss as weight of surgical gauze before and after the procedure, and the incidence of thermal, vascular, or lethal injury were recorded and converted to an overall performance score. Thermal damage was evaluated in the liver using tissue samples stained with hematoxylin and eosin. Clinical studies involved step-wise integration of the 980-nm laser system into four neurosurgical cases. Results demonstrate the successful integration of contact laser technology into microsurgery, with and without robotic assistance. In preclinical studies, the laser improved microsurgical performance and reduced thermal damage, while neuroArm decreased intra- and intersurgeon variability. Clinical studies demonstrate dutility in meningioma resection (n = 4). Together, laser and robotic technology offered a more consistent, expedient, and precise tool for microsurgery. PMID:23047855

  19. Toward robot-assisted neurosurgical lasers.

    PubMed

    Motkoski, Jason W; Yang, Fang Wei; Lwu, Shelly H H; Sutherland, Garnette R

    2013-04-01

    Despite the potential increase in precision and accuracy, laser technology is not widely used in neurological surgery. This in part relates to challenges associated with the early introduction of lasers into neurosurgery. Considerable advances in laser technology have occurred, which together with robotic technology could create an ideal platform for neurosurgical application. In this study, a 980-nm contact diode laser was integrated with neuroArm. Preclinical evaluation involved partial hepatectomy, bilateral nephrectomy, splenectomy, and bilateral submandibular gland excision in a Sprague-Dawley rat model (n = 50). Total surgical time, blood loss as weight of surgical gauze before and after the procedure, and the incidence of thermal, vascular, or lethal injury were recorded and converted to an overall performance score. Thermal damage was evaluated in the liver using tissue samples stained with hematoxylin and eosin. Clinical studies involved step-wise integration of the 980-nm laser system into four neurosurgical cases. Results demonstrate the successful integration of contact laser technology into microsurgery, with and without robotic assistance. In preclinical studies, the laser improved microsurgical performance and reduced thermal damage, while neuroArm decreased intra- and intersurgeon variability. Clinical studies demonstrate dutility in meningioma resection (n = 4). Together, laser and robotic technology offered a more consistent, expedient, and precise tool for microsurgery.

  20. 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

  1. The First Pilot Comprehensive Evaluation of the Outcomes of Different Types of Robotic Surgeries in the Different Surgical Departments: The Penta, Tetra and Trifecta Achievements in Robotic Surgeries

    PubMed Central

    Sejima, Takehiro; Morizane, Shuichi; Fujiwara, Kazunori; Ashida, Keigo; Saito, Hiroaki; Taniguchi, Yuji; Nakamura, Hiroshige; Takenaka, Atsushi

    2016-01-01

    Background To ensure safe performance in robotic surgery, the Minimal Invasive Surgery Center (MISC) is composed of the anesthesiology department, five surgery departments and co-medical staff in our institution. The objective of this study was to evaluate the outcomes of different types of robotic surgeries for cancer treatment (n = 326) from different surgery departments in the MISC. Methods The outcomes of robot-assisted radical prostatectomy (RARP), partial nephrectomy (RAPN), transoral robotic surgery (TORS) for pharyngeal cancer, and robotic surgery for lung, gastric and rectal cancer were evaluated using the similar concept of pentafecta in RARP. Results The pentafecta rates of RARP and robotic surgery for rectal cancer were 33.3 and 56.5%, respectively. The tetrafecta rates of RARP (excluding potency evaluation from pentafecta) and TORS were 48.4 and 57.1%, respectively. The trifecta rates of RAPN, robotic surgeries for lung and gastric cancer were 75.9, 74.2 and 84.2%, respectively. The failure of tetrafecta in RARP achievement was significantly associated with high risk than with low risk according to National Comprehensive Cancer Network classification. Conclusion This is the world’s first comprehensive evaluation of different types of robotic surgeries for cancer treatment in the constitutional framework of an academic institution. MISC, which provides the constitutional framework of an academic institution, is providing immeasurable benefits in terms of robotic surgery quality, and it may ultimately lead to high penta-, tetra-, and trifecta rates for robotic surgeries for cancer treatment in all surgical departments. PMID:27493484

  2. Transvaginal Route for Kidney Extraction in Laparoscopic Donor Nephrectomy

    PubMed Central

    Berber, Ibrahim; Cakir, Ulkem; Gurkan, Alihan

    2014-01-01

    Background and Objectives: The aim of this retrospective study was to compare conventional laparoscopic living-donor nephrectomy with transvaginal natural orifice transluminal endoscopic surgery–assisted living-donor nephrectomy in terms of feasibility and reproducibility. Methods: A total of 115 consecutive female patients who underwent laparoscopic living-donor nephrectomy (n = 70) or transvaginal natural orifice transluminal endoscopic surgery–assisted living-donor nephrectomy (n = 45) were included and compared in terms of operative characteristics, as well as donor and recipient outcomes. Results: No significant difference was observed between the laparoscopic living-donor nephrectomy and transvaginal natural orifice transluminal endoscopic surgery–assisted living-donor nephrectomy groups in terms of mean duration of warm and cold ischemia, operation time, length of hospital stay, arterial anastomoses, visual analog scale pain scores, serum creatinine levels, and receiver outcomes, whereas a significantly higher number of venous anastomoses was noted in the laparoscopic living-donor nephrectomy group than in the transvaginal natural orifice transluminal endoscopic surgery–assisted living-donor nephrectomy group (P = .029). Conclusions: Transvaginal natural orifice transluminal endoscopic surgery–assisted living-donor nephrectomy seems to be a feasible and reproducible alternative to conventional laparoscopic living-donor nephrectomy in female donors provided the viability of the vagina as an organ retrieval route. PMID:25419107

  3. [Bilateral stage nephrectomy as a preparation for kidney transplantation].

    PubMed

    Mayer, P; Bauer, H W; Land, W

    1982-03-01

    The indication for nephrectomy prior to kidney transplantation has changed. Contrary to the formerly in nearly all transplantation centres practiced one-time two-sided nephrectomy, at present the removal of the patient's own kidneys prior to transplantation is done only if strictly indicated. In contrast to other transplantation centres which, if indicated, still today carry out bilateral nephrectomy prior to transplantation is done only if strictly indicated. In contrast to other transplantation centres which, if indicated, still today carry out bilateral nephrectomy prior to transplantation, since 1977 the transplantation centre of Munich prefers the two-time bilateral nephrectomy. Technique, surgical approach, indication and results of our method are presented. In the course of the discussion the disadvantages of the one-time bilateral nephrectomy are opposed to the advantages of the two-time method.

  4. 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.

  5. Chylous ascites secondary to laparoscopic donor nephrectomy.

    PubMed

    Shafizadeh, Stephen F; Daily, Patrick P; Baliga, Prabhakar; Rogers, Jeffrey; Baillie, G Mark; Rajagopolan, P R; Chavin, Kenneth D

    2002-08-01

    Live donor renal transplantation offers many significant advantages over cadaveric donor transplantation. Yet living donation continues to be underused, accounting for less than 30% of all donor renal transplants. In an attempt to remove the disincentives to live donation, Ratner et al. developed laparoscopic donor nephrectomy (LDN). LDN is gaining acceptance in the transplant community. The overriding concern must always be the safety and welfare of the donor. To this end, potential complications of LDN must be identified and discussed. We present a patient who developed the complication of chylous ascites from LDN. To improve the laparoscopic technique further, a discussion of its successes and complications needs to be encouraged. To this end, we present chylous ascites as a potential complication after LDN. We also offer suggestions to minimize the likelihood of this complication. PMID:12137847

  6. Laparoscopic nephrectomy in a hemophilia B patient

    PubMed Central

    Szopiński, Tomasz; Szczepanik, Andrzej B.; Sosnowski, Roman; Szczepanik, Anna M.

    2016-01-01

    Surgery in patients with hemophilia is a serious challenge. It requires a comprehensive approach, as well as careful postoperative monitoring. We present here the first case of a transperitoneal laparoscopic radical nephrectomy (TLRN) for renal cell carcinoma, of the clear-cell type, performed in a hemophilia B patient. The level of factor IX clotting activity before surgery and on postoperative days 1–6 was maintained at 65–130% and at 30–40% on subsequent days until healing of the post-operative wound was achieved. The intraoperative and postoperative courses were uneventful. TLRN can therefore be considered safe and effective for renal cell carcinoma. In hemophilia patients, the TLRN procedure requires proper preparation, as well as adequate substitution therapy for the deficient coagulation factor provided by a multidisciplinary team in a comprehensive center. PMID:27729993

  7. Comparison of Acute and Chronic Pain after Open Nephrectomy versus Laparoscopic Nephrectomy

    PubMed Central

    Alper, Isik; Yüksel, Esra

    2016-01-01

    Abstract 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

  8. 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. PMID:24906840

  9. [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.

  10. [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. PMID:26526735

  11. Chylous ascites as a complication of laparoscopic donor nephrectomy.

    PubMed

    Caumartin, Yves; Pouliot, Frédéric; Sabbagh, Robert; Dujardin, Thierry

    2005-12-01

    Laparoscopic living donor nephrectomy (LLDN) is a minimally invasive technique for kidney procurement and was developed with the hope of reducing the disincentives associated with live renal donation. Compared with open donor nephrectomy (ODN), this alternative has many advantages including less postoperative pain and earlier return to work. Unfortunately, these benefits are sometimes negated by postoperative complications. Among these, chylous ascites (CA) is a rare but serious problem that is usually managed conservatively. We report the case of a living donor who developed CA refractory to initial conservative management and surgical treatment. We also discuss the role of surgery in the treatment of CA following LLDN. PMID:16297058

  12. Osteoprotective effects of osthole in a mouse model of 5/6 nephrectomy through inhibiting osteoclast formation.

    PubMed

    Li, Xiaofeng; Xue, Chunchun; Wang, Libo; Tang, Dezhi; Huang, Jian; Zhao, Yongjian; Chen, Yan; Zhao, Dongfeng; Shi, Qi; Wang, Yongjun; Shu, Bing

    2016-10-01

    The present study aimed to investigate the effects of osthole on osteoclast formation and bone loss in a mouse model of 5/6 nephrectomy. The mice in control and osthole groups were treated 1 month following 5/6 nephrectomy with either a placebo or osthole, respectively. At 2 months post‑nephrectomy, the L4 vertebrae were harvested. The bone mineral density (BMD) of cancellous bone was measured using micro‑CT and tartrate‑resistant acid phosphatase (TRAP) staining was performed to evaluate osteoclast formation. Immunohistochemistry staining and reverse transcription‑quantitative polymerase chain reaction were performed to detect the expression of nuclear factor of activated T‑cells, cytoplasmic‑1 (NFATc‑1), c‑Fos, cathepsin K, Trap, matrix metalloproteinase 9 (Mmp9), osteoprotegerin (Opg) and receptor activator for nuclear factor‑κB ligand (Rankl). Bone marrow cells were cultured with osthole, and osteoclast formation was shown by TRAP staining. Primary calvaria osteoblasts were cultured with osthole, and expression levels of Opg and Rankl were detected. Compared with the sham group, the BMD of mice in model group was significantly reduced. The numbers of osteoclasts and the expression levels of NFATc‑1, c‑Fos, cathepsin K and Mmp9 were significantly increased. Compared with the control group, the mice in the osthole group exhibited increased BMD of the L4 vertebrae, a reduction in osteoclast numbers and decreased expression levels of NFATc‑1, c‑Fos, cathepsin K and Mmp9. In vitro experiments also showed that osteoclast formation was decreased following treatment with osthole. Osteoprotegerin (Opg)/receptor activator for nuclear factor‑κB ligand (Rankl) was upregulated by osthole treatment in the L4 vertebrae and in primary cultures of calvarial osteoblasts. Osthole inhibited osteoclast formation and partially reversed the bone loss induced by 5/6 nephrectomy in mice through the upregulation of OPG/RANKL. PMID:27571745

  13. 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. PMID:26179472

  14. Cecal volvulus following laparoscopic nephrectomy and renal transplantation.

    PubMed

    Eng, Mary; Ravindra, Kadiyala

    2009-01-01

    Cecal volvulus is a rare cause of bowel obstruction that carries a high mortality. Recent surgery is known to be a risk factor for the development of cecal volvulus. We present a case of cecal volvulus following laparoscopic nephrectomy and renal transplantation.

  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. [Rhabdomyolysis after radical nephrectomy in the lateral decubitus position: report of 2 cases].

    PubMed

    Shibamori, Kosuke; Yamamoto, Takanobu; Matsuki, Masahiro; Matsuda, Yohei; Kato, Shuichi; Takei, Fumiyasu; Yanase, Masahiro

    2014-10-01

    Rhabdomyolysis is a rare perioperative complication, however, potentially lead to fatal outcome. We experienced 2 cases of rhabdomyolysis after radical nephrectomy and nephroureterectomy in the lateral decubitus position. (Case 1) A 40-years old man was seen in our hospital because of asymptomatic grosshematuria. Computed tomography revealed right renal pelvic cancer, cT3N0M0. Right radical nephroureterectomy, lymph node dissection, partial cystectomy was underwent, and the operation was finished without any trouble. At the post-operative day 1, serum creatinine level was elevated to the point of 4.2 mg/dl, and serum creatine kinase was 1,945 IU/l. Continuous hemodiafiltration (CHDF) was done at intensive-care unit (ICU), and serum creatinine and creatine kinase level were decreased. At the post-operative day 1, urine myoglobin level was prominently elevated (2,943.7 ng/ml), so we diagnosed acute renal failure due to rhabdomyolysis. (Case 2) A 40-years old man was incidentally pointed out of right renal tumor that was seen as renal cell carcinoma, cT1aN0M0. Open partial nephrectomy was underwent, and there was no trouble during the operation. After recovering from anesthesia, the patient felt left thigh pain strongly. Serum creatine kinase was 888 IU/L after the operation. At the postoperative day 1, serum creatine kinase level was markedly increased (31,138 IU/L). Serum creatinine level was 1.34 mg/dl. Urine and serum myoglobin level was prominently elevated (89,000 ng/ml and 8,634 ng/ml, respectively). We diagnosed it rhabdomyolysis, and he received large amount of fluid intravenously at intensive-care unit. Serum creatine kinase was peak out at the post-operative day 3 (20,709 IU/L), and hemodialysis was not performed. PMID:25757354

  17. [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.

  18. [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.

  19. Laparoscopic repair of left lumbar hernia after laparoscopic left nephrectomy.

    PubMed

    Gagner, Michel; Milone, Luca; Gumbs, Andrew; Turner, Patricia

    2010-01-01

    Lumbar hernias, rarely seen in clinical practice, can be acquired after open or laparoscopic flank surgery. We describe a successful laparoscopic preperitoneal mesh repair of multiple trocar-site hernias after extraperitoneal nephrectomy. All the key steps including creating a peritoneal flap, reducing the hernia contents, and fixation of the mesh are described. A review of the literature on this infrequent operation is presented. Laparoscopic repair of lumbar hernias has all the advantages of laparoscopic ventral hernia repair.

  20. Industrial robots and robotics

    SciTech Connect

    Kafrissen, S.; Stephens, M.

    1984-01-01

    This book discusses the study of robotics. It provides information of hardware, software, applications and economics. Eleven chapters examine the following: Minicomputers, Microcomputers, and Microprocessors; The Servo-Control System; The Activators; Robot Vision Systems; and Robot Workcell Environments. Twelve appendices supplement the data.

  1. Laparoscopic nephrectomy for complete renal infarction due to post traumatic renal artery thrombosis.

    PubMed

    Gidaro, Stefano; Schips, Luigi; Cindolo, Luca; Ziguener, Richard

    2008-06-01

    We report a case of post traumatic thrombosis of the renal artery with renal infarction and associated liver injury. Conservative treatment was initially planned in consideration of the delayed diagnosis (> 3 hours), but the patient subsequently developed hypertension not controllable with anti-hypertensive drugs. He underwent laparoscopy with nephrectomy and liver injury repair. Hypertension resolved after nephrectomy without further medical treatment. Laparoscopic nephrectomy is not a standard procedure for renal trauma but it could be an option in selected patients.

  2. The role of laparoscopic nephrectomy in pediatric xanthogranulomatous pyelonephritis: a case report.

    PubMed

    F Brown, James; Chamberlain, Jennifer C; Roth, Christopher C

    2013-01-01

    Xanthogranulomatous pyelonephritis (XGP) is a rare chronic renal infection characterized by the destruction of renal parenchyma. Traditional treatment involves open radical nephrectomy, which is challenging due to the inflammatory process associated with XGP. More recently, laparoscopic nephrectomy has been employed successfully in adult XGP. We present a case of a six-year-old female child with XGP who was successfully treated by laparoscopic nephrectomy with minor complications. Our case demonstrates the safety and feasibility of laparoscopic nephrectomy for childhood XGP, indicating that it should be considered a management option in such cases. PMID:23533930

  3. Impact of failed allograft nephrectomy on initial function and graft survival after kidney retransplantation.

    PubMed

    Schleicher, Christina; Wolters, Heiner; Kebschull, Linus; Anthoni, Christoph; Suwelack, Barbara; Senninger, Norbert; Palmes, Daniel; Mersfeld, Bernadette

    2011-03-01

    The management of an asymptomatic failed renal graft remains controversial. The aim of our study was to explore the effect of failed allograft nephrectomy on kidney retransplantation by comparing the outcome of recipients who underwent graft nephrectomy prior to retransplantation with those who did not. Retrospective comparison of patients undergoing kidney retransplantation with (group A, n = 121) and without (group B, n = 45) preliminary nephrectomy was performed, including subgroup analysis with reference to patients with multiple (≥2) retransplantations and patients of the European Senior Program (ESP). Nephrectomy leads to increased panel reactive antibody (PRA) levels prior to retransplantation and is associated with significantly increased rates of primary nonfunction (PNF; P = 0.05) and acute rejection (P = 0.04). Overall graft survival after retransplantation was significantly worse in group A compared with group B (P = 0.03). Among the subgroups especially ESP patients showed a shorter graft survival after previous allograft nephrectomy. On the multivariate analysis, pretransplant graft nephrectomy and PRA >70% were independent and significant risk factors associated with graft loss after kidney retransplantation. Nephrectomy of the failed allograft was not beneficial for retransplant outcome in our series. Patients with failed graft nephrectomy tended to have a higher risk of PNF and acute rejection after retransplantation. The possibility that the graft nephrectomy has a negative impact on graft function and survival after retransplantation is worth studying further.

  4. Robotic surgery

    MedlinePlus

    Robot-assisted surgery; Robotic-assisted laparoscopic surgery; Laparoscopic surgery with robotic assistance ... Robotic surgery is similar to laparoscopic surgery. It can be performed through smaller cuts than open surgery. ...

  5. Application of "cinch/tie" technique to robotic-assisted nephropexy for posterior abdominal wall fixation.

    PubMed

    Castle, Scott M; Karnjanawanichkul, Watid; Leveillee, Raymond J

    2012-06-01

    Nephropexy remains standard for symptomatic nephroptosis, and several minimally-invasive techniques have been described. Triangulation sutures placed between the abdominal wall and the renal capsule are often difficult to tie tightly due to the confined working space. We propose a technique modification to fixate the kidney utilizing the da Vinci Surgical System robot and Lapra-Ty absorbable suture clips. Four female patients with symptomatic nephroptosis diagnosed via kidney hypermobility demonstrated on intravenous urography (IVU) underwent robotic-assisted laparoscopic nephropexy (RALNP) from February 2008 to April 2010. After complete mobilization and stripping of perirenal fat, several 0 Vicryl sutures were placed in a "figure of eight" fashion and tied loosely. Subsequently we utilized a Lapra-Ty to tighten the stitch serially and fixate the kidney. The mean age was 46 years (43-52); one patient underwent simultaneous pyeloplasty and one underwent partial nephrectomy in the ipsilateral kidney. There were no intraoperative complications and two postoperative complications, both Clavien grade I. All patients were asymptomatic postoperatively at a mean follow-up of 9.2 months (1-28), and had no evidence of kidney hypermobility on upright IVU or diuretic renal scintigraphy (RS) scan at 6 weeks postoperatively. RALNP is a viable option in the treatment of symptomatic nephroptosis. Secure placement of several "pexing" sutures helps to ensure appropriate security of these itinerant kidneys. Our technique modification corrects kidney hypermobility while improving symptoms related to nephroptosis. PMID:27628279

  6. A Comparison of Hand-Assisted and Pure Laparoscopic Techniques in Live Donor Nephrectomy

    PubMed Central

    Branco, Anibal Wood; Kondo, William; Filho, Alcides José Branco; de George, Marco Aurélio; Rangel, Marlon; Stunitz, Luciano Carneiro

    2008-01-01

    PURPOSE To compare hand-assisted laparoscopic donor nephrectomy and pure laparoscopic live donor nephrectomy techniques in live donor nephrectomy. METHODS In this retrospective study, we included all patients submitted to hand-assisted laparoscopic donor nephrectomy and pure laparoscopic live donor nephrectomy between May 2002 and December 2007. The operative data and post-operative courses were reviewed. Information was collected on the operative time, warm ischemia time, estimated blood loss, intra-operative complications, time to first oral intake, length of hospital stay, and post-operative complications. The data were analyzed using Student’s t –tests and Fisher exact tests as appropriate, with statistical significance defined as p < 0.05. RESULTS The means of the operative duration, warm ischemia time and intra-operative bleeding were 83 min, 3.6 min and 130.9 cc, respectively, for hand-assisted laparoscopic donor nephrectomy, and 78.4 min, 2.5 min and 98.9 cc, respectively, for pure laparoscopic live donor nephrectomy (p=0.29, p<0.0001 and p=0.08, respectively). Intra-operative complications occurred in 6% of patients submitted to hand-assisted laparoscopic donor nephrectomy and in 4.5% of those submitted to pure laparoscopic live donor nephrectomy (p=0.68). Only one patient from each group required conversion to open surgery; one person receiving hand-assisted laparoscopic donor nephrectomy had bleeding and one person receiving pure laparoscopic live donor nephrectomy had low carbon dioxide levels during the warm ischemia period. Compared with patients receiving hand-assisted laparoscopic donor nephrectomy, patients submitted to pure laparoscopic live donor nephrectomy were able to take their first meal earlier (12.5 vs. 9.2 hours, p=0.046), were discharged home sooner (2.8 vs. 1.4 days, p<0.0001) and had fewer post-operative complications (7.5% vs. 0.6%, p=0.04). CONCLUSIONS Pure laparoscopic live donor nephrectomy had some advantages over hand

  7. Nephrectomy Type Was Not Associated with a Subsequent Risk of Coronary Heart Disease: A Population-Based Study.

    PubMed

    Chung, Shiu-Dong; Huang, Chao-Yuan; Wu, Sheng-Tang; Lin, Herng-Ching; Huang, Chung-Chien; Kao, Li-Ting

    2016-01-01

    Previous studies investigated the impacts of a partial nephrectomy (PN) or radical nephrectomy (RN) on cardiovascular events and death. However, the association between the type of nephrectomy (PN vs. RN) and cardiovascular disease is still equivocal. This retrospective cohort study aimed to compare the risk of coronary heart disease (CHD) between patients who underwent a PN and those who underwent an RN. We used data from the Taiwan Longitudinal Health Insurance Database 2005. In total, 60 patients who underwent a PN and 545 patients who underwent an RN were included. Each patient was tracked for 1-, 2-, 3-, and 5-year periods to identify those who were subsequently diagnosed with CHD. Cox proportional hazard regression analyses were used to calculate hazard ratios (HRs) for CHD during 1-, 2-, 3-, and 5-year follow-up periods between these two cohorts. For the 1-year follow-up period, the adjusted HR was 0.39 (95% CI: 0.05~2.90, p = 0.355) for patients who underwent a PN compared to those who underwent an RN. Additionally, the adjusted HRs of CHD in patients who underwent a PN for 2-, 3- and 5-year follow-up periods were 1.40 (95% CI: 0.62~3.16, p = 0.417), 1.09 (95% CI: 0.52~2.31, p = 0.814), and 1.02 (95% CI: 0.48~2.18, p = 0.961), respectively, compared to those who underwent an RN. We concluded that there was no significant difference in the risk of CHD between patients who underwent a PN and those who underwent an RN. PMID:27636094

  8. Nephrectomy Type Was Not Associated with a Subsequent Risk of Coronary Heart Disease: A Population-Based Study

    PubMed Central

    Huang, Chao-Yuan; Lin, Herng-Ching; Huang, Chung-Chien; Kao, Li-Ting

    2016-01-01

    Previous studies investigated the impacts of a partial nephrectomy (PN) or radical nephrectomy (RN) on cardiovascular events and death. However, the association between the type of nephrectomy (PN vs. RN) and cardiovascular disease is still equivocal. This retrospective cohort study aimed to compare the risk of coronary heart disease (CHD) between patients who underwent a PN and those who underwent an RN. We used data from the Taiwan Longitudinal Health Insurance Database 2005. In total, 60 patients who underwent a PN and 545 patients who underwent an RN were included. Each patient was tracked for 1-, 2-, 3-, and 5-year periods to identify those who were subsequently diagnosed with CHD. Cox proportional hazard regression analyses were used to calculate hazard ratios (HRs) for CHD during 1-, 2-, 3-, and 5-year follow-up periods between these two cohorts. For the 1-year follow-up period, the adjusted HR was 0.39 (95% CI: 0.05~2.90, p = 0.355) for patients who underwent a PN compared to those who underwent an RN. Additionally, the adjusted HRs of CHD in patients who underwent a PN for 2-, 3- and 5-year follow-up periods were 1.40 (95% CI: 0.62~3.16, p = 0.417), 1.09 (95% CI: 0.52~2.31, p = 0.814), and 1.02 (95% CI: 0.48~2.18, p = 0.961), respectively, compared to those who underwent an RN. We concluded that there was no significant difference in the risk of CHD between patients who underwent a PN and those who underwent an RN. PMID:27636094

  9. 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.

  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. Laparoscopic donor nephrectomy: impact on an established renal transplant program.

    PubMed

    Shafizadeh, S; McEvoy, J R; Murray, C; Baillie, G M; Ashcraft, E; Sill, T; Rogers, J; Baliga, P; Rajagopolan, P R; Chavin, K

    2000-12-01

    The current disparity of viable organs and patients in need of a transplant has been an impetus for innovative measures. Live donor renal transplantation offers significant advantages compared with cadaveric donor transplantation: increased graft and patient survival, diminution in incidence of delayed graft function, acute tubular necrosis (ATN), and reduction in waiting time. Notwithstanding these gains live donors continue to be underutilized and account for only approximately one quarter of all renal transplants performed in the United States. It has been felt that inherent disincentives to live donation have slowed its growth. These include degree and duration of postoperative pain and convalescence, child care concerns, cosmetic concerns, and time until return to full activities and employment. In an attempt to curtail the disincentives to live donation, laparoscopic live donation (laparoscopic donor nephrectomy; LDN) was developed. The purpose of this study was to compare the results of our first 25 laparoscopic nephrectomies (performed over a 10-month period from September 1998 through July 1999) with the previous 25 standard open donor nephrectomies (ODNs) completed over the past 3 years. We conducted a retrospective review of all donor nephrectomies and recipient pairs performed over the past 3 years. End points included sex, operative time, length of stay, immediate and long-term renal function, and willingness to donate. There were no differences in demographics of the ODN versus the LDN group. The average length of stay was 2.48+/-0.72 days for the LDN versus 4.08+/-0.28 days for the ODN. ODN and LDN have comparable short- and long-term function with no delayed graft function and no complications. Growth of living donor transplant has increased from 16 per cent of all kidney transplants performed in 1995 to 23 per cent in 1999. We conclude that LDN is a viable alternative to the standard donor operation. LDN has had a positive impact on the donor pool

  12. Pediatric retroperitoneoscopic nephrectomy: An initial experience of 15 cases

    PubMed Central

    Maitra, Souvik; Khanna, Puneet; Baidya, Dalim Kumar; Pawar, Dilip Kumar; Baipai, Minu; Panda, Shasanka Shekhar

    2015-01-01

    Retroperitoneoscopic approach of nephrectomy in pediatric patients is a debatable issue from surgical point of view. Experience of anesthetic management of 15 such patients from a tertiary care teaching hospital has been described here. We found that capno-retroperitoneum increases end-tidal carbon-di-oxide, but normocapnea was achieved in the most of the patients. No significant hemodynamic changes were noted in any patients. However, subcutaneous emphysema was common, but self-limiting without any serious consequence. Postoperative pain after this procedure is usually manageable by nonopioid analgesics. PMID:25788784

  13. Recurrent renal cell cancer: 10 years or more after nephrectomy.

    PubMed

    Abara, Emmanuel; Chivulescu, Iolanda; Clerk, Nilam; Cano, Pablo; Goth, Alexis

    2010-04-01

    Localized renal cell carcinoma (RCC) responds well to surgery. Patients often question how long they have to be on surveillance after their surgery. Several follow-up patterns have been described in the literature. Until 2009, no published established Canadian guidelines existed to assist Canadian health-care practitioners in the surveillance of these patients. We present 3 cases of RCC that recurred 10 years or longer after the initial nephrectomy. These cases emphasize the need for careful long-term follow-up, as recommended in the Canadian Urological Association guidelines. We also discuss the optimism of prolonged disease survival in the era of novel therapeutic agents that target angiogenesis. PMID:20368882

  14. Simultaneous bilateral robotic-assisted laparoscopic procedures in children.

    PubMed

    Kapoor, Victor; Elder, Jack S

    2015-12-01

    Our main objective is to report the feasibility of performing simultaneous robotic-assisted laparoscopic (RAL) heminephrectomy with contralateral ureteroureterostomy in children with bilateral duplicated systems. Three female children with bilateral congenital renal/ureteral anomalies underwent concurrent RAL simultaneous unilateral partial nephrectomy with ureterectomy and contralateral ureteroureterostomy with redundant ureterectomy using a four/five-port approach. Mean age at repair was 32.9 months (range 7-46 months) and mean weight was 13.7 kg (range 10.4-13.6 kg). The RAL heminephroureterectomy and contralateral ureteroureterostomy were performed via a four-port approach (five ports in one patient), and the patients were repositioned and draped when moving to the other side. Mean operative time was 446 min (range 356-503 min). Mean estimated blood loss was 23.3 cc (range 10-50 cc). Postoperative length of stay for two patients was 2 days and 1 day for one patient (mean = 1.7 days). Mean length of follow-up was 18.3 months (range 7-36 months). No significant intraoperative or postoperative complications occurred for any of the three patients. Two children had no hydronephrosis on postoperative imaging in follow-up, and one child had a small stable, residual pararenal fluid collection on the side of heminephrectomy. Two patients underwent postoperative ureteral stent removal under general anesthesia. In children with bilateral duplicated urinary tract with ureterocele, ectopic ureter, and/or vesicoureteral reflux, laparoscopic repair with robotic assistance can be accomplished safely in a single operative procedure with a short hospital stay.

  15. Simultaneous bilateral robotic-assisted laparoscopic procedures in children.

    PubMed

    Kapoor, Victor; Elder, Jack S

    2015-12-01

    Our main objective is to report the feasibility of performing simultaneous robotic-assisted laparoscopic (RAL) heminephrectomy with contralateral ureteroureterostomy in children with bilateral duplicated systems. Three female children with bilateral congenital renal/ureteral anomalies underwent concurrent RAL simultaneous unilateral partial nephrectomy with ureterectomy and contralateral ureteroureterostomy with redundant ureterectomy using a four/five-port approach. Mean age at repair was 32.9 months (range 7-46 months) and mean weight was 13.7 kg (range 10.4-13.6 kg). The RAL heminephroureterectomy and contralateral ureteroureterostomy were performed via a four-port approach (five ports in one patient), and the patients were repositioned and draped when moving to the other side. Mean operative time was 446 min (range 356-503 min). Mean estimated blood loss was 23.3 cc (range 10-50 cc). Postoperative length of stay for two patients was 2 days and 1 day for one patient (mean = 1.7 days). Mean length of follow-up was 18.3 months (range 7-36 months). No significant intraoperative or postoperative complications occurred for any of the three patients. Two children had no hydronephrosis on postoperative imaging in follow-up, and one child had a small stable, residual pararenal fluid collection on the side of heminephrectomy. Two patients underwent postoperative ureteral stent removal under general anesthesia. In children with bilateral duplicated urinary tract with ureterocele, ectopic ureter, and/or vesicoureteral reflux, laparoscopic repair with robotic assistance can be accomplished safely in a single operative procedure with a short hospital stay. PMID:26530838

  16. War without men. Robots on the future battlefield

    SciTech Connect

    Shaker, S.M.; Wise, A.R.

    1987-01-01

    The first book on unmanned military vehicles, the weapons of the next war: remotely piloted airborne vehicles, unmanned naval vessels and submersibles, unmanned spacecraft, and robotic ground vehicles. Contents (partial): Foreword; Introduction to the robot warrior; The evolution of military robotic systems; Current operational use and development of unmanned robotic ground vehicles; Current operational use and development of RPVs; Current operational use and development of unmanned naval vessels; Space-based robotics; Impact, applications, and the future of military robots; Index.

  17. Laparoscopic live donor nephrectomy with vaginal extraction: initial report.

    PubMed

    Allaf, M E; Singer, A; Shen, W; Green, I; Womer, K; Segev, D L; Montgomery, R A

    2010-06-01

    The recent decrease in the total number of living kidney transplants coupled with the increase in the number of candidates on the waiting list underscores the importance of eliminating barriers to living kidney donation. We report what we believe to be the first pure right-sided laparoscopic live donor nephrectomy with extraction of the kidney through the vagina. The warm ischemia time was 3 min and the renal vessels and ureter of the procured kidney were of adequate length for routine transplantation. The donor did not receive any postoperative parenteral narcotic analgesia, was discharged home within 24 h and was back to normal activity in 14 days. The kidney functioned well with no complications or infections. Laparoscopic live donor nephrectomy with vaginal extraction may be a viable alternative to open and standard laparoscopic approaches. Potential advantages include reduced postoperative pain, shorter hospital stay and convalescence and a more desirable cosmetic result. These possible, but yet unproven, advantages may encourage more individuals to consider live donation. PMID:20553450

  18. 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

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

    PubMed

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

    2016-01-01

    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

  20. 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.

  1. Transumbilical pure single-port laparoscopic donor nephrectomy.

    PubMed

    Kim, Joo Mee; Jeong, Won Jun; Choi, Byung Jo; Yuk, Seung Mo; Hwang, Jeong Kye; Lee, Sang Chul

    2015-11-01

    Transumbilical single-port laparoscopic donor nephrectomy (SPLDN) is a novel, rapidly evolving, minimally invasive treatment modality for kidney transplantation. This method causes minimal parietal injury, has cosmetic advantages, and allows rapid recovery because of low postoperative pain and short hospital stay. Like other abdominal surgeries, when conducted by experienced laparoscopic surgeons, it can meet the same graft requirements as conventional laparoscopic surgery. Here, we report the first two cases of transumbilical SPLDN at Daejeon St. Mary's Hospital, The Catholic University of Korea. We used the umbilicus as a common path for laparoscopic procedures and as a route for specimen retrieval. The operating times were 230 and 265 minutes in cases 1 and 2, respectively. No intra- or postoperative complications were noted. In case 1, the wound length was 4 cm and duration of hospitalization was 2 days. In case 2, the wound length was only 2.5 cm, and the duration of hospitalization was only 1 day. PMID:26576409

  2. Robot-assisted laparoscopic urological surgery in children.

    PubMed

    Sávio, Luís F; Nguyen, Hiep T

    2013-11-01

    Robot-assisted laparoscopic surgery (RALS) has been proven to be safe and effective for various urological procedures in children, including pyeloplasty, orchiopexy, nephrectomy, and bladder augmentation. The robot system enables delicate and precise movements, which are ideal for the types of reconstructive surgeries that children with urological issues often require, overcoming many of the impediments associated with the conventional laparoscopic approach. RALS helps the relative novice to perform fine surgical techniques and is thought to reduce the learning curve associated with some surgical techniques, such as intracorporeal suturing, owing to the improved freedom of movement of the surgical instruments, the ergonomic positioning of the surgeon, and the 3D vision provided by the robotic system. Given the favourable safety profile and associated benefits of the robot system, including reductions in mean postoperative hospital stay compared with conventional procedures, RALS is becoming more widely adopted by paediatric urologists.

  3. 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.

  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.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.

  6. 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.

  7. 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.

  8. Robotic surgery.

    PubMed

    Oleynikov, Dmitry

    2008-10-01

    This article discusses the developments that led up to robotic surgical systems as well as what is on the horizon for new robotic technology. Topics include how robotics is enabling new types of procedures, including natural orifice endoscopic translumenal surgery in which one cannot reach by hand under any circumstances, and how these developments will drive the next generation of robots. PMID:18790158

  9. 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.

  10. [Retroperitoneal lymphocele occurring in a child after nephrectomy and treated by percutaneous drainage].

    PubMed

    Tlili-Graiess, K; Gharbi-Jemni, H; Kraiem, C; Harbi, A; Allegue, M; Jeddi, M

    1994-01-01

    Lymphocele is a rare complication of kidney surgery in pediatric practice. Recent treatment consists in long term percutaneous drainage. The case reported was diagnosed 9 years after nephrectomy and improved with 3 weeks percutaneous drainage.

  11. [Renal cell carcinoma metastasis to the thyroid gland 15 years after nephrectomy].

    PubMed

    Mathiesen, Jes Sloth; Fleischer, Jens Geelmuyden; Godballe, Christian

    2015-01-26

    Renal cell carcinoma (RCC) metastasis to the thyroid gland is rare and can mimic primary thyroid carcinoma leading to diagnostic difficulties. We present a case of a 55-year-old female with RCC metastasis to the thyroid gland 15 years after nephrectomy. Diagnosis was made after total thyroidectomy. This case emphasizes the importance of considering metastasis in patients with increasing growth of the thyroid gland over a short period of time known with earlier RCC, even decades after nephrectomy. PMID:25612964

  12. Experience with sliding-clip splenorrhaphy for splenic injury during radical nephrectomy

    PubMed Central

    Giri, Subhasis K.; Abdelrahman, Mamoun; Flood, Hugh D.

    2015-01-01

    Introduction: We report our experience with sliding-clip splenorrhaphy (SCS), a novel splenic conservation technique, for iatrogenic splenic injury (ISI) during a left radical nephrectomy (RN). We also reviewed the literature on ISI. Methods: We retrospectively reviewed data from patients who had RN between January 2005 and December 2013 at our institution. The technique used was similar to sliding-clip renorrhaphy. Our Medline literature identified articles containing “splenic injury during nephrectomy,” “iatrogenic splenic injury.” “iatrogenic splenectomy,” and “splenorrhaphy.” Our primary outcome measures included incidence of splenic injury and splenic conservation rate and splenectomy. Results: Among the 370 RN, 140 were left sided. ISI injury occurred in 6 left RN (incidence 1.6% for all nephrectomies, 4.2% for left-sided nephrectomies). All 6 cases had open procedure and for the left-sided procedure. Splenic conservation was attempted in 4 patients using SCS and 3 out of 4 were successfully repaired. Altogether 3 patients had splenectomy (incidence 0.8% for all nephrectomies, 2.1% for left-sided nephrectomies). Our literature review revealed that the incidence of iatrogenic splenectomy during left nephrectomy varies from 1.3% to 13.2%. Conclusions: SCS is an acceptable novel splenic conservation technique due to its ease of use and success in selected patients with ISI. There is little evidence on the true incidence of ISI especially on splenic conservation during nephrectomy. Every attempt at splenic conservation is likely to improve immediate- and long-term patient outcomes. PMID:26279719

  13. 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.

  14. Robotics in paediatric urology.

    PubMed

    Olsen, Lars Henning

    2006-02-01

    After the emergence of robotically assisted systems in laparoscopic surgery more than 15 years ago, several systems have been on the market. At the time being only one system, the da Vinci surgical system (Intuitive Surgical, Sunnyvale, CA, USA), has survived in clinical use with an increasing spread particularly among adult urologists used primarily for radical prostatectomies. However, the reconstructive nature of paediatric urology makes the system interesting for the paediatric urologists, since its strength is laparoscopic suturing and difficult dissection. So far only few reports have been published about its clinical use in paediatric urology. The main advantages are the 3D magnified view, the wrist-like movements of the instruments, and the scaling and precision of instrument movements. The system has been used for upper tract reconstruction like pyeloplasties and heminephrectomies, both for the transperitoneal and, more technical challenging, the retroperitoneal approach. In the pelvic region, anti-reflux surgery (both extra- and intravesically) and surgery for malformations of the internal genitalia like utriculus cysts and gonadal streaks are feasible. More simple procedures like nephrectomies and the management of the intra-abdominal testis are not justified due to the high costs. In addition, no advantage for the patients related to standard laparoscopic procedures has been proofed yet. For the surgeon the minimally challenging invasive procedures become feasible with certainly improved ergonomics. The use of the system is much easier than standard laparoscopic surgery and its widespread will give more patients to access minimal invasive surgery. PMID:18947593

  15. Robotics in paediatric urology.

    PubMed

    Olsen, Lars Henning

    2006-02-01

    After the emergence of robotically assisted systems in laparoscopic surgery more than 15 years ago, several systems have been on the market. At the time being only one system, the da Vinci surgical system (Intuitive Surgical, Sunnyvale, CA, USA), has survived in clinical use with an increasing spread particularly among adult urologists used primarily for radical prostatectomies. However, the reconstructive nature of paediatric urology makes the system interesting for the paediatric urologists, since its strength is laparoscopic suturing and difficult dissection. So far only few reports have been published about its clinical use in paediatric urology. The main advantages are the 3D magnified view, the wrist-like movements of the instruments, and the scaling and precision of instrument movements. The system has been used for upper tract reconstruction like pyeloplasties and heminephrectomies, both for the transperitoneal and, more technical challenging, the retroperitoneal approach. In the pelvic region, anti-reflux surgery (both extra- and intravesically) and surgery for malformations of the internal genitalia like utriculus cysts and gonadal streaks are feasible. More simple procedures like nephrectomies and the management of the intra-abdominal testis are not justified due to the high costs. In addition, no advantage for the patients related to standard laparoscopic procedures has been proofed yet. For the surgeon the minimally challenging invasive procedures become feasible with certainly improved ergonomics. The use of the system is much easier than standard laparoscopic surgery and its widespread will give more patients to access minimal invasive surgery.

  16. 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

  17. Swarm Robotics

    NASA Astrophysics Data System (ADS)

    Şahin, Erol; Girgin, Sertan; Bayindir, Levent; Turgut, Ali Emre

    Swarm robotics is a novel approach to the coordination of large numbers of robots and has emerged as the application of swarm intelligence to multi-robot systems. Different from other swarm intelligence studies, swarm robotics puts emphases on the physical embodiment of individuals and realistic interactions among the individuals and between the individuals and the environment. In this chapter, we present a brief review of this new approach. We first present its definition, discuss the main motivations behind the approach, as well as its distinguishing characteristics and major coordination mechanisms. Then we present a brief review of swarm robotics research along four axes; namely design, modelling and analysis, robots and problems.

  18. Robotic surgery.

    PubMed

    Stoianovici, D

    2000-09-01

    The industrial revolution demonstrated the capability of robotic systems to facilitate and improve manufacturing. As a result, robotics extended to various other domains, including the delivery of health care. Hence, robots have been developed to assist hospital staff, to facilitate laboratory analyses, to augment patient rehabilitation, and even to advance surgical performance. As robotics lead usefulness and gain wider acceptance among the surgical community, the urologist should become familiar with this new interdisciplinary field and its "URobotics" subset: robotics applied to urology. This article reviews the current applications and experience, issues and debates in surgical robotics, and highlights future directions in the field.

  19. 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.

  20. 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.

  1. Severe hemorrhage complicating early transplant nephrectomy due to sepsis.

    PubMed

    Akoh, Jacob A; Rana, Tahawar

    2016-05-01

    Compared to the general population, transplant patients receiving immuno- suppression have an increased risk of wound and systemic infection that might lead to hemorrhage. We present a case of severe bleeding from the external iliac artery secondary to a pelvic abscess following renal transplantation and transplant nephrectomy. A 73-year-old man received an extended criteria donor organ from a 49-year-old person who died from systemic sepsis. The patient bled from the Carrel's patch while awaiting a computed tomographic scan- guided drainage of an infected peritransplant collection. At exploration, a nonviable allograft surrounded by about 1 L of thick pus was removed. Bleeding from a 2 mm hole in the Carrel's patch was repaired by prolene suture as the external iliac vessels could not be mobilized due to a frozen pelvis. The patient died 72 h later from a massive bleed confirmed at postmortem to have originated from the external iliac artery distal to the anastomosis. Diversion of blood flow away from an affected area (with or without excision of the infected vessels) through a bypass procedure probably represents the best option in avoiding such sequelae. PMID:27215254

  2. 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

  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. 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);…

  5. (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.

  6. 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

  7. Robot programming

    SciTech Connect

    Lozano-Perez, T.

    1982-12-01

    The industrial robot's principal advantage over traditional automation is programmability. Robots can perform arbitrary sequences of pre-stored motions or of motions computed as functions of sensory input. This paper reviews requirements for and developments in robot programming systems. The key requirements for robot programming systems examined in the paper are in the areas of sensing, world modeling, motion specification, flow of control, and programming support. Existing and proposed robot programming systems fall into three broad categories: guiding systems in which the user leads a robot through the motions to be performed, robot-level programming systems in which the user writes a computer program specifying motion and sensing, and task-level programming systems in which the user writes a computer program specifying motion and sensing, and task-level programming systems in which the user specifies operations by their desired effect on objects. A representative sample of systems in each of these categories is surveyed in the paper.

  8. Cystic local recurrence of renal cell carcinoma after laparoscopic radical nephrectomy in a hemodialysis patient.

    PubMed

    Ito, Kazuyo; Takagi, Toshio; Kondo, Tsunenori; Yoshida, Kazuhiko; Iizuka, Junpei; Kobayashi, Hirohito; Tomita, Eri; Hashimoto, Yasunobu; Tanabe, Kazunari

    2014-03-01

    Although local recurrence of renal cell carcinoma after laparoscopic radical nephrectomy is sometimes reported, cystic local recurrence of renal cell carcinoma has rarely been reported. We report the case of a 59-year-old man with hemodialysis who developed cystic local recurrence of renal cell carcinoma accompanied by acquired cystic disease of the kidney in the retroperitoneal space after laparoscopic radical nephrectomy. A cystic tumor of 5.1 cm in diameter occurred in the left retroperitoneal space 15 months after left laparoscopic radical nephrectomy, and enlarged to 7.2 cm in diameter with enhanced mass along the wall of the cyst 36 months after surgery. The cystic tumor was removed and showed local recurrence of renal cell carcinoma on pathological examination.

  9. Robotics and robot sensing systems; Proceedings of the Meeting, San Diego, CA, August 25, 1983

    NASA Astrophysics Data System (ADS)

    Casasent, D.; Hall, E. L.

    1983-01-01

    Topics related to robotic sensing are discussed, taking into account robot vision for machine part recognition, an evaluation of imaging sensors, binary and gray scale robot vision, and global and partial shape discrimination for computer vision. Aspects of shift-invariant and distortion-invariant object recognition are considered along with the control of a robot manipulator, the control of robot motion, robotics-related technology in the nuclear industry, and three-dimensional images for robot vision. Questions regarding the three-dimensional perception for robot vision are also explored, giving attention to two-dimensional model matching, surface measurement using shading information, stereo imaging, single image stereo for curved surface measurement and location, and problems of curved surface representation.

  10. A Case of Bilateral Cystic Partially Differentiated Nephroblastoma vs Cystic Wilms' Tumor: Highlighting a Diagnostic Dilemma.

    PubMed

    Stout, Thomas E; Au, Jason K; Hicks, J M; Gargollo, Patricio C

    2016-06-01

    Cystic partially differentiated nephroblastoma (CPDN) is a rare multicystic renal tumor along the spectrum of cystic nephroma and cystic Wilms' tumor. There have only been two previously reported cases of bilateral CPDN in the literature. We present here a case of bilateral CPDN vs cystic Wilms' tumor treated with neoadjuvant and adjuvant chemotherapy in addition to a bilateral partial nephrectomy. We also review the relevant literature regarding CPDN in an effort to aid in diagnosis and management of these rare cystic renal tumors.

  11. 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.

  12. Eclectic theory of intelligent robots

    NASA Astrophysics Data System (ADS)

    Hall, E. L.; Ghaffari, M.; Liao, X.; Ali, S. M. Alhaj; Sarkar, Saurabh; Reynolds, Scott; Mathur, Kovid

    2007-09-01

    The purpose of this paper is to introduce a concept of eclecticism for the design, development, simulation and implementation of a real time controller for an intelligent, vision guided robots. The use of an eclectic perceptual, creative controller that can select its own tasks and perform autonomous operations is illustrated. This eclectic controller is a new paradigm for robot controllers and is an attempt to simplify the application of intelligent machines in general and robots in particular. The idea is to uses a task control center and dynamic programming approach. However, the information required for an optimal solution may only partially reside in a dynamic database so that some tasks are impossible to accomplish. So a decision must be made about the feasibility of a solution to a task before the task is attempted. Even when tasks are feasible, an iterative learning approach may be required. The learning could go on forever. The dynamic database stores both global environmental information and local information including the kinematic and dynamic models of the intelligent robot. The kinematic model is very useful for position control and simulations. However, models of the dynamics of the manipulators are needed for tracking control of the robot's motions. Such models are also necessary for sizing the actuators, tuning the controller, and achieving superior performance. Simulations of various control designs are shown. Much of the model has also been used for the actual prototype Bearcat Cub mobile robot. This vision guided robot was designed for the Intelligent Ground Vehicle Contest. A novel feature of the proposed approach lies in the fact that it is applicable to both robot arm manipulators and mobile robots such as wheeled mobile robots. This generality should encourage the development of more mobile robots with manipulator capability since both models can be easily stored in the dynamic database. The multi task controller also permits wide

  13. Comparison of transperitoneal laparoscopic nephrectomy outcomes in atrophic and hydronephrotic kidneys

    PubMed Central

    Gülpınar, Murat Tolga; Akçay, Muzaffer; Sancak, Eyüp Burak; Akbaş, Alpaslan; Tepeler, Abdulkadir; Reşorlu, Berkan; Armağan, Abdullah

    2015-01-01

    Objective To compare the results of transperitoneal laparoscopic nephrectomy in patients with atrophic and hydronephrotic kidneys. Material and methods Clinical data were collected from 35 patients who had undergone laparoscopic nephrectomies for atrophic or hydronephrotic non-functioning kidneys between January 2010 and March 2014. Comparative analysis was carried out between the two groups examining demographic characteristics, imaging modalities, etiology, operative times, port numbers, conversion to open surgery, complications, pre-and post-operative hemoglobin and creatinine values, transfusion rates and length of hospital stays. Results Laparoscopic nephrectomy was performed for atrophic kidneys in 20 (57%) patients and for hydronephrotic kidneys in 15 (42%) patients. In the atrophic group, 3 patients (15%) required transfusion because of bleeding but none of the patients required conversion to open surgery. In the hydronephrotic group one patient (6.6%) required transfusion and conversion to open surgery because of bleeding. Both of the groups were similar in terms of postoperative hospital stay but compared to the atrophic kidneys, hydronephrotic ones were associated with a longer total operative times (90.1 min vs. 73.6 min, p=0.03). Any serious complication (except for bleeding) and mortality were not encountered in both groups. Conclusion Laparoscopic nephrectomy is a safe and effective minimally invasive technique that can be used in atrophic and hydronephrotic non-functioning kidneys. PMID:26623146

  14. Transvaginal natural orifice transluminal endoscopic surgery-assisted minilaparoscopic nephrectomy: a step towards scarless surgery.

    PubMed

    Porpiglia, Francesco; Fiori, Cristian; Morra, Ivano; Scarpa, Roberto Mario

    2011-10-01

    The feasibility of a transvaginal hybrid natural orifice transluminal endoscopic surgery (NOTES) nephrectomy has already been demonstrated using standard laparoscopic ports through the abdominal wall. We evaluated the feasibility of a transvaginal NOTES-assisted minilaparoscopic nephrectomy (mLN). The patient is positioned in a semilumbotomy position with legs separated to allow for vaginal access. A 3.5-mm port is placed at the umbilicus for a 30° laparoscope; two 3.5-mm ports are placed in the flank in the same location as for a standard transperitoneal nephrectomy; and a 12-mm port is placed through the vagina, perforating the vaginal wall. Kidney dissection is performed following the steps of a traditional nephrectomy. The renal pedicle is dissected and secured with Hem-o-Lok clips through the vaginal access port. The specimen is then extracted through an extended incision in the posterior wall of the vagina. We treated five patients. The average operative time was 120 min, blood loss was 160 ml, and no complications were recorded. Our initial experience suggests that transvaginal NOTES-assisted mLN is feasible and appears to be safe. It is simpler than a pure NOTES procedure and ensures excellent cosmetic results.

  15. 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

  16. Laparoscopic adrenalectomy for metachronous ipsilateral metastasis following nephrectomy for renal cell carcinoma

    PubMed Central

    Eret, Viktor; Ürge, Tomáš; Trávníček, Ivan; Chudáček, Zdeněk; Hes, Ondřej; Hora, Milan

    2013-01-01

    Introduction Although laparoscopic adrenalectomy (LA) is considered as a gold standard approach for adrenalectomy, there are minimal data describing options and outcomes of LA after previous ipsilateral nephrectomy (PIN). Aim To describe our results in a group of patients who underwent LA after PIN. Material and methods From August 2004 to October 2012 we performed at our institution 88 LA. Of this amount we performed 5 LA for metachronous metastasis of renal cell carcinoma (RCC) after PIN. This group was compared to a group without previous nephrectomy. Results The group comprised 4 men (80%) and 1 woman (20%); the mean age at the time of surgery was 66.8 ±8.5 (range: 60-77) years; the mean period between nephrectomy and adrenalectomy was 5.2 (range: 1.5-14) years; the operating time was longer in patients after PIN for 7 min; the mean blood loss was higher by 22 ml; duration of hospitalization was shorter by 1.3 days, paradoxically, compared with patients without PIN. There was no need for conversion to open surgery and we did not observe any other complications. Conclusions Laparoscopic adrenalectomy for metastasis of RCC after PIN is a technically feasible method in selected patients and it is associated with no significant differences in perioperative data in comparison with the group without prior nephrectomy. The patients benefit from minimally invasive surgery. The performance has required an experienced laparoscopic surgeon. PMID:24130636

  17. The role of embolization in the management of tumour recurrence after radical nephrectomy.

    PubMed

    Akhtar, Kashif; Lee, George; Khan, Masood; Mitchell, Adam; Livni, Naomi; Christmas, Timothy

    2010-01-01

    This article presents the case of a 56-year-old woman who developed a tumour recurrence following radical nephrectomy. This was invading the descending colon and causing severe gastrointestinal haemorrhage. Angiography revealed neovascularization from T11 and T12 intercostal arteries, which were successfully embolized percutaneously.

  18. Simultaneous Native Nephrectomy and Kidney Transplantation in Patients With Autosomal Dominant Polycystic Kidney Disease

    PubMed Central

    Veroux, Massimiliano; Zerbo, Domenico; Basile, Giusi; Gozzo, Cecilia; Sinagra, Nunziata; Giaquinta, Alessia; Sanfiorenzo, Angelo; Veroux, Pierfrancesco

    2016-01-01

    Introduction To evaluate the feasibility of simultaneous unilateral nephrectomy with kidney transplantation and to determine the effect of this procedure on perioperative morbidity and mortality and graft and patient survival. Methods Between January 2000 and May 2015, 145 patients with autosomal dominant polycystic kidney disease (ADPKD) underwent kidney transplantation. Of those, 40 (27.5%) underwent concurrent ipsilateral native nephrectomy (group NT). Patients in group NT were compared with patients with ADPKD not undergoing concurrent nephrectomy (group NT-) and asymptomatic patients undergoing pretransplant nephrectomy (group PNT). Results The average follow-up was 66 months. The graft survival rate at 1 and 5 years was 95% and 87.5% versus 93% and 76.2% in the NT and NT- groups, respectively (P = .903 and P = .544, respectively); 1-year patient survival was 100% for NT and 97% for NT- patients (P = .288), whereas 5-year patient survival was 100% and 92% for NT and NT- groups, respectively (P = .128). After propensity score matching (34 patients per group) no significant differences were observed in 1-year (97.1% in NT and 94.1%; P = 1) and 5-year (88.2% in NT and 91.2% in NT-; P = 1) graft survival, and in 1-year (100% for both groups; P = 1) and 5-year (100% in NT and 94.1% in NT-; P = 1) patient survival. Perioperative mortality was 0% among NT and 1.2% among NT- patients, whereas perioperative surgical complications were similar in both groups. One- and 5-year graft and patient survival were similar between the NT and PNT groups, but patients in the PNT group had significantly lower levels of hemoglobin and residual diuresis volumes at the time of transplant. Moreover, PNT patients had a longer pretransplant dialysis and a longer time on the waiting list. Conclusions Simultaneous unilateral nephrectomy does not have a negative effect on patient and graft survival in patients with ADPKD and is associated with low morbidity. Pretransplant nephrectomy should

  19. Robotic system

    NASA Technical Reports Server (NTRS)

    Ambrose, Robert O. (Inventor)

    2003-01-01

    A robot having a plurality of interconnected sections is disclosed. Each of the sections includes components which are moveable relative to components of an adjacent section. A plurality of electric motors are operably connected to at least two of said relatively moveable components to effect relative movement. A fitted, removable protective covering surrounds the sections to protect the robot.

  20. 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…

  1. 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.

  2. 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.

  3. Robot visions.

    PubMed

    Castañeda, Claudia; Suchman, Lucy

    2014-06-01

    This article explores the resonating figures of primate, child, and robot in contemporary technoscientific corporealizations of the 'almost human'. We take as our model (in)organism 'Lucy the Robot Orangutan', roboticist Steve Grand's project to create an artificial life form with a mind of its own. One aspect of Lucy's figuration by Grand, we argue, which ties her to Haraway's analysis of the primate, is of the robot as a model for animal, and more specifically (or aspirationally) human, cognition. We follow the trope of 'model organism' as it is under discussion within science and technology studies and as an ironic descriptor for our own interest in Lucy as an entity/project through which to illuminate figurations within robotics more widely. Primate and robot together are forms of natureculture that help to clarify how the categories of animal and machine are entangled, while making explicit investments in their differences from one another, and from the third category of the human. We conclude, again following Haraway, by imagining what other possibilities there might be for figuring humans, robots, and their relations if we escape the reiterative imaginary of the robot as proxy for becoming human. PMID:25051585

  4. 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.

  5. Robot visions.

    PubMed

    Castañeda, Claudia; Suchman, Lucy

    2014-06-01

    This article explores the resonating figures of primate, child, and robot in contemporary technoscientific corporealizations of the 'almost human'. We take as our model (in)organism 'Lucy the Robot Orangutan', roboticist Steve Grand's project to create an artificial life form with a mind of its own. One aspect of Lucy's figuration by Grand, we argue, which ties her to Haraway's analysis of the primate, is of the robot as a model for animal, and more specifically (or aspirationally) human, cognition. We follow the trope of 'model organism' as it is under discussion within science and technology studies and as an ironic descriptor for our own interest in Lucy as an entity/project through which to illuminate figurations within robotics more widely. Primate and robot together are forms of natureculture that help to clarify how the categories of animal and machine are entangled, while making explicit investments in their differences from one another, and from the third category of the human. We conclude, again following Haraway, by imagining what other possibilities there might be for figuring humans, robots, and their relations if we escape the reiterative imaginary of the robot as proxy for becoming human.

  6. 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. PMID:2208684

  7. [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. PMID:24144815

  8. [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.

  9. 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

  10. Chylous ascites after nephrectomy without lymphadenectomy for malignant rhabdoid tumor of the kidney: A rare occurrence and literature review

    PubMed Central

    Einama, Takahiro; Okada, Tadao; Sasaki, Fumiaki; Todo, Satoru

    2009-01-01

    Chylous ascites (CA) is an extremely rare complication of abdominal surgery in children. This report describes a 4-month-old girl with malignant rhabdoid tumor of the kidney (MRTK), who developed CA after left nephrectomy without lymphadenectomy, and who was successfully treated conservatively with enteral therapy. The literature on CA after nephrectomy without lymphadenectomy for MRTK is reviewed herein, and the clinical problems of postoperative CA are discussed. PMID:20419024

  11. 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.

  12. 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.

  13. Robotic vehicle

    SciTech Connect

    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.

  14. Robotic vehicle

    SciTech Connect

    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.

  15. 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.

  16. Robotic animation

    NASA Astrophysics Data System (ADS)

    Kretch, S. J.

    1982-08-01

    The effectiveness of the robotic systems Place and Animate at McDonnell Douglas is discussed. The systems are designed for CAD/CAM on a kinematic basis. Place allows creation, analysis, and editing of cell descriptions as part of the CAD process, and involves primitive cell configuring prior to eventual integration of the entire robot. Objects are displayed in wire frame form and movement receives an awkwardness rating automatically, indicating the percentage of the real-world joint limit that is being approached. The same program is employed in the Animate process, where verification and debugging of the robot programs proceeds. Clearances, motion limits, and correct responses to commands are checked, allowing decisions on production to be made before any robots are actually built.

  17. [Robotic surgery].

    PubMed

    Moreno-Portillo, Mucio; Valenzuela-Salazar, Carlos; Quiroz-Guadarrama, César David; Pachecho-Gahbler, Carlos; Rojano-Rodríguez, Martín

    2014-12-01

    Medicine has experienced greater scientific and technological advances in the last 50 years than in the rest of human history. The article describes relevant events, revises concepts and advantages and clinical applications, summarizes published clinical results, and presents some personal reflections without giving dogmatic conclusions about robotic surgery. The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) defines robotic surgery as a surgical procedure using technology to aid the interaction between surgeon and patient. The objective of the surgical robot is to correct human deficiencies and improve surgical skills. The capacity of repeating tasks with precision and reproducibility has been the base of the robot´s success. Robotic technology offers objective and measurable advantages: - Improving maneuverability and physical capacity during surgery. - Correcting bad postural habits and tremor. - Allowing depth perception (3D images). - Magnifying strength and movement limits. - Offering a platform for sensors, cameras, and instruments. Endoscopic surgery transformed conceptually the way of practicing surgery. Nevertheless in the last decade, robotic assisted surgery has become the next paradigm of our era.

  18. [Robotic surgery].

    PubMed

    Moreno-Portillo, Mucio; Valenzuela-Salazar, Carlos; Quiroz-Guadarrama, César David; Pachecho-Gahbler, Carlos; Rojano-Rodríguez, Martín

    2014-12-01

    Medicine has experienced greater scientific and technological advances in the last 50 years than in the rest of human history. The article describes relevant events, revises concepts and advantages and clinical applications, summarizes published clinical results, and presents some personal reflections without giving dogmatic conclusions about robotic surgery. The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) defines robotic surgery as a surgical procedure using technology to aid the interaction between surgeon and patient. The objective of the surgical robot is to correct human deficiencies and improve surgical skills. The capacity of repeating tasks with precision and reproducibility has been the base of the robot´s success. Robotic technology offers objective and measurable advantages: - Improving maneuverability and physical capacity during surgery. - Correcting bad postural habits and tremor. - Allowing depth perception (3D images). - Magnifying strength and movement limits. - Offering a platform for sensors, cameras, and instruments. Endoscopic surgery transformed conceptually the way of practicing surgery. Nevertheless in the last decade, robotic assisted surgery has become the next paradigm of our era. PMID:25643879

  19. Experience with pyeloureterostomy associated with simple ligation of native ureter without ipsilateral nephrectomy in renal transplantation.

    PubMed

    Baquero, A; Ginsberg, P C; Kaschak, D; Raja, R; Schneeberg, A; Solish, L; Bannett, A D

    1985-03-01

    Ureteroneocystostomy was used as the primary method of urinary tract reconstruction in 282 allograft renal transplants at our center since 1965. A nonrefluxing anastomosis was incorporated whenever possible. Seven patients who suffered major urological complications involving the ureteroneocystostomy required pyeloureterostomy as the method of repair using the patient's distal native ureter. No ipsilateral nephrectomy was performed and simple ligation of the native ureter with nonabsorbable suture was accomplished. Of the 7 patients 3 suffered hydronephrosis of the native kidney. None of these patients had signs or symptoms secondary to acute and chronic ureteral occlusion. Our experience suggests that intentional ligation of the native ureter during pyeloureterostomy does not result in increased morbidity to the transplant patient, and that the need for ipsilateral nephrectomy with its own added morbidity may not be necessary.

  20. Gastric metastasis of renal cell carcinoma 20 years after radical nephrectomy

    PubMed Central

    Akay, Ebru; Kala, Mehtap; Karaman, Hatice

    2016-01-01

    Renal cell carcinomas account for 2–3% of malignant neoplasms in adults. The lung, soft tissues and bone represent the most frequent sites of distant metastasis in renal cell carcinoma. Gastric metastasis is rare. Our case was a 72-year-old man with complaints of fatigue and loss of appetite. In history, he had unergone radical nephrectomy due to renal cell carcinoma in 1993. A polypoid lesion was observed in upper gastrointestinal endoscopy. Histopathology of gastric biopsy specimen was reported as renal cell carcinoma. In English literature, there are 50 cases diagnosed as gastric metastasis from renal cell carcinoma. To date, there are only 4 cases with extremely late gastric metastasis of renal cell carcinoma. Herein, we present a rare case which underwent radical nephrectomy due to renal cell carcinoma and found to have gastric metastasis at 20. year of his follow-up. PMID:27274897

  1. 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.

  2. 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.

  3. Single port laparoscopic donor nephrectomy: first case report in Ramathibodi Hospital.

    PubMed

    Attawettayanon, Worapat; Prasit, Sirianan; Sangkum, Premsant; Patcharatrakul, Suthep; Jirasiritham, Sophon; Khongcharoensombat, Wisoot

    2014-02-01

    The prevalence of patients with end stage renal disease (ESRD) is showing an increasing trend. At the same time, the waiting lists for cadaveric donor kidney transplantation continue to grow. Living donor kidneys may be an alternative for patients to receive kidneys for transplantation. However a wide gap exists between the numbers of living kidney donors and the numbers of recipients on waiting lists. Many considerations are involved in living organ donation, including cosmetic reasons. Laparoscopic living donor nephrectomy has become the technique of choice for kidney transplantation in many centers. The benefits of a laparoscopic technique compared with open surgery include reduced blood loss, less analgesic requirement, a shorter hospital stay, faster return to work, and fewer cosmetic effects. The next step in minimal invasive surgery is laparoendoscopic single port donor nephrectomy Early outcomes show this technique to be safe and cosmetically improved This procedure may be the answer to reduce the gap between numbers of kidney donors and waiting recipients. We report our first experience of single port laparoendoscopic left donor nephrectomy. A 48-year-old healthy Thai man wished to donate his kidney to his 18-year-old son who suffered from IgA nephropathy and ended up with ESRD. The operation took three hours. The estimated blood loss was 50 ml and no blood transfusion was required. The donor was discharged home safely without any complications. PMID:24765906

  4. Protective Effect of RNase on Unilateral Nephrectomy-Induced Postoperative Cognitive Dysfunction in Aged Mice

    PubMed Central

    Gan, Lu; Dong, Yuanlin; Zhu, Tao; Ma, Gang; Li, Tao; Zhang, Xiyang; Li, Qian; Cheng, Xu; Wu, Chaomeng; Yang, Jing; Zuo, Yunxia; Liu, Jin

    2015-01-01

    Postoperative cognitive dysfunction (POCD) is a common complication after surgery, especially for elderly patients. Administration of RNase has been reported to exhibit neuroprotective effects in acute stroke. However, the potential role of RNase on POCD is unknown. Therefore, we sought to investigate whether RNase treatment could mitigate unilateral nephrectomy induced-cognitive deficit in aged mice. In the present study, twelve-month-old mice were administered RNase or an equal amount of normal saline perioperatively. All mice underwent Morris Water Maze (MWM) training 3 times per day for 7 days to acclimatize them to the water maze before surgical operation, and testing on days 1, 3 and 7 after surgery. We found that perioperative administration of RNase: 1) attenuated unilateral nephrectomy-induced cognitive impairment at day 3 after surgery; 2) reduced the hippocampal cytokines mRNA production and serum cytokines protein production at day 1 and day 7 (for MCP-1) after surgery, and; 3) inhibited hippocampal apoptosis as indicated by cleaved caspase-3 western blot and TUNEL staining at day 1 after surgery. In addition, a trend decrease of total serum RNA levels was detected in the RNase treated group after surgery compared with the untreated group. Further, our protocol of RNase administration had no impact on the arterial blood gas analysis right after surgery, kidney function and mortality rate at the observed days postoperatively. In conclusion, perioperative RNase treatment attenuated unilateral nephrectomy-induced cognitive impairment in aged mice. PMID:26225860

  5. 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

  6. 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

  7. 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.

  8. 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.

  9. 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.

  10. Clear cell papillary renal cell carcinoma is the fourth most common histologic type of renal cell carcinoma in 290 consecutive nephrectomies for renal cell carcinoma.

    PubMed

    Zhou, Haijun; Zheng, Shaojiang; Truong, Luan D; Ro, Jae Y; Ayala, Alberto G; Shen, Steven S

    2014-01-01

    Clear cell papillary renal cell carcinoma (CCP-RCC) has recently been recognized as a distinct subtype of renal cell carcinoma (RCC) due to its unique morphologic, immunohistochemical, and genetic features and indolent clinical behavior. However, the incidence of this tumor in a nephrectomy series for renal mass has not been fully investigated. Twelve cases of CCP-RCC were identified from a total of 290 consecutive partial (n = 137) or radical nephrectomies (n = 153) for RCC from 2010 to 2012 in our hospital. In this series, CCP-RCC was the fourth most common (4.1%) kidney tumor following clear cell (conventional) (70%), papillary (16.6%), and chromophobe (5.9%) RCCs. The average age of the CCP-RCC patients was 58.2 years (range, 18-81 years), with an equal sex distribution. Four cases (33.3%) were associated with end-stage renal disease. Of the 12 CCP-RCCs, 9 presented as solitary tumors; 2 coexisted with clear cell RCC; and 1 with papillary RCC. The average size of tumors was 2.5 cm (range, 0.8-6.0 cm). All tumors were pT1 (10 pT1a and 2 pT1b). Two cases were initially misclassified as clear cell RCC. Strong positive cytokeratin 7 stain and negative stains with α-methylacyl-CoA racemase and RCC marker differentiate CCP-RCC from low-grade clear cell RCC with similar histologic features. We conclude that CCP-RCC is a common renal neoplastic entity, representing the fourth most common (4.1%) RCC. It can be easily misclassified due to its overlapping features with low-grade clear cell RCC. In equivocal cases, immunohistochemical stains with a small panel of markers (cytokeratin 7, α-methylacyl-CoA racemase, RCC marker, or CD10) are warranted in making the correct histologic classification. PMID:24182559

  11. 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."

  12. Robot soccer.

    PubMed

    Sammut, Claude

    2010-11-01

    Robot soccer is a test bed for a variety of robotic and Artificial Intelligence (AI) methods. Its relevance to Cognitive Science is that it confronts the designer with a task that requires the integration of almost all aspects of AI to create an agent that is capable of working in a complex, dynamic environment inhabited by other agents, some of which are cooperative and others competitive. We describe the main elements that make up a robot soccer player and how these players associate to create effective teams. We pay special attention to the architecture of the players. WIREs Cogn Sci 2010 1 824-833 For further resources related to this article, please visit the WIREs website.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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…

  18. 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…

  19. 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

  20. 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

  1. Laparoscopic radical nephrectomy with inferior vena cava thrombectomy: highlight of key surgical steps

    PubMed Central

    Sim, A.; Todenhöfer, T.; Mischinger, J.; Fahmy, O.; Boettge, J.; Rausch, S.; Bier, S.; Aufderklamm, S.; Stenzl, A.; Gakis, G.; Schwentner, C.

    2016-01-01

    ABSTRACT Objective: Vascular involvement in the form of renal vein (RV) or inferior vena cava (IVC) thrombus can be seen in 4-10% of patients presented with RCC. In patients without presence of metastasis, surgical treatment in the form of radical nephrectomy remains the treatment of choice with 5-year survival rates of 45-70%. Open surgery is still the first treatment option of choice at the moment for RCC patients with IVC thrombus. Materials and Methods: In our study, we are reporting a case of patient with RCC and level I IVC thrombus treated with laparoscopy. Our patient is a 72 years old man with underlying co-morbidity of hypertension and chronic kidney disease (CKD) presented with right-sided RCC. The CT scan done showed a large right renal upper pole tumor measuring 8.4x5.2cm with level I IVC thrombus (Figure-1). There were no regional lymphadenopathy and the staging scans were negative. Results: The operative time was 124 minutes and blood loss was minimal. The patient was progressed to diet on POD 1 with bowel movement on POD 2. There was no significant change in the pre and post-operative glomerular filtration rate (GFR). The surgical drain was removed on POD2. The patient was discharged well on POD 5. There were no perioperative complications. The pathology was pT3bN0M0 Fuhrman grade II clear cell RCC. Conclusions: As a conclusion, laparoscopic radical nephrectomy and IVC thrombectomy is a complex and technically demanding surgery. With advancement of surgical skills as well as technology, more cases of minimally invasive laparoscopic radical nephrectomy and IVC thrombectomy can performed to improve the perioperative outcomes of carefully selected patients in a high volume center. PMID:27564306

  2. [Giant renal angiomyolipoma disclosed by mild lumbar trauma and treated with nephrectomy: report of a case].

    PubMed

    Rosselló Barbará, M; Mus Malleu, A; Rebassa Llul, M; Casals Armada, J

    2004-02-01

    A case of giant angiomyolipoma of the kidney discovered during the study of a light lumbar trauma is presented. Disseminated tuberous sclerosis lesions are demonstrated at the brain, cerebellum, liver and contralateral kidney. External cutaneous stigmas of this illness are shown at the face. The size of the viscera and the loss of function of the left kidney conditioned the nephrectomy. The piece weighed upon extracting 6300 g, without malignant signs. To the microscopic exam atrophic sclerosis for compression was demonstrated. The postoperative course was satisfactory. Actually his arterial tension is controlled by medical treatment.

  3. 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

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

    PubMed

    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

  5. 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

  6. 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.

  7. Unilateral Ultrasound-Guided Transversus Abdominis Plane Block After Nephrectomy; Postoperative Pain and Use of Opioids

    PubMed Central

    Azawi, Nessn H.; Mosholt, Karina Sif Sondergaard; Fode, Mikkel

    2016-01-01

    Background Pain has a wide spectrum of effects on the body and inadequately controlled postoperative pain may have harmful physiologic and psychological consequences and increase morbidity. In addition, opioid anesthetic agents in high doses can blunt endocrine and metabolic responses following surgery and are associated with side effects including dizziness, nausea, vomiting, constipation, and respiratory depression. Objectives The current study aimed to investigate if unilateral ultrasound-guided transverse abdominal plane block (TAP-block) could reduce pain and postoperative use of patient requested analgesics following nephrectomy compared to local injection of the same ropivacaine dose in the surgical wound. Patients and Methods Retrospective chart reviews were performed in 42 consecutive patients who received TAP-block in conjunction with nephrectomy from November 2013 to August 2014 (group A). For comparison, data were used from 40 other nephrectomy patients registered as part of a previous study (group B). In this group the patients had received local ropivacaine injection in the surgical wound. On univariate analyses, the groups were compared by t-test and the Fisher exact test. Multivariate analyses were conducted by multiple linear regression. Results Mean surgical time was 162 minutes in group A and 92 minutes in group B (P < 0.0001). The means of visual analogue scale (VAS) were 3.05 and 1.55 in A and B groups, respectively (P = 0.001). The means of morphine consumption were 5.2 mg and 5.9 mg in groups A and B, respectively (P = 0.58); while the means of sufentanil use were 9.8 μg and 6.0 μg in groups A and B, respectively (P = 0.06). When controlling for age, tumor size and American society of anesthesiologists classification (ASA) score on multivariate analysis, TAP-block was associated with a significant increase in VAS (+1.4 [95% CI, 0.6 - 2.3], P = 0.001) and sufentanil use (+6.2 μg [95% CI, 2.3 - 10.2], P = 0.003). There was no difference in

  8. Facing Up to Robotation.

    ERIC Educational Resources Information Center

    Chamberlin, Leslie J.

    1982-01-01

    Speculates on the effects of introducing robots into American society. Robotization will be used increasingly to reduce labor costs in business and industry. The impact of robotization on leisure time use and education are discussed. (AM)

  9. 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.

  10. Soft robotics: a bioinspired evolution in robotics.

    PubMed

    Kim, Sangbae; Laschi, Cecilia; Trimmer, Barry

    2013-05-01

    Animals exploit soft structures to move effectively in complex natural environments. These capabilities have inspired robotic engineers to incorporate soft technologies into their designs. The goal is to endow robots with new, bioinspired capabilities that permit adaptive, flexible interactions with unpredictable environments. Here, we review emerging soft-bodied robotic systems, and in particular recent developments inspired by soft-bodied animals. Incorporating soft technologies can potentially reduce the mechanical and algorithmic complexity involved in robot design. Incorporating soft technologies will also expedite the evolution of robots that can safely interact with humans and natural environments. Finally, soft robotics technology can be combined with tissue engineering to create hybrid systems for medical applications.

  11. 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. PMID:27178784

  12. SOFT ROBOTICS. A 3D-printed, functionally graded soft robot powered by combustion.

    PubMed

    Bartlett, Nicholas W; Tolley, Michael T; Overvelde, Johannes T B; Weaver, James C; Mosadegh, Bobak; Bertoldi, Katia; Whitesides, George M; Wood, Robert J

    2015-07-10

    Roboticists have begun to design biologically inspired robots with soft or partially soft bodies, which have the potential to be more robust and adaptable, and safer for human interaction, than traditional rigid robots. However, key challenges in the design and manufacture of soft robots include the complex fabrication processes and the interfacing of soft and rigid components. We used multimaterial three-dimensional (3D) printing to manufacture a combustion-powered robot whose body transitions from a rigid core to a soft exterior. This stiffness gradient, spanning three orders of magnitude in modulus, enables reliable interfacing between rigid driving components (controller, battery, etc.) and the primarily soft body, and also enhances performance. Powered by the combustion of butane and oxygen, this robot is able to perform untethered jumping.

  13. Simultaneous Multi-Structure Segmentation and 3D Nonrigid Pose Estimation in Image-Guided Robotic Surgery.

    PubMed

    Nosrati, Masoud S; Abugharbieh, Rafeef; Peyrat, Jean-Marc; Abinahed, Julien; Al-Alao, Osama; Al-Ansari, Abdulla; Hamarneh, Ghassan

    2016-01-01

    In image-guided robotic surgery, segmenting the endoscopic video stream into meaningful parts provides important contextual information that surgeons can exploit to enhance their perception of the surgical scene. This information provides surgeons with real-time decision-making guidance before initiating critical tasks such as tissue cutting. Segmenting endoscopic video is a challenging problem due to a variety of complications including significant noise attributed to bleeding and smoke from cutting, poor appearance contrast between different tissue types, occluding surgical tools, and limited visibility of the objects' geometries on the projected camera views. In this paper, we propose a multi-modal approach to segmentation where preoperative 3D computed tomography scans and intraoperative stereo-endoscopic video data are jointly analyzed. The idea is to segment multiple poorly visible structures in the stereo/multichannel endoscopic videos by fusing reliable prior knowledge captured from the preoperative 3D scans. More specifically, we estimate and track the pose of the preoperative models in 3D and consider the models' non-rigid deformations to match with corresponding visual cues in multi-channel endoscopic video and segment the objects of interest. Further, contrary to most augmented reality frameworks in endoscopic surgery that assume known camera parameters, an assumption that is often violated during surgery due to non-optimal camera calibration and changes in camera focus/zoom, our method embeds these parameters into the optimization hence correcting the calibration parameters within the segmentation process. We evaluate our technique on synthetic data, ex vivo lamb kidney datasets, and in vivo clinical partial nephrectomy surgery with results demonstrating high accuracy and robustness. PMID:26151933

  14. Clinical significance of preoperative thrombocytosis in patients who underwent radical nephrectomy for nonmetastatic renal cell carcinoma

    PubMed Central

    Choi, Jae Young; Ko, Young Hwii

    2016-01-01

    Purpose The aim of this study was to examine the association of preoperative thrombocytosis with the prognosis of patients with nonmetastatic renal cell carcinoma (RCC). Materials and Methods We conducted a retrospective analysis of 187 patients who underwent a radical nephrectomy for nonmetastatic RCC between July 1997 and June 2009. Thrombocytosis was defined as a platelet count≥400,000 µL, and patients were divided into 2 groups according to presence of preoperative thrombocytosis, and the cancer-specific survival rates and overall survival rates of the 2 groups after radical nephrectomy were compared. Results The mean age of the patients was 56.0±11.7 years and the mean follow-up period was 59.3±42.1 months; there were 20 patients with preoperative thrombocytosis. Thirty patients developed metastases and 9 patients died during the follow-up period. In Kaplan-Meier analysis using a univariate log-rank test, both cancer-specific survival rate (p=0.013) and overall survival rate (p=0.012) showed significant association with preoperative thrombocytosis. Controlling for pathological TNM stage, Fuhrman grade and tumor diameter, the Cox proportional hazards model for cancer-specific survival rates showed that preoperative thrombocytosis was an independent prognostic factor (p=0.025). Conclusions Preoperative thrombocytosis was associated with poorer prognosis in patients with nonmetastatic RCC. Thus, preoperative platelet count may be clinically useful for risk stratification of patients undergoing surgery for nonmetastatic RCC.

  15. Cardiovascular parameters in rat model of chronic renal failure induced by subtotal nephrectomy.

    PubMed

    Svíglerová, J; Kuncová, J; Nalos, L; Tonar, Z; Rajdl, D; Stengl, M

    2010-01-01

    Chronic renal failure (CRF) is associated with high incidence of cardiovascular complications. To clarify pathogenesis of CRF numerous animal models have been developed. The aim of our work was to describe methodology of subtotal surgical renal ablation in rat and to characterize some biochemical and cardiovascular parameters of this animal model. Male rats underwent 5/6 surgical nephrectomy or sham operations in two steps. The following parameters were measured on day 10 and in week 10 after the surgery: plasma concentrations of creatinine and urea, blood pressure, resting heart rate, chronotropic response to atropine and metipranol, heart ventricles weight, contraction parameters and action potential duration in the left ventricle. Increased serum concentrations of creatinine and urea, decreased creatinine clearance, polyuria and alteration of the remnant kidney tissue were found in CRF rats. Changes in cardiovascular parameters identified after subtotal nephrectomy resembled alterations of cardiovascular system in uremic patients and included hypertension, elevated resting heart rate, diminished parasympathetic cardiac tone, hypertrophy of the left ventricle associated with weakened force of contraction, prolonged contraction and relaxation and shortening of action potential duration. These data suggest that the present model can be a useful tool in the study of CRF and its cardiovascular complications.

  16. Clinical significance of preoperative thrombocytosis in patients who underwent radical nephrectomy for nonmetastatic renal cell carcinoma

    PubMed Central

    Choi, Jae Young; Ko, Young Hwii

    2016-01-01

    Purpose The aim of this study was to examine the association of preoperative thrombocytosis with the prognosis of patients with nonmetastatic renal cell carcinoma (RCC). Materials and Methods We conducted a retrospective analysis of 187 patients who underwent a radical nephrectomy for nonmetastatic RCC between July 1997 and June 2009. Thrombocytosis was defined as a platelet count≥400,000 µL, and patients were divided into 2 groups according to presence of preoperative thrombocytosis, and the cancer-specific survival rates and overall survival rates of the 2 groups after radical nephrectomy were compared. Results The mean age of the patients was 56.0±11.7 years and the mean follow-up period was 59.3±42.1 months; there were 20 patients with preoperative thrombocytosis. Thirty patients developed metastases and 9 patients died during the follow-up period. In Kaplan-Meier analysis using a univariate log-rank test, both cancer-specific survival rate (p=0.013) and overall survival rate (p=0.012) showed significant association with preoperative thrombocytosis. Controlling for pathological TNM stage, Fuhrman grade and tumor diameter, the Cox proportional hazards model for cancer-specific survival rates showed that preoperative thrombocytosis was an independent prognostic factor (p=0.025). Conclusions Preoperative thrombocytosis was associated with poorer prognosis in patients with nonmetastatic RCC. Thus, preoperative platelet count may be clinically useful for risk stratification of patients undergoing surgery for nonmetastatic RCC. PMID:27617313

  17. Embolization of polycystic kidneys as an alternative to nephrectomy before renal transplantation: a pilot study.

    PubMed

    Cornelis, F; Couzi, L; Le Bras, Y; Hubrecht, R; Dodré, E; Geneviève, M; Pérot, V; Wallerand, H; Ferrière, J M; Merville, P; Grenier, N

    2010-10-01

    In autosomal polycystic kidney disease, nephrectomy is required before transplantation if kidney volume is excessive. We evaluated the effectiveness of transcatheter arterial embolization (TAE) to obtain sufficient volume reduction for graft implantation. From March 2007 to December 2009, 25 patients with kidneys descending below the iliac crest had unilateral renal TAE associated with a postembolization syndrome protocol. Volume reduction was evaluated by CT before, 3, and 6 months after embolization. The strategy was considered a success if the temporary contraindication for renal transplantation could be withdrawn within 6 months after TAE. TAE was well tolerated and the objective was reached in 21 patients. The temporary contraindication for transplantation was withdrawn within 3 months after TAE in 9 patients and within 6 months in 12 additional patients. The mean reduction in volume was 42% at 3 months (p = 0.01) and 54% at 6 months (p = 0.001). One patient required a cyst sclerosis to reach the objective. The absence of sufficient volume reduction was due to an excessive basal renal volume, a missed accessory artery and/or renal artery revascularization. Embolization of enlarged polycystic kidneys appears to be an advantageous alternative to nephrectomy before renal transplantation.

  18. Retroperitoneal laparoscopic nephrectomy and other procedures in the upper retroperitoneum using a balloon dissection technique.

    PubMed

    Rassweiler, J J; Henkel, T O; Stoch, C; Greschner, M; Becker, P; Preminger, G M; Schulman, C C; Frede, T; Alken, P

    1994-01-01

    This article describes a hydraulic balloon dissection technique. The retroperitoneum is developed via a small lumbodorsal incision between the edges of the musculus latissimus dorsi and musculus obliquus externus and then after visualization of its correct position the balloon catheter is filled with 500-1,200 ml of warm normal saline (according to patient size). The device consists of the finger of a surgeon's glove ligated around the end of a rigid bladder catheter. The balloon insufflation is maintained for 5 min to guarantee adequate hemostasis. Recently, we have replaced the balloon catheter by a balloon trocar sheath allowing direct endoscopic control of the hydraulic dissection. After retrieval of the balloon the CO2 insufflator is connected to the first trocar. All secondary trocars are placed under endoscopic control. The hydraulic dissection techniques also enable optimal creation of an effective pneumoperitoneum in children. Until now, we have used this technique for twelve procedures in the upper retroperitoneum including five nephrectomies, two nephroureterectomies, one tumor nephrectomy, one nephropexy, one renal cyst marsupialization and two renal biopsies. Up to now we have encountered no major complications. Three of the nephrectomized patients had undergone multiple previous abdominal surgical interventions. The retroperitoneal approach allows the surgeon to apply similar dissecting techniques as used in respective open procedures. It has become the routine approach for laparoscopic procedures in benign renal disease. This procedure can be performed even in cases with previous abdominal surgery.

  19. [A case of renal hypertension after pyelolithotomy cured by segmental nephrectomy].

    PubMed

    Konishi, T; Pak, K; Takayama, H; Tomoyoshi, T

    1985-12-01

    A case of renal hypertension after pyelolithotomy cured by segmental nephrectomy is reported. The patient, a 39-year-old man had had pyelolithotomy performed by the lumbodorsal approach at another hospital. Two months after operation he started to complain of headache and palpitation. The blood pressure was markedly high when he visited our hospital and peripheral plasma renin activity was also elevated. Urinalysis was normal except for slight proteinuria. The excretory urogram demonstrated cortical scarring in the lower portion of the left kidney. The renal scintigram demonstrated low uptake in this area, suggesting renal infarction. Renal arteriogram showed decreased vascularity in this area. Plasma renin activity was measured on the blood drawn from the renal vein of both sides and the ratio was about 2.4, and renin activity of the segmental renal vein from the left lower portion was elevated. Segmental nephrectomy of the lower pole was performed. The blood pressure three weeks after lower pole resection was estimated to be normal and renin activity returned to an almost normal level. Discussion was made on the cause of renal hypertension after renal surgery. In this case, it was suggested that renal hypertension is caused by subinfraction due to lesions of the dorsal renal artery in surgery for renal calculus. PMID:3832924

  20. 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.

  1. Laparoscopic nephrectomy: safe and comfortable surgical alternative for living donors and for good results of graft function.

    PubMed

    Rocca, X; Espinoza, O; Hidalgo, F; Gonzalez, F

    2005-10-01

    Laparoscopic nephrectomy for kidney donation from living related donors has the advantages of a less invasive surgical access, better cosmesis, and a shorter hospital stay for the donor. However, some workers have reported up to 10% life-threatening complications for the donor using this technique. The purpose of our study was to evaluate hand-assisted laparoscopic nephrectomy for living donors of kidney transplants in terms of graft function. Thirty donors who underwent open nephrectomy (ON) were compared with 27 who had hand-assisted nephrectomy (HALN). Surgery and ischemia times, hospital stay, bleeding, graft function, remaining kidney function, and complications were compared in both groups. Mean surgery time was 126.9 minutes for ON and 98 minutes for HALN (P = .0005), warm ischemia time was 3 minutes versus 6 for ON vs HALN, respectively (P = .02). Hospitalization stay was 6.3 days for ON versus 4.8 days for HALN (P = .0015). Differences in change in hematocrit and in serum creatinine levels were not significant; graft outcomes were also similar. Complications were minimal. We conclude that HALN is a valid, safe technique to obtain kidneys from living related donors, significantly reducing the hospital stay and allowing return to normal activities sooner, with risks falling within those reported in the literature. PMID:16298592

  2. 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

  3. Effects of Open versus Laparoscopic Nephrectomy Techniques on Oxidative Stress Markers in Patients with Renal Cell Carcinoma

    PubMed Central

    Mila-Kierzenkowska, Celestyna; Drewa, Tomasz; Woźniak, Bartosz; Szpinda, Michał; Krzyżyńska-Malinowska, Ewa; Rajewski, Paweł

    2013-01-01

    The aim of the study was to determine the concentration of lipid peroxidation products, the activity of selected antioxidant and lysosomal enzymes, and protease inhibitor in patients with renal cell carcinoma who underwent radical nephrectomy. The studied group included 44 patients: 21 of them underwent open surgery, while 23 underwent laparoscopy. Blood samples were collected three times: before treatment and 12 hours and five days after nephrectomy. In blood of participants, the concentration of thiobarbituric acid reactive substances (TBARS), the activity of catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidase (GPx), and the activity of acid phosphatase (AcP), arylsulfatase (ASA), cathepsin D (CTSD), and α1-antitrypsin (AAT) were assayed. No statistically significant differences in investigated parameters were found between studied groups. Moreover, TBARS concentration and CAT, SOD, and GPx activity were not altered in the course of both types of surgery. Five days after both open and laparoscopic nephrectomy techniques, AAT activity was higher than its activity 12 hours after the procedure. The obtained results suggest that laparoscopy may be used for nephrectomy as effectively as open surgery without creating greater oxidative stress. Reduced period of convalescence at patients treated with laparoscopy may be due to less severe response of acute-phase proteins. PMID:23533691

  4. 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.

  5. Robotic Stripping

    NASA Technical Reports Server (NTRS)

    2000-01-01

    UltraStrip Systems, Inc.'s M-200 removes paint from the hulls of ships faster than traditional grit-blasting methods. And, it does so without producing toxic airborne particles common to traditional methods. The M-2000 magnetically attaches itself to the hull of the ship. Its water jets generate 40,000 pounds of pressure per square inch, blasting away paint down to the ships steel substrate. The only by product is water and dried paint chips and these are captured by a vacuum system so no toxic residue can escape. It was built out of a partnership between the Jet Propulsion Laboratory and the National Robotics Engineering Consortium.

  6. Epilepsy (partial)

    PubMed Central

    2011-01-01

    Introduction About 3% of people will be diagnosed with epilepsy during their lifetime, but about 70% of people with epilepsy eventually go into remission. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of starting antiepileptic drug treatment following a single seizure? What are the effects of drug monotherapy in people with partial epilepsy? What are the effects of additional drug treatments in people with drug-resistant partial epilepsy? What is the risk of relapse in people in remission when withdrawing antiepileptic drugs? What are the effects of behavioural and psychological treatments for people with epilepsy? What are the effects of surgery in people with drug-resistant temporal lobe epilepsy? We searched: Medline, Embase, The Cochrane Library, and other important databases up to July 2009 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 83 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: antiepileptic drugs after a single seizure; monotherapy for partial epilepsy using carbamazepine, gabapentin, lamotrigine, levetiracetam, phenobarbital, phenytoin, sodium valproate, or topiramate; addition of second-line drugs for drug-resistant partial epilepsy (allopurinol, eslicarbazepine, gabapentin, lacosamide, lamotrigine, levetiracetam, losigamone, oxcarbazepine, retigabine, tiagabine, topiramate, vigabatrin, or zonisamide); antiepileptic drug withdrawal for people with partial or

  7. The evaluation of pulmonary function and blood gas analysis in patients submitted to laparoscopic versus open nephrectomy

    PubMed Central

    Koc, Ayfer; Inan, Gozde; Bozkirli, Fusun; Coskun, Demet; Tunc, Lutfi

    2015-01-01

    ABSTRACT Background: The aim of this study was to assess the early postoperative pulmonary function and arterial blood gases in patients who have undergone open versus laparoscopic nephrectomy. Materials and Methods: Forty patients were randomly assigned to undergo laparoscopic (LN, n=20) or open nephrectomy (ON, n=20). Pulmonary function tests including forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), forced expiratory volume at 25% (FEF25), forced expiratory volume at 50% (FEF50), forced expiratory volume at 25% to 75% (FEF25–75), forced expiratory volume in 1 second (FIV1) and peak expiratory flow (PEF) were performed one day before the operation and on the postoperative day 1. The arterial blood gas analysis (pH, pCO2, pO2, SaO2) was made at breathing room preoperatively, in the recovery phase and on postoperative day 1. Results: All spirometric variables decreased after both open and laparoscopic nephrectomy on postoperative day 1. FEV1, FVC, FEF25 and FEF25–75 values decreased on postoperative day 1 (39.7%, 37.4%, 27.7%, 51.8% respectively) in the open surgery group and they were significantly lower in laparoscopic group (29.9%, 32.5%, 23.2%, 44.5% respectively). There were no significant differences in FEF50, PEF and FIV1 between the groups. The SaO2 and pO2 values also decreased in both groups. During early recovery, pH decreased while pCO2 increased significantly but they returned to preoperative values on postoperative day 1 in both groups. Conclusion: Laparoscopic nephrectomy is better than open nephrectomy considering pulmonary functions. PMID:26742981

  8. [Cosmesis and Body Image after Laparo-Endoscopic Single Site Donor Nephrectomy].

    PubMed

    Yanishi, Masaaki; Kinoshita, Hidefumi; Yoshida, Takashi; Takayasu, Kenta; Mishima, Takao; Yoshida, Kenji; Sugi, Motohiko; Kawa, Gen; Matsuda, Tadashi

    2015-07-01

    Using a questionnaire, we objectively assessed the body image of donors who underwent conventional laparoscopic donor nephrectomy (L-DN) or laparoscopic single-site donor nephrectomy (LESS-DN). Subjects were 15 patients who underwent an L-DN and 15 who underwent an LESS-DN. The questionnaire consisted of the Body Image Questionnaire (BIQ), including a Body Image Scale (BIS) and Cosmetic Scale (CS), and a Photo-Series Questionnaire (PSQ). A higher score indicated a more favorable assessment, and patient scores were compared. Subjects were also asked which procedure they preferred if they had to undergo donor nephrectomy again. Pain was assessed by comparing the number of times an analgesic was administered during hospitalization. The average BIS score was 18.7 points (out of 20) for patients who underwent an L-DN and 19.5 points for patients who underwent an LESS-DN ; those who underwent an LESS-DN had a significantly higher score (p=0.03). Patients who underwent an L-DN had a median CS score of 17.5 points (out of 24) while patients who underwent an LESS-DN had a median CS score of 19.1 points ; those who underwent an LESS-DN had a higher score, but the difference in average CS scores was not significant (p=0.123). The average PSQ score was 7.1 points for patients who underwent an L-DN and 8.8 points for patients who underwent an LESS-DN ; the higher score for LESS-patients was statistically significant (p=0.01). Patients who underwent an L-DN were administered an analgesic a median of 4 times during hospitalization (range : 3-10 times) while patients who underwent an LESS-DN were administered an analgesic a median of 2 times (range : 0-4 times), which was significantly less (p=0.01). Patients who underwent LESS-DN had a better body image and better cosmetic appearance than those who underwent LDN, thus indicating the usefulness of LESS-DN. However, a more prospective larger study needs to be performed. PMID:26278210

  9. 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

  10. Chylous Ascites Requiring Surgical Intervention after Donor Nephrectomy — Case Series and Single Center Experience

    PubMed Central

    Aerts, Johan; Matas, Arthur; Sutherland, David; Kandaswamy, Raja

    2013-01-01

    Chylous ascites as a result of laparoscopic donor nephrectomy (LDN) is a rare complication which carries significant morbidity, including severe protein-calorie malnutrition and an associated immunocompromised state. We report a patient who underwent hand-assisted left LDN and subsequently developed chylous ascites. He failed conservative therapy including low-fat diet with medium-chain triglycerides (LFD/MCT) and oral protein supplementation as well as strict NPO status with intravenous (IV) total parenteral nutrition (TPN) and subcutaneous (SQ) somatostatin analogue administration. Laparoscopic re-exploration and intracorporeal suture ligation and clipping of leaking lymph channels successfully sealed the chyle leak. We review the literature to date including diagnosis, incidence, management options, psychosocial aspects and clinical outcomes of chylous ascites after LDN. PMID:19958336

  11. Chylous ascites requiring surgical intervention after donor nephrectomy: case series and single center experience.

    PubMed

    Aerts, J; Matas, A; Sutherland, D; Kandaswamy, R

    2010-01-01

    Chylous ascites as a result of laparoscopic donor nephrectomy (LDN) is a rare complication that carries significant morbidity, including severe protein-calorie malnutrition and an associated immunocompromised state. We report a patient who underwent hand-assisted left LDN and subsequently developed chylous ascites. He failed conservative therapy including low-fat diet with medium-chain triglycerides (LFD/MCT) and oral protein supplementation as well as strict NPO status with intravenous (IV) total parenteral nutrition (TPN) and subcutaneous (SQ) somatostatin analogue administration. Laparoscopic re-exploration and intracorporeal suture ligation and clipping of leaking lymph channels successfully sealed the chyle leak. We review the literature to date including diagnosis, incidence, management options, psychosocial aspects and clinical outcomes of chylous ascites after LDN.

  12. [Anesthetic Management of Laparoscopic Nephrectomy for a Renal Cancer Patient with Distal Myopathy of Rimmed Vacuole].

    PubMed

    Saito, Junichi; Noguchi, Satoko; Matsumoto, Anna; Jinushi, Kei; Kasai, Toshinori; Kitayama, Masato; Hirota, Kazuyoshi

    2015-02-01

    A 56-year-old male with distal myopathy of rimmed vacuoles underwent laparoscopic nephrectomy. Anesthesia was induced with propofol, remifentanil and ketamine. Tracheal intubation using McGRATH was uneventful without using muscle relaxants. Then ultrasound-guided right thoracic paravertebral (TPVB) block was performed using 20 ml 0.75% ropivacaine with 10 ml 2% lidocaine by 3 injections of 10 ml each at T9 to T11. General anesthesia was maintained with propofol, remifentanil and ketamine monitoring bispectral index. Good surgical condition and pneumoperitoneum were maintained without using muscle relaxants. His postoperative course was smooth and uneventful, even though a small amount of fentanyl was administrated to relieve wound pain. This case suggests that McGRATH and ultrasound-guided TPVB can be one of the options to avoid using muscle relaxants in patient with neuromuscular disease.

  13. 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

  14. Low-dose epidural dexmedetomidine improves thoracic epidural anaesthesia for nephrectomy.

    PubMed

    Zeng, X Z; Xu, Y M; Cui, X G; Guo, Y P; Li, W Z

    2014-03-01

    Thoracic epidural anaesthesia alone is an applied technique of anaesthesia for nephrectomy which has both advantages and limitations. Dexmedetomidine is a highly selective alpha2-adrenoreceptor agonist which has both central and peripheral analgesic properties. Forty patients undergoing nephrectomy were enrolled in this clinical trial and allocated randomly to two groups, a control group (C group) and a dexmedetomidine group (D group). The C group received epidural 0.75% levobupivacaine 12 ml with 1 ml of isotonic sodium chloride solution, while the D group received epidural 0.75% levobupivacaine 12 ml with 1 ml (0.5 µg/kg) of dexmedetomidine. Haemodynamic changes, onset time and duration of sensory and motor block, muscle relaxation score, verbal rating score for pain, sedation score and the total postoperative analgesic consumption were evaluated. Sensory blockade duration was longer in the D group than in the C group (P=0.01). The incidence of motor block and the muscle relaxation score were significantly higher in the D group compared with the C group (P=0.01). Compared with the C group, pain scores were significantly lower in the first four postoperative hours in the D group (two hours rest P=0.038; two hours activity P=0.009; four hours rest P=0.044; four hours activity P=0.003). The total amount of flurbiprofen analgesic was significantly lower in the D group compared with the C group (P=0.03). Epidural dexmedetomidine 0.5 µg/kg appears to intensify thoracic epidural anaesthesia with levobupivacaine.

  15. Taking a Step Forward in Laparoscopic Donor Nephrectomy: Transvaginal Retrieval of Donor's Kidney.

    PubMed

    Tan, Ying Hao; Lim, Yu Ming Joel; Ng, Ying Woo; Tiong, Ho Yee

    2016-09-01

    Laparoscopic donor nephrectomy has been broadly recognized as the gold standard for kidney procurement used in kidney transplantation where it is not uncommon for donors to experience discomfort and aesthetic dissatisfaction over larger incision site. Natural orifice transluminal endoscopic surgery is a surgical approach that allows scarless intraabdominal operations through natural orifices, such as the vagina. In this case report, we describe the first case of transvaginal retrieval of donor's kidney at the National University Hospital, Singapore. A 51-year-old Malay lady with no significant medical history volunteered to a living-related kidney donor. Perioperative antibiotics were administered. A 12 mm Excel port was placed over the left iliac fossa with camera insertion. Two additional ports were inserted over the left rectus sheath edge and left costal margin under direct vision. An additional 5 mm port at the left loin was placed for lateral retraction. A vaginal probe was then inserted to facilitate posterior colpotomy and transection of the left uterosacral ligament. Pneumoperitoneum was subsequently maintained with a LiNA McCartney(®) Tube. A 15 mm Endocatch(®) bag was inserted for retrieval of the kidney. The left kidney was placed in the Endocatch bag after transection of the hilar vessels where the kidney was retrieved vaginally with ease. Colpotomy was closed vaginally using Vicryl-0 continuous suture. Total blood loss was noted as 50 mL with warm ischemia time being 7 minutes and the entire retrieval taking totally 20 minutes. Postoperative recovery was uneventful and the donor was discharged stable 3 days postoperation. The transplanted kidney retained normal graft function. Colpotomy retrieval for donor nephrectomy presents an innovative method for specimen retrieval with minimal disruption of donor anatomy. Doing away with laparotomy for kidney retrieval has indeed shown a reduction in recovery time, reduced postoperative pain, and

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. Soft robotics: a bioinspired evolution in robotics.

    PubMed

    Kim, Sangbae; Laschi, Cecilia; Trimmer, Barry

    2013-05-01

    Animals exploit soft structures to move effectively in complex natural environments. These capabilities have inspired robotic engineers to incorporate soft technologies into their designs. The goal is to endow robots with new, bioinspired capabilities that permit adaptive, flexible interactions with unpredictable environments. Here, we review emerging soft-bodied robotic systems, and in particular recent developments inspired by soft-bodied animals. Incorporating soft technologies can potentially reduce the mechanical and algorithmic complexity involved in robot design. Incorporating soft technologies will also expedite the evolution of robots that can safely interact with humans and natural environments. Finally, soft robotics technology can be combined with tissue engineering to create hybrid systems for medical applications. PMID:23582470

  1. 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…

  2. 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

  3. 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.

  4. Robotic space colonies

    NASA Technical Reports Server (NTRS)

    Schenker, P.; Easter, R.; Rodriguez, G.

    2001-01-01

    This paper reviews recent advances in these technologies, with a particular focus on experimental state-of-the-art robot work crew system demonstrations at JPL, that are being conducted now to begin to realize the futuristic robotic colony vision.

  5. 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 ...

  6. 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...

  7. Acid-base equilibrium during capnoretroperitoneoscopic nephrectomy in patients with end-stage renal failure: a preliminary report.

    PubMed

    Demian, A D; Esmail, O M; Atallah, M M

    2000-04-01

    We have studied the acid-base equilibrium in 12 patients with end-stage renal failure (ESRF) during capnoretroperitoneoscopic nephrectomy. Bupivacaine (12 mL, 0.375%) and morphine (2mg) were given in the lumbar epidural space, and fentanyl (0.5 microg kg(-1)) and midazolam (50 microg kg(-1)) were given intravenously. Anaesthesia was induced by thiopental, maintained with halothane carried by oxygen enriched air (inspired oxygen fraction = 0.35), and ventilation was achieved with a tidal volume of 10 mL kg(-1) at a rate of 12 min(-1). This procedure resulted in a mild degree of respiratory acidosis that was cleared within 60 min. We conclude that capnoretroperitoneoscopic nephrectomy can be performed in patients with end-stage renal failure with minimal transient respiratory acidosis that can be avoided by increased ventilation.

  8. Acid-base equilibrium during capnoretroperitoneoscopic nephrectomy in patients with end-stage renal failure: a preliminary report.

    PubMed

    Demian, A D; Esmail, O M; Atallah, M M

    2000-04-01

    We have studied the acid-base equilibrium in 12 patients with end-stage renal failure (ESRF) during capnoretroperitoneoscopic nephrectomy. Bupivacaine (12 mL, 0.375%) and morphine (2mg) were given in the lumbar epidural space, and fentanyl (0.5 microg kg(-1)) and midazolam (50 microg kg(-1)) were given intravenously. Anaesthesia was induced by thiopental, maintained with halothane carried by oxygen enriched air (inspired oxygen fraction = 0.35), and ventilation was achieved with a tidal volume of 10 mL kg(-1) at a rate of 12 min(-1). This procedure resulted in a mild degree of respiratory acidosis that was cleared within 60 min. We conclude that capnoretroperitoneoscopic nephrectomy can be performed in patients with end-stage renal failure with minimal transient respiratory acidosis that can be avoided by increased ventilation. PMID:10866009

  9. 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. PMID:25314845

  10. 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.

  11. 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.

  12. 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.

  13. The Robots Are Coming!

    ERIC Educational Resources Information Center

    Watt, Molly

    1984-01-01

    Describes two robots that can be communicated with in Logo--Topo and Tasman Turtle--and briefly presents merchandise information on Topo II and Turtle Tot. Educational issues and possibilities related to robot use in school classrooms are discussed, and a school visit to introduce students to robots is recounted. (MBR)

  14. 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,…

  15. 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.

  16. 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.

  17. 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.

  18. Pentosan polysulfate prevents glomerular hypertension and structural injury despite persisting hypertension in 5/6 nephrectomy rats.

    PubMed

    Bobadilla, N A; Tack, I; Tapia, E; Sánchez-Lozada, L G; Santamaría, J; Jiménez, F; Striker, L J; Striker, G E; Herrera-Acosta, J

    2001-10-01

    Five/six nephrectomy induces systemic and glomerular hypertension, glomerulosclerosis, proteinuria, and tubulointerstitial fibrosis. Polysulfate pentosan (PPS) decreases mesangial proliferation and extracellular matrix accumulation. The aim of this study was to determine whether PPS prevents glomerular hemodynamic changes and renal damage. Micropuncture studies were performed in three groups of eight male Wistar rats. Two groups included rats with 5/6 nephrectomy-one of which was treated with PPS in drinking water (100 mg/kg body wt) and the second of which received normal drinking water-and the third group consisted of normal rats that served as controls. Five/six nephrectomy produced systemic hypertension, a 50% reduction in GFR, and a 67% increase in single-nephron GFR due to elevated glomerular pressure and single-nephron plasma flow as well as proteinuria. Hypertension persisted in PPS-treated animals. Despite a similar reduction in GFR, PPS prevented the rise in single-nephron GFR, glomerular capillary hydrostatic pressure, and proteinuria. By morphometry, glomerular volume was increased by 46% and mesangial area by 94%. Fractional glomerular capillary area decreased by 24%. PPS prevented these changes. Tubular dilatation, epithelial cell atrophy, and increased interstitial area were largely prevented by PPS, as was the interstitial inflammatory infiltrate. These results suggest that the renal protection conferred by PPS was mediated both by prevention of glomerular hypertension as well as suppression of the inflammatory response. It was postulated that this was partly due to the preservation of a greater fraction of functional nephrons.

  19. 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

  20. Treatment of 5/6 nephrectomy rats with sulodexide: a novel therapy for chronic renal failure

    PubMed Central

    Li, Ping; Ma, Lin-lin; Xie, Ru-juan; Xie, Yuan-sheng; Wei, Ri-bao; Yin, Min; Wang, Jian-zhong; Chen, Xiang-mei

    2012-01-01

    Aim: Sulodexide, a glycosaminoglycan, could reduce albuminuria in diabetic patients. The aim of this study was to determine whether sulodexide could be used to treat chronic kidney failure in rats. Methods: Sixty Wistar rats undergone 5/6 nephrectomy, then were randomly divided into 4 groups: the model group, sulodexide group (sulodexide 5 mg/kg per day, im), irbesartan group irbesartan (20 mg/kg per day, ig) and sulodexide plus irbesartan group. Another 12 rats were enrolled into the sham operation group. After the treatments for 4, 8 and 12 weeks, urinary protein and serum creatinine levels were measured. After 12 weeks, serum cholesterin and triglycerides levels were measured, and the degrees of glomerular sclerosis and renal tubulointerstitial fibrosis were scored. The expression of aminopeptidase P (JG-12) in the renal tissue was examined using immunohistochemical staining. The renal expressions of endothelial nitric oxide synthase (eNOS) and tissue type plasminogen activator (tPA) were detected with RT-PCR and Western blot. Results: Proteinuria was markedly attenuated in the sulodexide-treated groups. After 4 and 8 weeks only the sulodexide-treated groups showed significant reduction in serum creatinine; while after 12 weeks all the three treatment groups showed significant reduction in serum creatinine. Furthermore, all the three treatment groups showed significant reduction in the scores of glomerular sclerosis and tubulointerstitial fibrosis. The glomerular expression of JG-12 was increased in both the sulodexide group and the sulodexide plus irbesartan group, but not in the irbesartan group. The eNOS mRNA and protein expression was decreased and the tPA mRNA and protein expression was significantly increased in the model group compared with Sham group. Sulodexide, irbesartan, and their combination reversed the decrease of eNOS expression but increased the tPA expression much more compared with model group. Conclusion: Sulodexide was similar to irbesartan

  1. Partially Opened Oven on Phoenix

    NASA Technical Reports Server (NTRS)

    2008-01-01

    This view from the Robotic Arm Camera on NASA's Phoenix Mars Lander shows partial opening of doors to one of the tiny ovens of the Thermal and Evolved-Gas Analyzer.

    Each oven has a pair of spring-loaded doors. Near the center of the image, the partial opening of a pair of doors reveals screen over the opening where a soil sample will be delivered. The door to the right is fully opened and the one to the left is partially deployed. The doors are 10 centimeters (4 inches) long. The opening is 4 centimeters (1.5 inches) wide.

    Tests on the Phoenix testbed at the University of Arizona, Tucson, indicate that a soil sample could be delivered into the oven through the partially opened doors. Engineers are also exploring possibilities for opening the doors more completely.This image was taken during Phoenix's eighth Martian day, or sol (June 2, 2008).

    The Phoenix Mission is led by the University of Arizona, Tucson, on behalf of NASA. Project management of the mission is by NASA's Jet Propulsion Laboratory, Pasadena, Calif. Spacecraft development is by Lockheed Martin Space Systems, Denver.

  2. Position error correcting method and apparatus for industrial robot

    SciTech Connect

    Okada, T.; Mohri, S.

    1987-06-02

    A method is described of correcting a position error of an industrial robot. The method comprises: operating the industrial robot according to position command values, thereby moving a measurement point provided on the industrial robot to a first position; measuring the position values of the first position of the measurement point with a three-dimensional measuring unit to obtain three-dimensional coordinates defining the measurement point; computing a position error of the industrial robot by defining the coordinates of the measurement point in a first equation incorporating parameters of the robot contributing to the position error, forming partial differential equations from the first equation for each of the parameters contributing to the position error.

  3. Impacts of industrial robots

    SciTech Connect

    Ayres, R.; Miller, S.

    1981-11-01

    This report briefly describes robot technology and goes into more depth about where robots are used, and some of the anticipated social and economic impacts of their use. A number of short term transitional issues, including problems of potential displacement, are discussed. The ways in which robots may impact the economics of batch production are described. A framework for analyzing the impacts of robotics on economywide economic growth and employment is presented. Human resource policy issues are discussed. A chronology of robotics technology is also given.

  4. [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.

  5. Assessing User Needs and Requirements for Assistive Robots at Home.

    PubMed

    Werner, Katharina; Werner, Franz

    2015-01-01

    'Robots in healthcare' is a very trending topic. This paper gives an overview of currently and commonly used methods to gather user needs and requirements in research projects in the field of assistive robotics. Common strategies between authors are presented as well as examples of exceptions, which can help future researchers to find methods suitable for their own work. Typical problems of the field are discussed and partial solutions are proposed. PMID:26294470

  6. 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.

  7. 2509 living donor nephrectomies, morbidity and mortality, including the UK introduction of laparoscopic donor surgery.

    PubMed

    Hadjianastassiou, V G; Johnson, R J; Rudge, C J; Mamode, N

    2007-11-01

    The worldwide expansion of laparoscopic, at the expense of open, donor nephrectomy (DN) has been driven on the basis of faster convalescence for the donor. However, concerns have been expressed over the safety of the laparoscopic procedure. The UK Transplant National Registry collecting mandatory information on all living kidney donations in the country was analyzed for donations between November 2000 (start of living donor follow-up data reporting) to June 2006 to assess the safety of living DN, after the recent introduction of the laparoscopic procedure in the United Kingdom. Twenty-four transplant units reported data on 2509 donors (601 laparoscopic, 1800 open and 108 [4.3%] unspecified); 46.5% male; mean donor age: 46 years. There was one death 3 months postdischarge and a further five deaths beyond 1 year postdischarge. The mean length of stay was 1.5 days less for the laparoscopic procedure (p < 0.001). The risk of major morbidity for all donors was 4.9% (laparoscopic = 4.5%, open = 5.1%, p = 0.549). The overall rate of any morbidity was 14.3% (laparoscopic = 10.3%, open = 15.7%, p = 0.001). Living donation has remained a safe procedure in the UK during the learning curve of introduction of the laparoscopic procedure. The latter offers measurable advantages to the donor in terms of reduced length of stay and morbidity. PMID:17868058

  8. Laparoscopic versus conventional live donor nephrectomy: experience in a community transplant program.

    PubMed

    Hawasli, A; Boutt, A; Cousins, G; Schervish, E; Oh, H

    2001-04-01

    Fifty-nine consecutive patients underwent live donor nephrectomy for transplantation. Twenty-nine patients (Group I) had open kidney procurement, and 30 patients (Group II) had laparoscopic procurement. The mean operative time in Group I was 2:30 hours (range 1:55-2:59), whereas in Group II it was 3:01 hours (1:54-5:21). All kidneys functioned immediately after transplantation. The average warm ischemia time was not calculated in Group I; it was 3.9 minutes (2-15) in Group II. Intraoperative complications occurred in two patients in Group II. One patient had bleeding from an accessory renal artery. The second patient had a tear in the splenic capsule. No ureteral complications occurred in either group. Postoperatively one patient in Group I developed incisional hernia, one developed pneumothorax, and two developed atelectasis. In Group II one patient developed pancreatitis, one developed flank ecchymosis, and two had suprapubic wound hematomas. Using the laparoscopic approach the hospital stay decreased from 4.1 to 1.27 days (69%) (P < 0.001) and return to work decreased from 28.4 to 14.8 days (49%) (P < 0.01). Live donation increased by 67 per cent. We conclude that the laparoscopic procurement of kidneys for transplantation compares well with the open method. It offers several advantages that may increase the living donor pool. PMID:11308000

  9. Serum prolactin levels in a uremic child: effects of bilateral nephrectomy and kidney transplantation.

    PubMed

    Rondeau, Geneviève; Merouani, Aïcha; Phan, Véronique; Deal, Cheri; Robitaille, Pierre

    2011-10-01

    Elevated levels of serum prolactin (PRL) are common and well described in patients with chronic renal failure. We report the case of a 4-year-old girl who also presented with premature thelarche and transient galactorrhea. Neither peritoneal dialysis nor hemodialysis reduced her extremely elevated levels of PRL, which fluctuated from time to time, probably reflecting variations in lactotroph secretion rate. Bilateral nephrectomy (BN) was eventually followed by a progressive and significant rise in PRL levels, suggesting that even uremic kidneys can eliminate PRL through tubular breakdown. Kidney transplantation was responsible for a very abrupt normalization of PRL serum levels, much faster than that observed for creatinine. This confirms animal studies suggesting that elimination of PRL occurs both through glomerular filtration and tubular breakdown. We hypothesized that the seemingly precocious puberty may have resulted from a combination of growth hormone therapy, elevated PRL and a rise in estrogens through the aromatization of adrenal androgens. This case illustrates the impact of dialysis, BN and kidney transplantation on PRL, providing new knowledge on renal PRL metabolism. PMID:25984175

  10. Unilateral nephrectomy elongates primary cilia in the remaining kidney via reactive oxygen species.

    PubMed

    Han, Sang Jun; Jang, Hee-Seong; Kim, Jee In; Lipschutz, Joshua H; Park, Kwon Moo

    2016-02-29

    The length of primary cilia is associated with normal cell and organ function. In the kidney, the change of functional cilia length/mass is associated with various diseases such as ischemia/reperfusion injury, polycystic kidney disease, and congenital solitary kidney. Here, we investigate whether renal mass reduction affects primary cilia length and function. To induce renal mass reduction, mice were subjected to unilateral nephrectomy (UNx). UNx increased kidney weight and superoxide formation in the remaining kidney. Primary cilia were elongated in proximal tubule cells, collecting duct cells and parietal cells of the remaining kidney. Mn(III) Tetrakis (1-methyl-4-pyridyl) porphyrin (MnTMPyP), an antioxidant, reduced superoxide formation in UNx-mice and prevented the elongation of primary cilia. UNx increased the expression of phosphorylated ERK, p21, and exocyst complex members Sec8 and Sec10, in the remaining kidney, and these increases were prevented by MnTMPyP. In MDCK, a kidney tubular epithelial cell line, cells, low concentrations of H2O2 treatment elongated primary cilia. This H2O2-induced elongation of primary cilia was also prevented by MnTMPyP treatment. Taken together, these data demonstrate that kidney compensation, induced by a reduction of renal mass, results in primary cilia elongation, and this elongation is associated with an increased production of reactive oxygen species (ROS).

  11. Unilateral nephrectomy elongates primary cilia in the remaining kidney via reactive oxygen species

    PubMed Central

    Han, Sang Jun; Jang, Hee-Seong; Kim, Jee In; Lipschutz, Joshua H.; Park, Kwon Moo

    2016-01-01

    The length of primary cilia is associated with normal cell and organ function. In the kidney, the change of functional cilia length/mass is associated with various diseases such as ischemia/reperfusion injury, polycystic kidney disease, and congenital solitary kidney. Here, we investigate whether renal mass reduction affects primary cilia length and function. To induce renal mass reduction, mice were subjected to unilateral nephrectomy (UNx). UNx increased kidney weight and superoxide formation in the remaining kidney. Primary cilia were elongated in proximal tubule cells, collecting duct cells and parietal cells of the remaining kidney. Mn(III) Tetrakis (1-methyl-4-pyridyl) porphyrin (MnTMPyP), an antioxidant, reduced superoxide formation in UNx-mice and prevented the elongation of primary cilia. UNx increased the expression of phosphorylated ERK, p21, and exocyst complex members Sec8 and Sec10, in the remaining kidney, and these increases were prevented by MnTMPyP. In MDCK, a kidney tubular epithelial cell line, cells, low concentrations of H2O2 treatment elongated primary cilia. This H2O2-induced elongation of primary cilia was also prevented by MnTMPyP treatment. Taken together, these data demonstrate that kidney compensation, induced by a reduction of renal mass, results in primary cilia elongation, and this elongation is associated with an increased production of reactive oxygen species (ROS). PMID:26923764

  12. Inferior Vena Cava Resection and Reconstruction for Tumoral Recurrence after Right Nephrectomy.

    PubMed

    Botianu, Pv-H; Chirtes, R; Marcu, C; Kosza, H; Stoian, M; Brusnic, O; Botianu, Amv; Dobre, A

    2016-01-01

    We report a 60 years old patient who was admitted for a local recurrence after a right nephrectomy performed 2 years ago (papillary renal carcinoma with areas of sarcomatoid differentiation - pT3a). CT scan showed a retroperitoneal mass with invasion of the inferior vena cava. We performed a complete en-bloque excision of the tumor with the infrarenal portion of the inferior vena cava and lympha-denectomy. The vascular reconstruction was performed by the interposition of a 20 mm diameter Dacron prosthesis. The postoperative course was complicated due to an episode of digestive bleeding (duodenal ulcer) which stopped after conservative treatment (antisecretory and hemostatics, including rFVIIa), but eventually favourable. At 6 months follow-up the patient presents no sign of tumoral relapse and a functional vascular prosthesis. The case is interesting due to the rarity of the surgical procedure and the indication. The surgical approach of the retroperitoneal tumors with vascular involvement is possible in centers with adequate technical endownment and human expertise. PMID:27604673

  13. 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. PMID:25833120

  14. Cardiac arrest during radical nephrectomy due to a mass in the right ventricular outflow tract.

    PubMed

    Kim, Hee Young; Baek, Seung-Hoon; Yoon, Ji Uk; Lee, Dong Hoon; Byeon, Gyeong-Jo; Ahn, Ji Hye

    2016-09-01

    We report cardiac arrest due to obstruction of the right ventricular outflow tract (RVOT) caused by an RVOT mass that was not identified preoperatively. A 62-year-old woman with renal cell carcinoma (RCC) experienced deteriorating hypotension and bradycardia during radical nephrectomy. Hemodynamic stability was maintained on extracorporeal membrane oxygenation, and after surgery, she was transferred to the intensive care unit. On postoperative day 3, transthoracic echocardiography showed an intracardiac mass obstructing the RVOT, which caused severe functional pulmonary stenosis and moderate resting pulmonary hypertension. Despite maintaining extracorporeal membrane oxygenation, the patient died of cardiac arrest. Our findings suggest that it may be necessary to perform additional tests if RCC has invaded the renal vein and inferior vena cava or if a patient with RCC has abnormal cardiovascular symptoms without definite etiology for exclusion of cardiac metastasis or tumor thrombus. In addition, intraoperative transesophageal echocardiography might be the procedure of choice for the evaluation of these conditions because other diagnostic tests are difficult to perform during surgery. In conclusion, for patients with acute hemodynamic instability for whom other possible causes have been excluded, we recommend that anesthesiologists use transesophageal echocardiography to detect outflow tract obstruction or pulmonary thromboembolism and perform anesthetic management. PMID:27555152

  15. 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.

  16. Planetary exploration by a mobile robot: mission teleprogramming and autonomous navigation.

    NASA Astrophysics Data System (ADS)

    Chatila, R.; Lacroix, S.; Simeon, T.; Herrb, M.

    Sending mobile robots to accomplish planetary exploration missions is scientifically promising and technologically challenging. The authors present a complete approach that encompasses the major aspects involved in the design of a robotic system for planetary exploration. It includes mission teleprogramming and supervision at a ground station, and autonomous mission execution by the remote mobile robot. They have partially implemented and validated these concepts. Experimental results illustrate the approach and the results.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. Applying robotics to HAZMAT

    NASA Astrophysics Data System (ADS)

    Welch, Richard V.; Edmonds, Gary O.

    1994-02-01

    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.

  2. 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.

  3. Robotics and industrial inspection

    SciTech Connect

    Casasent, D.P.

    1983-01-01

    Image processing algorithms are discussed, taking into account hidden information in early visual processing, three-dimensional shape recognition by moirecorrelation, spatial-frequency representations of images with scale invariant properties, image-based focusing, the computational structure for the Walsh-Hadamard transform, a hybrid optical/digital moment-based robotic pattern recognition system, affordable implementations of image processing algorithms, and an analysis of low-level computer vision algorithms for implementation on a very large scale integrated processor array. Other topics considered are related to government programs and needs in robotics, DoD research and applications in robotics, time-varying image processing and control, industrial robotics, industrial applications of computer vision, and object perception and mensuration for robotics. Attention is given to laser scanning techniques for automatic inspection of heat-sealed film packages, computer software for robotic vision, and computerized tomography on a logarithmic polar grid.

  4. Multigait soft robot

    PubMed Central

    Shepherd, Robert F.; Ilievski, Filip; Choi, Wonjae; Morin, Stephen A.; Stokes, Adam A.; Mazzeo, Aaron D.; Chen, Xin; Wang, Michael; Whitesides, George M.

    2011-01-01

    This manuscript describes a unique class of locomotive robot: A soft robot, composed exclusively of soft materials (elastomeric polymers), which is inspired by animals (e.g., squid, starfish, worms) that do not have hard internal skeletons. Soft lithography was used to fabricate a pneumatically actuated robot capable of sophisticated locomotion (e.g., fluid movement of limbs and multiple gaits). This robot is quadrupedal; it uses no sensors, only five actuators, and a simple pneumatic valving system that operates at low pressures (< 10 psi). A combination of crawling and undulation gaits allowed this robot to navigate a difficult obstacle. This demonstration illustrates an advantage of soft robotics: They are systems in which simple types of actuation produce complex motion. PMID:22123978

  5. Multigait soft robot.

    PubMed

    Shepherd, Robert F; Ilievski, Filip; Choi, Wonjae; Morin, Stephen A; Stokes, Adam A; Mazzeo, Aaron D; Chen, Xin; Wang, Michael; Whitesides, George M

    2011-12-20

    This manuscript describes a unique class of locomotive robot: A soft robot, composed exclusively of soft materials (elastomeric polymers), which is inspired by animals (e.g., squid, starfish, worms) that do not have hard internal skeletons. Soft lithography was used to fabricate a pneumatically actuated robot capable of sophisticated locomotion (e.g., fluid movement of limbs and multiple gaits). This robot is quadrupedal; it uses no sensors, only five actuators, and a simple pneumatic valving system that operates at low pressures (< 10 psi). A combination of crawling and undulation gaits allowed this robot to navigate a difficult obstacle. This demonstration illustrates an advantage of soft robotics: They are systems in which simple types of actuation produce complex motion.

  6. 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.

  7. 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.

  8. 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.

  9. Recurrent infections in partial complement factor I deficiency: evaluation of three generations of a Brazilian family

    PubMed Central

    Grumach, A S; Leitão, M F; Arruk, V G; Kirschfink, M; Condino-Neto, A

    2006-01-01

    We report here on the evaluation of a factor I-deficient Brazilian family (three generations, 39 members) with strong consanguinity. The complete factor I-deficient patients (n = 3) presented recurrent respiratory infections, skin infections and meningitis; one of them died after sepsis. They presented an impaired total haemolytic activity (CH50), low C3, low factor H and undetectable C3dg/C3d. Partial factor I deficiency was detected in 16 family members (normal low cut-off value was 25 µg/ml). Respiratory infections were the most common clinical occurrence among partial factor I-deficient relatives. Two of them were submitted to nephrectomy following recurrent urinary tract infections. An additional two heterozygous relatives presented with arthritis and rheumatic fever. Apparently, patients with partial factor I deficiency are also at higher risk for recurrent infections. Vaccination against capsulated bacteria and the eventual use of prophylactic antibiotics should be considered individually in this patient group. PMID:16412054

  10. 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

  11. Robotic liver surgery.

    PubMed

    Leung, Universe; Fong, Yuman

    2014-10-01

    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

  12. 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.

  13. Viselike Robotic Gripper

    NASA Technical Reports Server (NTRS)

    Vranish, John M.

    1991-01-01

    Split-rail/roller bearing system minimizes both friction and jamming under side loads. Viselike, high-performance, general-purpose robot hand developed for use in both industry and outer space. Device, called "split-rail parallel gripper", is simple, compact, inexpensive, rugged, light enough to be used on small robots, strong enough to be used on large robots to lift loads up to 100 lbs, and capable of gripping objects up to 7 in. wide.

  14. Robotics in neurosurgery.

    PubMed

    McBeth, Paul B; Louw, Deon F; Rizun, Peter R; Sutherland, Garnette R

    2004-10-01

    Technological developments in imaging guidance, intraoperative imaging, and microscopy have pushed neurosurgeons to the limits of their dexterity and stamina. The introduction of robotically assisted surgery has provided surgeons with improved ergonomics and enhanced visualization, dexterity, and haptic capabilities. This article provides a historical perspective on neurosurgical robots, including image-guided stereotactic and microsurgery systems. The future of robot-assisted neurosurgery, including the use of surgical simulation tools and methods to evaluate surgeon performance, is discussed.

  15. Kinematics of robot wrists

    NASA Astrophysics Data System (ADS)

    Paul, R. P.; Stevenson, C. N.

    1983-05-01

    Robots for use in assembly and other interactive tasks must be able to respond to both forces and velocity commands within their workspace. By considering a general six-joint robot it is shown that all such robots are limited in their ability to respond in orientation to feedback commands. It is also shown that it is simple to predict, if not to avoid, these regions of degeneracy in which the manipulator loses a degree of freedom.

  16. Budd-Chiari syndrome in urology: Impact on nephrectomy for advanced renal cell carcinoma

    PubMed Central

    Shirodkar, Samir P.; Soloway, Mark S.; Ciancio, Gaetano

    2011-01-01

    Objectives: Budd-Chiari syndrome (BCS) is a poorly understood entity in urology. It results from obstruction of the hepatic veins and the subsequent complications. It has been infrequently reported to be secondary to hepatic venous obstruction from invasion by an inferior vena cava (IVC) tumor thrombus in renal cell carcinoma (RCC). We report the largest known series of patients with RCC and BCS. Patients and Methods: Ten patients presented to a tertiary hospital with locally advanced RCC with IVC tumor thrombus. All were evaluated and had clinical or radiographic evidence of BCS. All underwent nephrectomy, IVC thrombectomy or ligation, and tumor removal from the hepatic veins. The perioperative and pathological factors were measured. These included estimated blood loss (EBL) and transfusions. Inpatient factors including duration of intubation, length of intensive care unit (ICU) stay, and overall length of stay (LOS) were recorded. The tumor-free status was evaluated. Results: The average age was 59 years. No intraoperative deaths occurred. Two intraoperative complications were noted. The mean EBL was 4244 cc; mean surgery length was 8 hours 12 minutes; and the mean ICU stay was nine days. The overall LOS averaged 13.25 days. One patient died postoperatively of sepsis and multisystem organ failure. One patient required reoperation for an abdominal wall hematoma caused by subcutaneous enoxaparin administration. Average follow-up was 28 months. Five patients are alive with no evidence of disease. Conclusions: Budd-Chiari syndrome is a rare entity in urology, with a potential for significant morbidity and mortality. Surgical excision of the primary tumor along with thrombectomy results in alleviation of BCS and improvement in the patient. PMID:22022058

  17. Cytokines induce small intestine and liver injury after renal ischemia or nephrectomy

    PubMed Central

    Park, Sang Won; Chen, Sean W.C.; Kim, Mihwa; Brown, Kevin M.; Kolls, Jay K.; D’Agati, Vivette D.; Lee, H. Thomas

    2010-01-01

    Patients with acute kidney injury (AKI) frequently suffer from extra-renal complications including hepatic dysfunction and systemic inflammation. We aimed to determine the mechanisms of AKI induced hepatic dysfunction and systemic inflammation. Mice subjected to AKI [renal ischemia reperfusion (IR) or nephrectomy] rapidly developed acute hepatic dysfunction and suffered significantly worse hepatic IR injury. After AKI, rapid peri-portal hepatocyte necrosis, vacuolization, neutrophil infiltration and pro-inflammatory mRNA upregulation were observed suggesting an intestinal source of hepatic injury. Small intestine histology after AKI demonstrated profound villous lacteal capillary endothelial apoptosis, disruption of vascular permeability and epithelial necrosis. After ischemic or non-ischemic AKI, plasma TNF-α, IL-17A and IL-6 increased significantly. Small intestine appears to be the source of IL-17A as IL-17A levels were higher in the portal circulation and small intestine compared to the levels measured from the systemic circulation and liver. Wild type mice treated with neutralizing antibodies against TNF-α, IL-17A or IL-6 or mice deficient in TNF-α, IL-17A, IL-17A receptor or IL-6 were protected against hepatic and small intestine injury due to ischemic or non-ischemic AKI. For the first time, we implicate the increased release of IL-17A from small intestine together with induction of TNF-α and IL-6 as a cause of small intestine and liver injury after ischemic or non-ischemic AKI. Modulation of the inflammatory response and cytokine release in the small intestine after AKI may have important therapeutic implications in reducing complications arising from AKI. PMID:20697374

  18. Simplifying Laparoscopic Nephrectomy: The Inferior Approach with En Bloc Stapling of the Renal Hilum

    PubMed Central

    Nadu, Andrei; Lindner, Uri; Ramon, Jacob

    2014-01-01

    Introduction: Laparoscopic nephrectomy (LN) is likely the most common laparoscopic procedure performed by general urologists without formal laparoscopic training. The traditional technique is cumbersome because it entails making an early approach to the hilum with the risk of bleeding and need for conversion. We perform a different technique that we believe is simpler to learn and to teach. It consists of a complete dissection of the inferior and posterior aspects of the kidney, followed by en bloc stapling of the renal hilum. The present report is a detailed description of our technique including outcomes and complications. Materials and Methods: Perioperative data of 129 consecutive patients who underwent LN between November 2003 and September 2007 were prospectively collected and retrospectively reviewed. Complications were reported using the Clavien classification system, and follow-up was performed according to our institution's protocol and included physical examination, blood count, blood chemistry, and renal function tests at every visit, in addition to abdominal computed tomography scan six months after surgery. Additional imaging was scheduled according to disease stage and grade. Results: Mean patient age, tumor size, and operative time were 63 ± 15.6 years, 6.3 ± 2.4 cm, and 128 ± 41.4 minutes, respectively. Median estimated blood loss was 0 mL (0.200). Conversion to open surgery occurred in 3.1% of patients, and 8% of the patients had a blood transfusion. Complications were recorded in 26% of the patients; 91% of them had Clavien grade scores of 1 or 2. Conclusion: We present a standardized technique for LN. Its main advantage is that postpones any manipulation of the hilum to a later step during the procedure when it is easy to identify and control. This decreases early bleeding and main vascular complications. PMID:25392654

  19. 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...

  20. [Robotic surgery: marking time?].

    PubMed

    van der Poel, Henk G; Beerlage, Harry P; Klaver, Sjoerd O

    2013-01-01

    Robot-assisted surgery provides the next step in surgical evolution. Where laparoscopic surgery shortened both hospital stay and recovery, it often prolonged the surgical procedure. Novel laparoscopic instruments such as robotic systems improve visibility and patient outcome. Recent randomized studies show improved functional patient outcome after robot-assisted laparoscopic prostatectomy. Introduction of image-guided surgical technologies is aided by robotic systems. Outside medicine, randomized controlled studies in technological improvements are non-existent. A careful monitoring of study results is mandatory for the introduction of novel technologies in the field of medicine.

  1. The robotics review 1

    SciTech Connect

    Khatib, O.; Craig, J.J.; Lozano-Perez, T.

    1989-01-01

    Theoretical and implementation issues in robotics are discussed in reviews of recent investigations. Sections are devoted to programming, planning, and learning; sensing and perception; kinematics, dynamics, and design; and motion and force control. Particular attention is given to a robust layered control system for a mobile robot, camera calibration for three-dimensional machine vision, walking vehicles, design and control of direct-drive vehicles, an efficient parallel algorithm for robot inverse dynamics, stability problems in contact tasks, and kinematics and reaction-moment compensation for satellite-mounted robot manipulators.

  2. [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.

  3. 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.

  4. 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.

  5. 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

  6. 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.

  7. Robotic hair restoration.

    PubMed

    Rose, Paul T; Nusbaum, Bernard

    2014-01-01

    The latest innovation to hair restoration surgery has been the introduction of a robotic system for harvesting grafts. This system uses the follicular unit extraction/follicular isolation technique method for harvesting follicular units, which is particularly well suited to the abilities of a robotic technology. The ARTAS system analyzes images of the donor area and then a dual-chamber needle and blunt dissecting punch are used to harvest the follicular units. The robotic technology is now being used in various locations around the world. This article discusses the use of the robotic system, its capabilities, and the advantages and disadvantages of the system. PMID:24267426

  8. 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.

  9. Changes in the Enzymic Capacity of the Rat Kidney and Heart Due to Unilateral Nephrectomy and Deoxycorticosterone Induced Hypertension

    PubMed Central

    Mangnall, D.; Bartley, W.

    1970-01-01

    Changes in the chemical and enzymic composition of the kidney and heart of rats after unilateral nephrectomy and deoxycorticosterone implantation were studied during the 3 week period following operation. The remaining kidney doubled in weight and the heart mass increased by 25 per cent during this time. The initial response in the kidney was an increase in protein and RNA, but after 6 days DNA also increased and approximately doubled by 21 days after operation. No increase in blood urea was observed from 3 days after operation to the end of the experimental period. In the hypertrophying kidney the enzymes NADH cytochrome “c” oxidoreductase, succinate cytochrome “c” oxidoreductase, pyruvate carboxylase, glucose-6-phosphate dehydrogenase, PEP carboxykinase and glutaminase all increased in specific activity with greatest increase usually having occurred by the sixth day after the nephrectomy. Cytochrome oxidase alone showed a decrease in specific activity. At the end of the experiment (21 days after the nephrectomy) the enzyme activities (with the exception of cytochrome oxidase) were between 130-280 per cent of the activities present in the 2 control kidneys. In contrast there was only about 80 per cent of the cytochrome oxidase activity as compared with the 2 control kidneys. The growth of the kidney is discussed with respect to attainment of compensation for removal of its partner. The initial response of the heart was an immediate increase in RNA, DNA and protein and mitochondrial enzymes, although increases in heart weight were not observed until after day 3. Glucose-6-phosphate dehydrogenase activity closely followed the growth of the heart. The changes are discussed in relation to growth of the heart. PMID:4321628

  10. 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.

  11. 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.

  12. Multi-robot control interface

    DOEpatents

    Bruemmer, David J.; Walton, Miles C.

    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.

  13. Design and optimization of a brachytherapy robot

    NASA Astrophysics Data System (ADS)

    Meltsner, Michael A.

    Trans-rectal ultrasound guided (TRUS) low dose rate (LDR) interstitial brachytherapy has become a popular procedure for the treatment of prostate cancer, the most common type of non-skin cancer among men. The current TRUS technique of LDR implantation may result in less than ideal coverage of the tumor with increased risk of negative response such as rectal toxicity and urinary retention. This technique is limited by the skill of the physician performing the implant, the accuracy of needle localization, and the inherent weaknesses of the procedure itself. The treatment may require 100 or more sources and 25 needles, compounding the inaccuracy of the needle localization procedure. A robot designed for prostate brachytherapy may increase the accuracy of needle placement while minimizing the effect of physician technique in the TRUS procedure. Furthermore, a robot may improve associated toxicities by utilizing angled insertions and freeing implantations from constraints applied by the 0.5 cm-spaced template used in the TRUS method. Within our group, Lin et al. have designed a new type of LDR source. The "directional" source is a seed designed to be partially shielded. Thus, a directional, or anisotropic, source does not emit radiation in all directions. The source can be oriented to irradiate cancerous tissues while sparing normal ones. This type of source necessitates a new, highly accurate method for localization in 6 degrees of freedom. A robot is the best way to accomplish this task accurately. The following presentation of work describes the invention and optimization of a new prostate brachytherapy robot that fulfills these goals. Furthermore, some research has been dedicated to the use of the robot to perform needle insertion tasks (brachytherapy, biopsy, RF ablation, etc.) in nearly any other soft tissue in the body. This can be accomplished with the robot combined with automatic, magnetic tracking.

  14. Robotic coronary artery bypass grafting.

    PubMed

    Folliguet, Thierry A; Dibie, Alain; Philippe, François; Larrazet, Fabrice; Slama, Michel S; Laborde, François

    2010-12-01

    Robotically assisted surgery enables coronary surgery to be performed totally or partially endoscopically. Using the Da Vinci robotic technology allows minimally invasive treatments. We report on our experience with coronary artery surgery in our department: patients requiring single or double vessel surgical revascularization were eligible. The procedure was performed without cardiopulmonary bypass on a beating heart. From April 2004 to May 2008, 55 consecutive patients were enrolled in the study, and were operated on by a single surgical team. Operative outcomes included operative time, estimated blood loss, transfusions, ventilation time, intensive care unit (ICU) and hospital length of stay. Average operative time was 270 ± 101 min with an estimated blood loss of 509 ± 328 ml, a postoperative ventilation time of 6 ± 12 h, ICU stay of 52 ± 23 h, and a hospital stay of 7 ± 3 days. Nine patients (16%) were converted to open techniques, and transfusion was required in four patients (7%). Follow-up was complete for all patients up to 1 year. There was one hospital death (1.7%) and two deaths at follow-up. Coronary anastomosis was controlled in 48 patients by either angiogram or computed tomography scan, revealing occlusion or anastomotic stenoses (>50%) in six patients. Overall permeability was 92%. Major adverse events occurred in 12 patients (21%). One-year survival was 96%. Our initial experience with robotically assisted coronary surgery is promising: it avoids sternotomy and with a methodical approach we were able to implement the procedure safely and effectively in our practice, combining minimal mortality with excellent survival. PMID:27627952

  15. Robotics: Generation soft

    NASA Astrophysics Data System (ADS)

    Mazzolai, Barbara; Mattoli, Virgilio

    2016-08-01

    Meet the octobot, the first robot to be made entirely from soft materials. Powered by a chemical reaction and controlled by a fluidic logic circuit, it heralds a generation of soft robots that might surpass conventional machines. See Letter p.451

  16. Mechanochemically Active Soft Robots.

    PubMed

    Gossweiler, Gregory R; Brown, Cameron L; Hewage, Gihan B; Sapiro-Gheiler, Eitan; Trautman, William J; Welshofer, Garrett W; Craig, Stephen L

    2015-10-14

    The functions of soft robotics are intimately tied to their form-channels and voids defined by an elastomeric superstructure that reversibly stores and releases mechanical energy to change shape, grip objects, and achieve complex motions. Here, we demonstrate that covalent polymer mechanochemistry provides a viable mechanism to convert the same mechanical potential energy used for actuation in soft robots into a mechanochromic, covalent chemical response. A bis-alkene functionalized spiropyran (SP) mechanophore is cured into a molded poly(dimethylsiloxane) (PDMS) soft robot walker and gripper. The stresses and strains necessary for SP activation are compatible with soft robot function. The color change associated with actuation suggests opportunities for not only new color changing or camouflaging strategies, but also the possibility for simultaneous activation of latent chemistry (e.g., release of small molecules, change in mechanical properties, activation of catalysts, etc.) in soft robots. In addition, mechanochromic stress mapping in a functional robotic device might provide a useful design and optimization tool, revealing spatial and temporal force evolution within the robot in a way that might be coupled to autonomous feedback loops that allow the robot to regulate its own activity. The demonstration motivates the simultaneous development of new combinations of mechanophores, materials, and soft, active devices for enhanced functionality.

  17. Robotics in gynecologic surgery.

    PubMed

    Frick, A C; Falcone, T

    2009-06-01

    Robotic surgery has evolved from an investigational surgical approach to a clinically useful adjunct in multiple surgical specialties over the past decade. Advocates of robotic-assisted gynecologic surgery revere the system's wristed instrumentation, ergonomic positioning, and three-dimensional high-definition vision system as significant improvements over laparoscopic equipment's four degrees of freedom and two-dimensional laparoscope that demand the surgeon stand throughout a procedure. The cost, lack of haptic feedback, and the bulky size of the equipment make robotics less attractive to others. Studies evaluating outcomes in robotic-assisted gynecologic surgery are limited. Multiple small retrospective studies demonstrate the safety and feasibility of robotic hysterectomy. With increased surgeon experience, operative times are similar to, or shorter than, laparoscopic cases. Robotic assistance can facilitate suturing in laparoscopic myomectomies, and is associated with decreased blood loss and a shorter hospital stay, although may require longer operative times. Robotic assistance has also been applied to multiple procedures in the subspecialties of infertility, urogynecology and gynecologic oncology with good success and relatively low morbidity. However, further research is warranted to better evaluate the relative benefits and costs of robotic assisted gynecologic surgery.

  18. 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.

  19. 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.

  20. Randomization in robot tasks

    NASA Technical Reports Server (NTRS)

    Erdmann, Michael

    1992-01-01

    This paper investigates the role of randomization in the solution of robot manipulation tasks. One example of randomization is shown by the strategy of shaking a bin holding a part in order to orient the part in a desired stable state with some high probability. Randomization can be useful for mobile robot navigation and as a means of guiding the design process.

  1. 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…

  2. 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.)

  3. 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.).

  4. 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.

  5. Mechanochemically Active Soft Robots.

    PubMed

    Gossweiler, Gregory R; Brown, Cameron L; Hewage, Gihan B; Sapiro-Gheiler, Eitan; Trautman, William J; Welshofer, Garrett W; Craig, Stephen L

    2015-10-14

    The functions of soft robotics are intimately tied to their form-channels and voids defined by an elastomeric superstructure that reversibly stores and releases mechanical energy to change shape, grip objects, and achieve complex motions. Here, we demonstrate that covalent polymer mechanochemistry provides a viable mechanism to convert the same mechanical potential energy used for actuation in soft robots into a mechanochromic, covalent chemical response. A bis-alkene functionalized spiropyran (SP) mechanophore is cured into a molded poly(dimethylsiloxane) (PDMS) soft robot walker and gripper. The stresses and strains necessary for SP activation are compatible with soft robot function. The color change associated with actuation suggests opportunities for not only new color changing or camouflaging strategies, but also the possibility for simultaneous activation of latent chemistry (e.g., release of small molecules, change in mechanical properties, activation of catalysts, etc.) in soft robots. In addition, mechanochromic stress mapping in a functional robotic device might provide a useful design and optimization tool, revealing spatial and temporal force evolution within the robot in a way that might be coupled to autonomous feedback loops that allow the robot to regulate its own activity. The demonstration motivates the simultaneous development of new combinations of mechanophores, materials, and soft, active devices for enhanced functionality. PMID:26390078

  6. 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.

  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. 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…

  9. 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

  10. Education by Robot!

    ERIC Educational Resources Information Center

    Cobb, Cheryl

    2004-01-01

    This article describes BEST (Boosting Engineering, Science, and Technology), a hands-on robotics program founded by Texas Instruments engineers Ted Mahler and Steve Marum. BEST links educators with industry to provide middle and high school students with a peek into the exciting world of robotics, with the goal of inspiring and interesting…

  11. 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.

  12. 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.

  13. 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'.

  14. 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.

  15. 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. PMID:25489130

  16. PD-L1 Expression in Clear Cell Renal Cell Carcinoma: An Analysis of Nephrectomy and Sites of Metastases

    PubMed Central

    Jilaveanu, L.B.; Shuch, B.; Zito, C. R.; Parisi, F.; Barr, M.; Kluger, Y.; Chen, L.; Kluger, H. M.

    2014-01-01

    Background: Expression of programmed death ligand (PD-L1/B7-H1/CD274) represents a mechanism of immune escape for renal cell carcinoma (RCC) cells. Drugs blocking PD-L1 or its receptor are in clinical development and early data suggests that tumor PD-L1 expression may predict response. Patients and Methods: A tissue microarray (TMA) consisting of four biopsy cores from 34 matched pairs of nephrectomy and metastatic sites of clear cell RCC was used to assess PD-L1 expression by quantitative immunofluorescence. Assessment of intra- and inter-tumor heterogeneity and primary and metastatic tumor expression was performed using a method of Automated Quantitative Analysis (AQUA). Results: The median AQUA scores were higher in metastatic than primary specimens (P < 0.0001). The correlation between PD-L1 expression in matched primary and metastatic specimens was weak (R= 0.24). Within a given tumor, variable PD-L1 staining heterogeneity was seen, however the degree of heterogeneity was similar in primary and metastatic sites (P = 0.482). Conclusions: The weak correlation between PD-L1 expression in primary and metastatic sites for a given patient suggests that expression in nephrectomy specimens cannot be used to select metastatic RCC patients for PD-L1 and PD-1 inhibitors. The intra-tumor heterogeneity seen in both primary and metastatic specimens indicates that a single core biopsy might not be sufficient to determine PD-L1 expression. PMID:24563671

  17. 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.

  18. 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

  19. Long-term survival after renal transplantation: the influence of pretransplant bilateral nephrectomy.

    PubMed

    Douglas, James F; Craig, W J Colin

    2010-01-01

    The long-term survival of first successful renal transplants, along with overall patient survival, was studied retrospectively in 309 recipients at Belfast City Hospital between 1968 and 1986, of whom 155 had undergone prior bilateral nephrectomy (BN) and 154 had not (non-BN). The groups were comparable as regards mean age, gender, primary diagnoses, clinical status, pre-existing hypertension and pre-transplant dialysis and transfusion. There were 34 organs (BN 14, non-BN 20) from living related donors. Donor ages were comparable, as were histocompatibility findings. Recipients more than 60, with diabetic nephropathy, or with other co-morbidity were excluded. All recipients took azathioprine and low-dose steroid as maintenance antirejection, fewer than 3% switching to cyclosporine or other drugs during first graft survival. Mean BN graft survival was 15.9 years (95% CI 14.1-17.7) compared to 12.9 for non-BN (95% CI 11.3-14.5; p < 0.01). Mean BN patient survival was 19.4 years (95% CI 17.6-21.2) and non-BN was 14.9 years (95% CI 13.2-16.6; p < 0.01). Cumulative BN graft survival was 76.8% at 5 years, 61.6% at 10 years, and 37.4% at 20 years, compared to 67.1%, 53.5% and 27.0% for non-BN (p < 0.01). Overall BN patient survival was 84.5% at 5 years, 74.2% at 10 years and 51.6% at 20 years, with non-BN equivalents of 72.3%, 49.0% and 24.5%, respectively (p < 0.01). Long-term BN survivors also had less hypertension than non-BN (22.8% v 54.8% at 20 years; p < 0.05) which may be relevant to their better survival. Overall (BN plus non-BN) median graft (14.4 years) and patient (17.6 years) survival are testimony to the continuing long-term success of the low-dose steroid regime followed in Belfast from 1968 to 1986.

  20. 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.

  1. 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.

  2. Robotic Surgery for Thoracic Disease

    PubMed Central

    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. PMID:26822625

  3. 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.

  4. 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.

  5. 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…

  6. 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. PMID:24977234

  7. On terrain acquisition by a finite-sized mobile robot in plane

    SciTech Connect

    Rao, N.S.V.; Iyengar, S.S.; Jorgensen, C.C.; Weisbin, C.R.

    1987-01-01

    The terrain acquisition problem deals with the acquisition of the complete obstacle terrain model by a mobile robot placed in an unexplored terrain. This is a precursory problem to many well-known find-path and related problems which assume the availability of the complete terrain model. In this paper, we present a method for terrain acquisition by a finite sized robot operating in plane populated by an unknown (but, finite) number of polygonal obstacles; each obstacle is arbitrarily located and has unknown (but, finite) number of vertices. The robot progressively explores newer vertices of the obstacles using sensor equipment. We show that the complete terrain model will be built by the robot in a finite time. We also show that at any point of time the partially acquired terrain suffices for the navigation of the robot during the exploration. Hence we conclude that the navigation techniques for known terrains can be applied for the robot navigation during exploration.

  8. 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.

  9. 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.

  10. 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.

  11. Robotic systems in surgery.

    PubMed

    Bargar, W L; Carbone, E J

    1993-10-01

    Computer-driven robots and medical imaging technology may soon enable surgeons to plan and execute intricate procedures with unprecedented precision. Our experience in introducing a robotic system for use in an active role in cementless total hip replacement surgery has convinced us that the marriage of these two technologies-robotics and medical imaging-is likely to change the way many types of surgical procedures are performed. The ability to link an image-based preoperative plan with its surgical execution by a robot may be the key to improved outcomes. Research and development of robotic systems for a wide variety of medical applications is underway at a number of prestigious institutions. Grenoble University has developed the IGOR (Imaged Guided Operating Robot) system. This six-axis robot has performed more than 400 interventions, acting as a positioner for brain surgery in both biopsy and therapeutic procedures. AlephMed and Digital are currently assisting the developers in integrating image analysis into the system. Future development plans include an application for spinal surgery. PMID:25951597

  12. 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.

  13. 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.

  14. An Unusual Case of Metastatatic Renal Cell Carcinoma Presenting as Melena and Duodenal Ulcer, 16 Years After Nephrectomy; a Case Report and Review of the Literature

    PubMed Central

    Geramizadeh, Bita; Mostaghni, AmirAhmad; Ranjbar, Zeinab; Moradian, Farid; Heidari, Mina; Khosravi, Mohammad Bagher; Malekhosseini, Seyed Ali

    2015-01-01

    Renal cell carcinoma comprises about 2% of adult tumors. The overall 10-year survival rate of patients with RCC after nephrectomy is about 18-27%. The incidence of metastasis of initial RCC is about 24-28%, but this rate after nephrectomy is as high as 51%. The most common site of recurrence is the lung, however liver and bone metastases are common. There are many reported cases with late metastasis, however isolated late metastasis in the gastrointestinal tract especially duodenum is very rare. Herein we report our experience with a case of gastrointestinal bleeding secondary to metastatic renal cell carcinoma to duodenum, 16 years after nephrectomy. To the best of our knowledge, about 30 of such cases have been reported in the English literature. Many of the previous cases have been part of disseminated disease and isolated duodenal metastasis is very rare. The longest reported duration between nephrectomy for renal cell carcinoma and duodenal metastasis has been 13 years, thus it seems our case to be also unique because of very late duodenal metastasis. PMID:25821299

  15. 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

  16. 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.

  17. 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.

  18. Robotic liver resection technique.

    PubMed

    Hart, Marquis E; Precht, Andrew

    2013-01-01

    The robotic approach to hepatic resection has evolved because of advances in laparoscopy and digital technology and based on the modern understanding of hepatic anatomy. Robotic technology has allowed for the development of a minimally invasive approach, which is conceptually similar to the open approach. The major differences are improved visualization and smaller incisions without a haptic interface. As a result, the operative strategy is reliant on visual cues and knowledge of hepatic surgical anatomy. Development of a robotic liver resection program ideally occurs in the setting of a comprehensive liver program with significant experience in all aspects of surgical liver care.

  19. 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.

  20. 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.

  1. Walking Humanoid Robot Lola

    NASA Astrophysics Data System (ADS)

    Schwienbacher, Markus; Favot, Valerio; Buschmann, Thomas; Lohmeier, Sebastian; Ulbrich, Heinz

    Based on the experience gathered from the walking robot Johnnie the new performance enhanced 25-DoF humanoid robot Lola was built. The goal of this project is to realize a fast, human-like walking. This paper presents different aspects of this complex mechatronic system. Besides the overall lightweight construction, custom build multi-sensory joint drives with high torque brush-less motors were crucial for reaching the performance goal. A decentralized electronics architecture is used for joint control and sensor data processing. A simulation environment serves as a testbed for the walking control, to minimize the risk of damaging the robot hardware during real world experiments.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. Laser radar in robotics

    SciTech Connect

    Carmer, D.C.; Peterson, L.M.

    1996-02-01

    In this paper the authors describe the basic operating principles of laser radar sensors and the typical algorithms used to process laser radar imagery for robotic applications. The authors review 12 laser radar sensors to illustrate the variety of systems that have been applied to robotic applications wherein information extracted from the laser radar data is used to automatically control a mechanism or process. Next, they describe selected robotic applications in seven areas: autonomous vehicle navigation, walking machine foot placement, automated service vehicles, manufacturing and inspection, automotive, military, and agriculture. They conclude with a discussion of the status of laser radar technology and suggest trends seen in the application of laser radar sensors to robotics. Many new applications are expected as the maturity level progresses and system costs are reduced.

  7. 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)

  8. Robotic heart surgery.

    PubMed

    Zenati, M A

    2001-01-01

    Advances in computer and robotic technology are transforming cardiac surgery, overcoming the limitations of conventional endoscopic tools. Using minimal access through 5 millimeter ports, computer-enhanced instruments provide superhuman dexterity through tremor filtration and motion scaling, and are capable of precise manipulation in confined body cavities. Using these technologies, endoscopic beating heart coronary bypass surgery as well as complex mitral valve repairs have been performed in the last few years. However, the current world experience with robotic heart surgery is mostly anecdotal, retrospective, and noncontrolled. Results of rigorous prospective randomized studies in the United States under Food and Drug Administration approved protocols, are awaited. The use of robotic telemanipulation technology for heart surgery is restricted in the United States to patients enrolled in clinical studies in a few elite centers. Further refinement in robotic and image-guided technology for cardiac surgery may further expand the use of computer enhanced instrumentation in the near future.

  9. 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

  10. 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—...

  11. 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.

  12. 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. PMID:26643022

  13. 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.

  14. 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)

  15. 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.

  16. 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...

  17. Robotics and neuroscience.

    PubMed

    Floreano, Dario; Ijspeert, Auke Jan; Schaal, Stefan

    2014-09-22

    In the attempt to build adaptive and intelligent machines, roboticists have looked at neuroscience for more than half a century as a source of inspiration for perception and control. More recently, neuroscientists have resorted to robots for testing hypotheses and validating models of biological nervous systems. Here, we give an overview of the work at the intersection of robotics and neuroscience and highlight the most promising approaches and areas where interactions between the two fields have generated significant new insights. We articulate the work in three sections, invertebrate, vertebrate and primate neuroscience. We argue that robots generate valuable insight into the function of nervous systems, which is intimately linked to behaviour and embodiment, and that brain-inspired algorithms and devices give robots life-like capabilities.

  18. 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.

  19. 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

  20. Robot Grasps Rotating Object

    NASA Technical Reports Server (NTRS)

    Wilcox, Brian H.; Tso, Kam S.; Litwin, Todd E.; Hayati, Samad A.; Bon, Bruce B.

    1991-01-01

    Experimental robotic system semiautomatically grasps rotating object, stops rotation, and pulls object to rest in fixture. Based on combination of advanced techniques for sensing and control, constructed to test concepts for robotic recapture of spinning artificial satellites. Potential terrestrial applications for technology developed with help of system includes tracking and grasping of industrial parts on conveyor belts, tracking of vehicles and animals, and soft grasping of moving objects in general.

  1. 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.

  2. Robotic inguinal hernia repair.

    PubMed

    Escobar Dominguez, Jose E; Gonzalez, Anthony; Donkor, Charan

    2015-09-01

    Inguinal hernias have been described throughout the history of medicine with many efforts to achieve the cure. Currently, with the advantages of minimally invasive surgery, new questions arise: what is going to be the best approach for inguinal hernia repair? Is there a real benefit with the robotic approach? Should minimally invasive hernia surgery be the standard of care? In this report we address these questions by describing our experience with robotic inguinal hernia repair. PMID:26153353

  3. 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

  4. Robotic surgery in gynecology.

    PubMed

    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. Robotic assisted andrological surgery

    PubMed Central

    Parekattil, Sijo J; Gudeloglu, Ahmet

    2013-01-01

    The introduction of the operative microscope for andrological surgery in the 1970s provided enhanced magnification and accuracy, unparalleled to any previous visual loop or magnification techniques. This technology revolutionized techniques for microsurgery in andrology. Today, we may be on the verge of a second such revolution by the incorporation of robotic assisted platforms for microsurgery in andrology. Robotic assisted microsurgery is being utilized to a greater degree in andrology and a number of other microsurgical fields, such as ophthalmology, hand surgery, plastics and reconstructive surgery. The potential advantages of robotic assisted platforms include elimination of tremor, improved stability, surgeon ergonomics, scalability of motion, multi-input visual interphases with up to three simultaneous visual views, enhanced magnification, and the ability to manipulate three surgical instruments and cameras simultaneously. This review paper begins with the historical development of robotic microsurgery. It then provides an in-depth presentation of the technique and outcomes of common robotic microsurgical andrological procedures, such as vasectomy reversal, subinguinal varicocelectomy, targeted spermatic cord denervation (for chronic orchialgia) and robotic assisted microsurgical testicular sperm extraction (microTESE). PMID:23241637

  6. Robotic assisted andrological surgery.

    PubMed

    Parekattil, Sijo J; Gudeloglu, Ahmet

    2013-01-01

    The introduction of the operative microscope for andrological surgery in the 1970s provided enhanced magnification and accuracy, unparalleled to any previous visual loop or magnification techniques. This technology revolutionized techniques for microsurgery in andrology. Today, we may be on the verge of a second such revolution by the incorporation of robotic assisted platforms for microsurgery in andrology. Robotic assisted microsurgery is being utilized to a greater degree in andrology and a number of other microsurgical fields, such as ophthalmology, hand surgery, plastics and reconstructive surgery. The potential advantages of robotic assisted platforms include elimination of tremor, improved stability, surgeon ergonomics, scalability of motion, multi-input visual interphases with up to three simultaneous visual views, enhanced magnification, and the ability to manipulate three surgical instruments and cameras simultaneously. This review paper begins with the historical development of robotic microsurgery. It then provides an in-depth presentation of the technique and outcomes of common robotic microsurgical andrological procedures, such as vasectomy reversal, subinguinal varicocelectomy, targeted spermatic cord denervation (for chronic orchialgia) and robotic assisted microsurgical testicular sperm extraction (microTESE).

  7. 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.

  8. Robotic hand with modular extensions

    SciTech Connect

    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.

  9. Two-dimensional robot navigation among unknown stationary polygonal obstacles

    SciTech Connect

    Foux, G.; Heymann, M.; Bruckstein, A. . Dept. of Computer Science)

    1993-02-01

    The authors describe an algorithm for navigating a polygonal robot, capable of translational motion, in an unknown environment. The environment contains stationary polygonal obstacles and is bounded by polygonal walls, all of which are initially unknown to the robot. The environment is learned during the navigation process by use of a laser range-finding device, and new knowledge is integrated with previously acquired information. A partial map of the environment is thus obtained. The map contains parts of the obstacles that were seen by the robot and the free space between them. The obstacles in the map are transformed into a new set of expanded polygonal obstacles. This enables treating the robot as a point instead of a polygon, and the navigation problem is reduced to point navigation among unknown polygonal obstacles. A navigation graph is built from the transformed obstacles in the map. This is a partial visibility graph of the enlarged obstacles. A search is conducted on the graph for a path to the destination. The path is piecewise linear; at its corners, the robot stops, scans its environment, and updates the map, the obstacles, and the planned path. The algorithm is proved to converge to the desired destination in a finite number of steps provided a path to the destination exists. If such a path does not exist, then the navigation process terminates in a finite number of steps with the conclusion that the destination is unreachable.

  10. 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. ...

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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…

  16. Backstepping Control Augmented by Neural Networks For Robot Manipulators

    NASA Astrophysics Data System (ADS)

    Belkheiri, Mohammed; Boudjema, Farès

    2008-06-01

    A new control approach is proposed to address the tracking problem of robot manipulators. In this approach, one relies first on a partially known model to the system to be controlled using a backstepping control strategy. The obtained controller is then augmented by an online neural network that serves as an approximator for the neglected dynamics and modeling errors. The proposed approach is systematic, and exploits the known nonlinear dynamics to derive the stepwise virtual stabilizing control laws. At the final step, an augmented Lyapunov function is introduced to derive the adaptation laws of the network weights. The effectiveness of the proposed controller is demonstrated through computer simulation on PUMA 560 robot.

  17. 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,...

  18. 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.

  19. Robotic Tube-Gap Inspector

    NASA Technical Reports Server (NTRS)

    Gilbert, Jeffrey L.; Gutow, David A.; Maslakowski, John E.

    1993-01-01

    Robotic vision system measures small gaps between nearly parallel tubes. Robot-held video camera examines closely spaced tubes while computer determines gaps between tubes. Video monitor simultaneously displays data on gaps.

  20. 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)

  1. 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...

  2. Robots and Kids: Classroom Encounters.

    ERIC Educational Resources Information Center

    Slesnick, Twila

    1984-01-01

    Describes how three different levels of students interacted with three different commercially available robots. Considers the educational value of these devices and provides a list of seven robots (indicating their source, computer compatibility, language, current cost, capabilities, and options). (JN)

  3. 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

  4. 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. PMID:25197187

  5. 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.

  6. 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).

  7. 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.

  8. 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.

  9. Modular robotic architecture

    NASA Astrophysics Data System (ADS)

    Smurlo, Richard P.; Laird, Robin T.

    1991-03-01

    The development of control architectures for mobile systems is typically a task undertaken with each new application. These architectures address different operational needs and tend to be difficult to adapt to more than the problem at hand. The development of a flexible and extendible control system with evolutionary growth potential for use on mobile robots will help alleviate these problems and if made widely available will promote standardization and cornpatibility among systems throughout the industry. The Modular Robotic Architecture (MRA) is a generic control systern that meets the above needs by providing developers with a standard set of software hardware tools that can be used to design modular robots (MODBOTs) with nearly unlimited growth potential. The MODBOT itself is a generic creature that must be customized by the developer for a particular application. The MRA facilitates customization of the MODBOT by providing sensor actuator and processing modules that can be configured in almost any manner as demanded by the application. The Mobile Security Robot (MOSER) is an instance of a MODBOT that is being developed using the MRA. Navigational Sonar Module RF Link Control Station Module hR Link Detection Module Near hR Proximi Sensor Module Fluxgate Compass and Rate Gyro Collision Avoidance Sonar Module Figure 1. Remote platform module configuration of the Mobile Security Robot (MOSER). Acoustical Detection Array Stereoscopic Pan and Tilt Module High Level Processing Module Mobile Base 566

  10. Robotic Microsurgery Optimization

    PubMed Central

    Brahmbhatt, Jamin V; Gudeloglu, Ahmet; Liverneaux, Philippe

    2014-01-01

    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. PMID:24883272

  11. 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.

  12. Controlling multiple groups of robots

    NASA Astrophysics Data System (ADS)

    Hor, MawKae

    1992-11-01

    Coordinating multiple robots has attracted researchers' interests for many years. However, most of the problems being studied deal with multiple robots acted only within a single group. Coordinated robots are categorized into different groups when the coordination involves robots interchange or heterogeneous motion during the manipulation process. In such a case, coordination between robot groups has to be considered. This is required in certain types of coordinated manipulations such as passing an object, held by multiple robots, between groups of robots or rotating or rolling an object, held by multiple robots, continuously. In the former task, coordinations are made between two isotropic groups of robots whereas in the latter task, coordinations are made between non-isotropic groups of robots. This paper investigates problems related to the control and coordinating of multiple groups of robots. We analyze various kind of tasks of these types and propose a hierarchical control mechanism in achieving these coordinations. Scenarios and limitations for these tasks are presented and discussed. A hybrid force and position control principle is employed in both global and local planning and control. A hierarchical architecture is used to control different levels of the control and planning primitives. The primitives developed for controlling individual robot group can be adopted in this architecture. The primitives in one level offer services only to those in its neighboring levels and hides them from the details of actual service implementations hence reducing the system designing complexity.

  13. Robot teachers: The very idea!

    PubMed

    Sharkey, Amanda

    2015-01-01

    Insufficient attention has been paid to the use of robots in classrooms. Robot "teachers" are being developed, but because Kline ignores such technological developments, it is not clear how they would fit within her framework. It is argued here that robots are not capable of teaching in any meaningful sense, and should be deployed only as educational tools.

  14. 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.

  15. 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.

  16. Robotics: Applications and social implications

    SciTech Connect

    Ayres, R.U.; Miller, S.M.

    1983-01-01

    Robots are expected to dramatically alter the U.S. economy in the 1980s. In this assessment of their effects on everyday life, the authors examine the scope of the robotics revolution and provide recommendations for a smooth introduction of robots into American industry.

  17. KC-135 materials handling robotics

    NASA Astrophysics Data System (ADS)

    Workman, Gary L.

    1991-04-01

    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.

  18. 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)

  19. 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. PMID:21917107

  20. 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)

  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. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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. PMID:27628774

  7. 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.

  8. RX130 Robot Calibration

    NASA Astrophysics Data System (ADS)

    Fugal, Mario

    2012-10-01

    In order to create precision magnets for an experiment at Oak Ridge National Laboratory, a new reverse engineering method has been proposed that uses the magnetic scalar potential to solve for the currents necessary to produce the desired field. To make the magnet it is proposed to use a copper coated G10 form, upon which a drill, mounted on a robotic arm, will carve wires. The accuracy required in the manufacturing of the wires exceeds nominal robot capabilities. However, due to the rigidity as well as the precision servo motor and harmonic gear drivers, there are robots capable of meeting this requirement with proper calibration. Improving the accuracy of an RX130 to be within 35 microns (the accuracy necessary of the wires) is the goal of this project. Using feedback from a displacement sensor, or camera and inverse kinematics it is possible to achieve this accuracy.

  9. 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.

  10. 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.

  11. Robotically assisted ultrasound interventions

    NASA Astrophysics Data System (ADS)

    Ding, Jienan; Swerdlow, Dan; Wang, Shuxin; Wilson, Emmanuel; Tang, Jonathan; Cleary, Kevin

    2008-03-01

    The goal of this project is to develop a robotic system to assist the physician in minimally invasive ultrasound interventions. In current practice, the physician must manually hold the ultrasound probe in one hand and manipulate the needle with the other hand, which can be challenging, particularly when trying to target small lesions. To assist the physician, the robot should not only be capable of providing the spatial movement needed, but also be able to control the contact force between the ultrasound probe and patient. To meet these requirements, we are developing a prototype system based on a six degree of freedom parallel robot. The system will provide high bandwidth, precision motion, and force control. In this paper we report on our progress to date, including the development of a PC-based control system and the results of our initial experiments.

  12. 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.

  13. 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

  14. Technical vision for robots

    NASA Astrophysics Data System (ADS)

    1985-01-01

    A new invention by scientists who have copied the structure of a human eye will help replace a human telescope-watching astronomer with a robot. It will be possible to provide technical vision not only for robot astronomers but also for their industrial fellow robots. So far, an artificial eye with dimensions close to those of a human eye discerns only black-and-white images. But already the second model of the eye is to perceive colors as well. Polymers which are suited for the role of the coat of an eye, lens, and vitreous body were applied. The retina has been replaced with a bundle of the finest glass filaments through which light rays get onto photomultipliers. They can be positioned outside the artificial eye. The main thing is to prevent great losses in the light guide.

  15. 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…

  16. Segway robotic mobility platform

    NASA Astrophysics Data System (ADS)

    Nguyen, Hoa G.; Morrell, John; Mullens, Katherine D.; Burmeister, Aaron B.; Miles, Susan; Farrington, Nathan; Thomas, Kari M.; Gage, Douglas W.

    2004-12-01

    The Segway Robotic Mobility Platform (RMP) is a new mobile robotic platform based on the self-balancing Segway Human Transporter (HT). The Segway RMP is faster, cheaper, and more agile than existing comparable platforms. It is also rugged, has a small footprint, a zero turning radius, and yet can carry a greater payload. The new geometry of the platform presents researchers with an opportunity to examine novel topics, including people-height sensing and actuation modalities. This paper describes the history and development of the platform, its characteristics, and a summary of current research projects involving the platform at various institutions across the United States.

  17. Microwave vision for robots

    NASA Technical Reports Server (NTRS)

    Lewandowski, Leon; Struckman, Keith

    1994-01-01

    Microwave Vision (MV), a concept originally developed in 1985, could play a significant role in the solution to robotic vision problems. Originally our Microwave Vision concept was based on a pattern matching approach employing computer based stored replica correlation processing. Artificial Neural Network (ANN) processor technology offers an attractive alternative to the correlation processing approach, namely the ability to learn and to adapt to changing environments. This paper describes the Microwave Vision concept, some initial ANN-MV experiments, and the design of an ANN-MV system that has led to a second patent disclosure in the robotic vision field.

  18. Robotics and ergonomics.

    PubMed

    Stylopoulos, Nicholas; Rattner, David

    2003-12-01

    Industrial robotics have proven the benefit of using an untiring machine to perform precise repetitive tasks in uncomfortable or dangerous for humans environments. Highly skilled surgeons are trained to operate and adapt to difficult conditions. They are even capable of developing intelligent mechanisms to exploit a variety of tactile, visual, and other cues. The robotic systems, however, can enhance the surgeon's capability to perform a wide variety of tasks. They cannot replace the surgeon's problem-solving ability. Instead, they will redefine his role. They will significantly enhance the surgeon's skills and dexterity by providing their complementary capabilities and an ergonomically efficient and more user-friendly working environment.

  19. Robotic component preparation

    SciTech Connect

    Dokos, J.R.

    1986-04-01

    This report provides information on the preparation of robotic components. Component preparation includes pretinning or solder dipping, preforming, and pretrimming of component leads. Since about 70% of all components are axial-leaded resistor-type components, it was decided to begin with them and then later develop capabilities to handle other types. The first workcell is the first phase of an overall system to pretin, preform, and pretrim all components and to feed them to an automatic insertion system. Before use of the robot, a Unimation PUMA Modal 260, pretinning and preforming was done by first hand with a shield and vented booth.

  20. Robotic Planetary Drill Tests

    NASA Technical Reports Server (NTRS)

    Glass, Brian J.; Thompson, S.; Paulsen, G.

    2010-01-01

    Several proposed or planned planetary science missions to Mars and other Solar System bodies over the next decade require subsurface access by drilling. This paper discusses the problems of remote robotic drilling, an automation and control architecture based loosely on observed human behaviors in drilling on Earth, and an overview of robotic drilling field test results using this architecture since 2005. Both rotary-drag and rotary-percussive drills are targeted. A hybrid diagnostic approach incorporates heuristics, model-based reasoning and vibration monitoring with neural nets. Ongoing work leads to flight-ready drilling software.

  1. 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. PMID:24268746

  2. 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.

  3. Coordination of multiple robot arms

    NASA Technical Reports Server (NTRS)

    Barker, L. K.; Soloway, D.

    1987-01-01

    Kinematic resolved-rate control from one robot arm is extended to the coordinated control of multiple robot arms in the movement of an object. The structure supports the general movement of one axis system (moving reference frame) with respect to another axis system (control reference frame) by one or more robot arms. The grippers of the robot arms do not have to be parallel or at any pre-disposed positions on the object. For multiarm control, the operator chooses the same moving and control reference frames for each of the robot arms. Consequently, each arm then moves as though it were carrying out the commanded motions by itself.

  4. SDIO robotics in space applications

    NASA Technical Reports Server (NTRS)

    Iliff, Richard

    1990-01-01

    Robotics in space supporting the Strategic Defense System (SDS) program is discussed. Ongoing initiatives which are intended to establish an initial Robotics in Space capability are addressed. This is specifically being referred to as the Satellite Servicing System (SSS). This system is based on the NASA Orbital Maneuvering Vehicle (OMV) with a Robotic Manipulator(s) based on the NASA Flight Telerobotic Servicer (FTS) and other SSS equipment required to do the satellite servicing work attached to the OMV. Specific Robotics in Space Requirements which have resulted from the completion of the Robotics Requirements Study Contract are addressed.

  5. 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.

  6. Open Issues in Evolutionary Robotics.

    PubMed

    Silva, Fernando; Duarte, Miguel; Correia, Luís; Oliveira, Sancho Moura; Christensen, Anders Lyhne

    2016-01-01

    One of the long-term goals in evolutionary robotics is to be able to automatically synthesize controllers for real autonomous robots based only on a task specification. While a number of studies have shown the applicability of evolutionary robotics techniques for the synthesis of behavioral control, researchers have consistently been faced with a number of issues preventing the widespread adoption of evolutionary robotics for engineering purposes. In this article, we review and discuss the open issues in evolutionary robotics. First, we analyze the benefits and challenges of simulation-based evolution and subsequent deployment of controllers versus evolution on real robotic hardware. Second, we discuss specific evolutionary computation issues that have plagued evolutionary robotics: (1) the bootstrap problem, (2) deception, and (3) the role of genomic encoding and genotype-phenotype mapping in the evolution of controllers for complex tasks. Finally, we address the absence of standard research practices in the field. We also discuss promising avenues of research. Our underlying motivation is the reduction of the current gap between evolutionary robotics and mainstream robotics, and the establishment of evolutionary robotics as a canonical approach for the engineering of autonomous robots.

  7. Hiding robot inertia using resonance.

    PubMed

    Vallery, Heike; Duschau-Wicke, Alexander; Riener, Robert

    2010-01-01

    To enable compliant training modes with a rehabilitation robot, an important prerequisite is that any undesired human-robot interaction forces caused by robot dynamics must be avoided, either by an appropriate mechanical design or by compensating control strategies. Our recently proposed control scheme of "Generalized Elasticities" employs potential fields to compensate for robot dynamics, including inertia, beyond what can be done using closed-loop force control. In this paper, we give a simple mechanical equivalent using the example of the gait rehabilitation robot Lokomat. The robot consists of an exoskeleton that is attached to a frame around the patient's pelvis. This frame is suspended by a springloaded parallelogram structure. The mechanism allows vertical displacement while providing almost constant robot gravity compensation. However, inertia of the device when the patient's pelvis moves up and down remains a source of large interaction forces, which are reflected in increased ground reaction forces. Here, we investigate an alternative suspension: To hide not only gravity, but also robot inertia during vertical pelvis motion, we suspend the robot frame by a stiff linear spring that allows the robot to oscillate vertically at an eigenfrequency close to the natural gait frequency. This mechanism reduces human-robot interaction forces, which is demonstrated in pilot experimental results. PMID:21095916

  8. Hiding robot inertia using resonance.

    PubMed

    Vallery, Heike; Duschau-Wicke, Alexander; Riener, Robert

    2010-01-01

    To enable compliant training modes with a rehabilitation robot, an important prerequisite is that any undesired human-robot interaction forces caused by robot dynamics must be avoided, either by an appropriate mechanical design or by compensating control strategies. Our recently proposed control scheme of "Generalized Elasticities" employs potential fields to compensate for robot dynamics, including inertia, beyond what can be done using closed-loop force control. In this paper, we give a simple mechanical equivalent using the example of the gait rehabilitation robot Lokomat. The robot consists of an exoskeleton that is attached to a frame around the patient's pelvis. This frame is suspended by a springloaded parallelogram structure. The mechanism allows vertical displacement while providing almost constant robot gravity compensation. However, inertia of the device when the patient's pelvis moves up and down remains a source of large interaction forces, which are reflected in increased ground reaction forces. Here, we investigate an alternative suspension: To hide not only gravity, but also robot inertia during vertical pelvis motion, we suspend the robot frame by a stiff linear spring that allows the robot to oscillate vertically at an eigenfrequency close to the natural gait frequency. This mechanism reduces human-robot interaction forces, which is demonstrated in pilot experimental results.

  9. [Robotic surgery in gynecology].

    PubMed

    Hibner, Michał; Marianowski, Piotr; Szymusik, Iwona; Wielgós, Mirosław

    2012-12-01

    Introduction of robotic surgery in the first decade of the 21 century was one of the biggest breakthroughs in surgery since the introduction of anesthesia. For the first time in history the surgeon was placed remotely from the patient and was able to operate with the device that has more degrees of freedom than human hand. Initially developed for the US Military in order to allow surgeons to be removed from the battlefield, surgical robots quickly made a leap to the mainstream medicine. One of the first surgical uses for the robot was cardiac surgery but it is urology and prostate surgery that gave it a widespread popularity Gynecologic surgeons caught on very quickly and it is estimated that 31% of hysterectomies done in the United States in 2012 will be done robotically. With over half a million hysterectomies done each year in the US alone, gynecologic surgery is one of the main driving forces behind the growth of robotic surgery Other applications in gynecology include myomectomy oophorectomy and ovarian cystectomy resection of endometriosis and lymphadenectomy Advantages of the surgical robot are clearly seen in myomectomy The wrist motion allows for better more precise suturing than conventional "straight stick" laparoscopy The strength of the arms allow for better pulling of the suture and the third arm for holding the suture on tension. Other advantage of the robot is scaling of the movements when big movement on the outside translates to very fine movement on the inside. This enables much more precise surgery and may be important in the procedures like tubal anastomosis and implantation of the ureter Three-dimensional vision provides excellent depth of field perception. It is important for surgeons who are switching from open surgeries and preliminary evidence shows that it may allow for better identification of lesions like endometriosis. Another big advantage of robotics is that the surgeon sits comfortably with his/her arms and head supported. This

  10. Bladder sparing robot-assisted laparoscopic en bloc resection of urachus and umbilicus for urachal adenocarcinoma.

    PubMed

    Aoun, Fouad; Peltier, Alexandre; van Velthoven, Roland

    2015-06-01

    Urachal adenocarcinoma is a rare and aggressive form of bladder cancer that arises from the urachus. An en bloc resection of the urachus and umbilicus is recommended with either a total or partial cystectomy. However, there is no standard laparoscopic or robotic surgical technique for the operative management of these tumors. In the present report, we describe our robotic-assisted laparoscopic technique for the treatment of a primary malignant urachal tumor. PMID:26531120

  11. Fruit harvesting robots in Japan.

    PubMed

    Kondo, N; Monta, M; Fujiura, T

    1996-01-01

    We have developed harvesting robots for tomato, petty-tomato, cucumber and grape in Japan. These robots mainly consist of manipulators, end-effectors, visual sensors and traveling devices. These mechanisms of the robot components were developed based on the physical properties of the work objects. The robots must work automatically by themselves in greenhouses or fields, since we are considering for one operator to tend several robots in the production system. The system is modeled after Japanese agriculture which is commonly seen to produce many kinds of crops in greenhouses and in many small fields intensively. Bioproduction in space is somewhat similar to the agricultural system in Japan, because few operators have to work in a small space. Employing robots for bioproduction in space is considered desirable in near future. The following is a description of the harvesting robots.

  12. Fruit harvesting robots in Japan

    NASA Astrophysics Data System (ADS)

    Kondo, N.; Monta, M.; Fujiura, T.

    We have developed harvesting robots for tomato /1/, petty-tomato, cucumber /2/ and grape /3/ in Japan. These robots mainly consist of manipulators, end-effectors, visual sensors and traveling devices. These mechanisms of the robot components were developed based on the physical properties of the work objects. The robots must work automatically by themselves in greenhouses or fields, since we are considering for one operator to tend several robots in the production system. The system is modeled after Japanese agriculture which is commonly seen to produce many kinds of crops in greenhouses and in many small fields intensively. Bioproduction in space is somewhat similar to the agricultural system in Japan, because few operators have to work in a small space. Employing robots for bioproduction in space is considered desirable in near future. The following is a description of the harvesting robots.

  13. Intelligent Robots for Factory Automation

    NASA Astrophysics Data System (ADS)

    Hall, E. L.; Oh, S. J.

    1985-04-01

    Industrial robots are now proven technology in a variety of applications including welding, materials handling, spray painting, machine loading and assembly. However, to fully realize the potential of these universal manipulators , "intelligence" needs to be added to the industrial robot. This involves adding sensory capability and machine intelligence to the controls. The "intelligence" may be added externally or as integral components of the robot. These new "intelligent robots" promise to greatly enhance the versatility of the robot for factory applications. The purpose of this paper is to present a brief review of the techniques and applications of intelligent robots for factory automation and to suggest possible designs for the intelligent robot of the future.

  14. Touch Sensor for Robots

    NASA Technical Reports Server (NTRS)

    Primus, H. C.

    1986-01-01

    Touch sensor for robot hands provides information about shape of grasped object and force exerted by gripper on object. Pins projecting from sensor create electrical signals when pressed. When grasped object depresses pin, it contacts electrode under it, connecting electrode to common electrode. Sensor indicates where, and how firmly, gripper has touched object.

  15. Robot Serviced Space Facility

    NASA Technical Reports Server (NTRS)

    Purves, Lloyd R. (Inventor)

    1992-01-01

    A robot serviced space facility includes multiple modules which are identical in physical structure, but selectively differing in function. and purpose. Each module includes multiple like attachment points which are identically placed on each module so as to permit interconnection with immediately adjacent modules. Connection is made through like outwardly extending flange assemblies having identical male and female configurations for interconnecting to and locking to a complementary side of another flange. Multiple rows of interconnected modules permit force, fluid, data and power transfer to be accomplished by redundant circuit paths. Redundant modules of critical subsystems are included. Redundancy of modules and of interconnections results in a space complex with any module being removable upon demand, either for module replacement or facility reconfiguration. without eliminating any vital functions of the complex. Module replacement and facility assembly or reconfiguration are accomplished by a computer controlled articulated walker type robotic manipulator arm assembly having two identical end-effectors in the form of male configurations which are identical to those on module flanges and which interconnect to female configurations on other flanges. The robotic arm assembly moves along a connected set or modules by successively disconnecting, moving and reconnecting alternate ends of itself to a succession of flanges in a walking type maneuver. To transport a module, the robot keeps the transported module attached to one of its end-effectors and uses another flange male configuration of the attached module as a substitute end-effector during walking.

  16. An Inexpensive Robotics Laboratory.

    ERIC Educational Resources Information Center

    Inigo, R. M.; Angulo, J. M.

    1985-01-01

    Describes the design and implementation of a simple robot manipulator. The manipulator has three degrees of freedom and is controlled by a general purpose microcomputer. The basis for the manipulator (which costs under $100) is a simple working model of a crane. (Author/JN)

  17. Savannah River Site Robotics

    ScienceCinema

    None

    2016-07-12

    Meet Sandmantis and Frankie, two advanced robotic devices that are key to cleanup at Savannah River Site. Sandmantis cleans hard, residual waste off huge underground storage tanks. Frankie is equipped with unique satellite capabilities and sensing abilties that can determine what chemicals still reside in the tanks in a cost effective manner.

  18. Brain controlled robots

    PubMed Central

    Kawato, Mitsuo

    2008-01-01

    In January 2008, Duke University and the Japan Science and Technology Agency (JST) publicized their successful control of a brain-machine interface for a humanoid robot by a monkey brain across the Pacific Ocean. The activities of a few hundred neurons were recorded from a monkey’s motor cortex in Miguel Nicolelis’s lab at Duke University, and the kinematic features of monkey locomotion on a treadmill were decoded from neural firing rates in real time. The decoded information was sent to a humanoid robot, CB-i, in ATR Computational Neuroscience Laboratories located in Kyoto, Japan. This robot was developed by the JST International Collaborative Research Project (ICORP) as the “Computational Brain Project.” CB-i’s locomotion-like movement was video-recorded and projected on a screen in front of the monkey. Although the bidirectional communication used a conventional Internet connection, its delay was suppressed below one over several seconds, partly due to a video-streaming technique, and this encouraged the monkey’s voluntary locomotion and influenced its brain activity. This commentary introduces the background and future directions of the brain-controlled robot. PMID:19404467

  19. Industrial robot's vision systems

    NASA Astrophysics Data System (ADS)

    Iureva, Radda A.; Raskin, Evgeni O.; Komarov, Igor I.; Maltseva, Nadezhda K.; Fedosovsky, Michael E.

    2016-03-01

    Due to the improved economic situation in the high technology sectors, work on the creation of industrial robots and special mobile robotic systems are resumed. Despite this, the robotic control systems mostly remained unchanged. Hence one can see all advantages and disadvantages of these systems. This is due to lack of funds, which could greatly facilitate the work of the operator, and in some cases, completely replace it. The paper is concerned with the complex machine vision of robotic system for monitoring of underground pipelines, which collects and analyzes up to 90% of the necessary information. Vision Systems are used to identify obstacles to the process of movement on a trajectory to determine their origin, dimensions and character. The object is illuminated in a structured light, TV camera records projected structure. Distortions of the structure uniquely determine the shape of the object in view of the camera. The reference illumination is synchronized with the camera. The main parameters of the system are the basic distance between the generator and the lights and the camera parallax angle (the angle between the optical axes of the projection unit and camera).

  20. Space robot simulator vehicle

    NASA Technical Reports Server (NTRS)

    Cannon, R. H., Jr.; Alexander, H.

    1985-01-01

    A Space Robot Simulator Vehicle (SRSV) was constructed to model a free-flying robot capable of doing construction, manipulation and repair work in space. The SRSV is intended as a test bed for development of dynamic and static control methods for space robots. The vehicle is built around a two-foot-diameter air-cushion vehicle that carries batteries, power supplies, gas tanks, computer, reaction jets and radio equipment. It is fitted with one or two two-link manipulators, which may be of many possible designs, including flexible-link versions. Both the vehicle body and its first arm are nearly complete. Inverse dynamic control of the robot's manipulator has been successfully simulated using equations generated by the dynamic simulation package SDEXACT. In this mode, the position of the manipulator tip is controlled not by fixing the vehicle base through thruster operation, but by controlling the manipulator joint torques to achieve the desired tip motion, while allowing for the free motion of the vehicle base. One of the primary goals is to minimize use of the thrusters in favor of intelligent control of the manipulator. Ways to reduce the computational burden of control are described.