Minim Invasive Ther Allied Technol
April 2022
Commercially available laparoscopic instruments are not designed for female surgeons. We redesigned the endoscopic flexible head purse-string suture instrument for improved use by female surgeons. The weight, total length, and diameter of the swing head handle and clump handle were reduced (786 to 565 g, 715 to 700 mm, 70 to 50 mm, and 30 to 25 mm, respectively).
View Article and Find Full Text PDFPurpose: 3D images offer true depth perception, which overcomes one of the disadvantages of laparoscopic surgery. We evaluated differences in the use of 3D and 2D images in laparoscopic surgery based on the recording of traces of forceps.
Methods: Twelve surgeons at our hospital participated in the study.
In laparoscopic and thoracoscopic surgery for malignant tumors, it is often necessary to recognize intraoperative rapid diagnosis by sampling a small section of tissue that is suspected of the lymphatic or disseminated metastasis of malignant tumor cells, or of the direct invasion. However, sampling of the target tissue has to be carried out without dropping a section into the peritoneal or thoracic cavity and port-site tumor recurrence. We developed a device named the "lymph node carrier (LNC)" that is capable of instantaneously carrying a small piece of tissue out of the body after its insertion into the trocar for conventional laparoscopic surgery.
View Article and Find Full Text PDFWe know that experienced endoscopic surgeons, despite having extensive training, may make a rare but fatal mistake. Prof. Takeshi Ohdaira developed a device visualizing brain action potential to reflect the latent psychological instability of the surgeon.
View Article and Find Full Text PDFAims: To investigate the utility of ozone nanobubble water (NBW3) for the treatment of Helicobacter pylori in the stomach, we tested the influence of pepsin concentrations and pH levels on the disinfective activity of NBW3, and the cytotoxicity of NBW3 against mammalian cells and mucosa.
Methods: Different concentrations of pepsin were dissolved in NBW3, and the bactericidal activity was tested on H. pylori.
Background: Current robotic systems have limitations for single-port surgery (SPS) because the instruments are large, the arms collide and the field of vision requires manual readjustment. We have developed an SPS robotic system that manipulates the vision field.
Methods: The master-slave system included a six degrees of freedom (DOFs) tool manipulator, an easy set-up mechanism, a flexible shaft drive with sufficient DOFs and a vertical arrangement for improved vision.
Minim Invasive Ther Allied Technol
June 2014
Background: Metacognition is the knowledge about one's own methods of perceiving, remembering, thinking, and acting. This study determined the significance of metacognitive skills in laparoscopic surgery with the aim of applying the findings in a laparoscopic surgery training program.
Material And Methods: Eighteen medical students with no experience in laparoscopic surgery (novice group) and eight expert surgeons who had each performed >100 laparoscopic surgeries (expert group) were enrolled.
Minim Invasive Ther Allied Technol
December 2013
Background: Endoscopic surgery is currently a standard procedure in many countries. Furthermore, conventional four-port laparoscopic cholecystectomy is developing into a single-port procedure. However, in many developing countries, disposable medical products are expensive and adequate medical waste disposable facilities are absent.
View Article and Find Full Text PDFRadiofrequency (RF) ablation is increasingly used to treat cancer because it is minimally invasive. However, it is difficult for operators to control precisely the formation of coagulation zones because of the inadequacies of imaging modalities. To overcome this limitation, we previously proposed a model-based robotic ablation system that can create the required size and shape of coagulation zone based on the dimensions of the tumor.
View Article and Find Full Text PDFMed Image Comput Comput Assist Interv
January 2013
We have developed a new generation device called rigid-flexible outer sheath with multi-piercing surgery (MPS) to solve the issues of tissue closure, triangulation, and platform stability in natural orifice transluminal endoscopic surgery (NOTES), and the problems of restricted visual field, organ damage, and removing a resected organ from body in needlescopic surgery (NS). The shape of the flexible outer sheath can be selectively locked by a novel pneumatic shapelocking mechanism. Major features include four directional flexion at the distal end, four working channels, and suction and water jet functions.
View Article and Find Full Text PDFMinim Invasive Ther Allied Technol
June 2013
Introduction: Transrectal natural orifice translumenal endoscopic surgery (NOTES) requires a good endoluminal view and adequate intrarectal bacterial clearance in the working area. We developed a new occlusion balloon unit with an easily detachable inflation device, which allows the surgeon a clear working area distal to the balloon.
Material And Methods: The effectiveness of the sealing balloon and the extent of macroscopic and histopathological injury to the bowel wall at the site of balloon placement were examined in 12 pigs.
Radiofrequency ablation is increasingly being used for liver cancer because it is a minimally invasive treatment method. However, it is difficult for the operators to precisely control the formation of coagulation zones because of the cooling effect of capillary vessels. To overcome this limitation, we have proposed a model-based robotic ablation system using a real-time numerical simulation to analyze temperature distributions in the target organ.
View Article and Find Full Text PDFAnnu Int Conf IEEE Eng Med Biol Soc
August 2012
Recently, robotics systems are focused to assist in Single Port Endoscopic Surgery (SPS). However, the existing system required a manual operation of vision and viewpoint, hindering the surgical task. We proposed a surgical endoscopic robot for SPS with dynamic vision control, the endoscopic view being manipulated by a master controller.
View Article and Find Full Text PDFPurpose: In endoscopic surgery, limited views and lack of tactile sensation restrict the surgeon's abilities and cause stress to the surgeon. Therefore, an intra-operative navigation system is strongly recommended. We developed an augmented reality (AR) navigation system based on preoperative CT imaging.
View Article and Find Full Text PDFMed Image Comput Comput Assist Interv
November 2011
Single port access (SPA) surgery is a laparoscopic procedure using only one transumbilical-placed port. Natural orifice transluminal endoscopic surgery (NOTES) offers the possibility of surgery without visible scars. To address the access and stability problems in SPA and NOTES, we developed a device called rigid-flexible outer sheath.
View Article and Find Full Text PDFBackground/purpose: We have invented multi-piercing surgery (MPS) which could potentially solve the triangular formation loss and device clashing which occur in single-port surgery (SPS), as well as restricted visual field, organ damage by needle-type instruments, and impaired removal of a resected organ from the body which occur in needlescopic surgery (NS). MPS is natural orifice translumenal endoscopic surgery (NOTES)-assisted NS. We used 3-mm diameter robots as needle-type instruments for MPS to examine the possibility of local immune cell therapy and regenerative therapy using stem cells for pancreatic cancer.
View Article and Find Full Text PDFWe developed a flexible port for NOTES which allows the use of conventional forceps for laparoscope-assisted surgery without change. The port is not affected by the location of the through hole in the gastrointestinal tract or vagina which elicits a problem in conventional NOTES, and its length can be adjusted during surgery by cutting the port itself. The port is made of polymer resin with a low friction coefficient.
View Article and Find Full Text PDFIn natural orifice transluminal endoscopic surgery (NOTES) using a single endoscope, the visual field moves unstably and a wide blind space is formed. We used wireless two wireless CCD cameras (270,000 and 380,000 pixels) placed on the abdominal wall of pigs and a conventional endoscope (410,000 pixels) at the same time to assess whether it was possible to observe the entire process of sigmoidectomy by NOTES. The titanium dioxide-coated lens was used as an antifogging apparatus.
View Article and Find Full Text PDFBackground: In natural orifice transluminal endoscopic surgery (NOTES), the endoscope has the disadvantages of an unstable visual field and wide blind space. We developed a compact charge-coupled device (CCD) camera unit that can be transgastrointestinally placed in the abdominal cavity.
Methods: The requisites for a wireless CCD camera unit for use in NOTES have been cited as: monitoring performance, fixation to the abdominal wall, attitude control, and antifogging functionality.
Background/purpose: We tried to determine whether the customization of an X-TRACT Tissue Morcellator could avoid the laceration-induced distension of surgical incisions/openings when transintestinally removing resected liver tissue from the body, when the greatest dimension of the tissue exceeded the dimension of the opening.
Methods: Pigs were used to examine changes in the caliber and shape of surgical incisions made with a conventional hook knife and insulation-tipped diathermic (IT) knife for electrodissection in endoscopy, and to examine changes in circular incision made with a customized X-TRACT Tissue Morcellator. The ENDO CATCH II device was used to remove tissue.
Surg Technol Int
January 2010
The objective of this study was to evaluate the efficiency of tumor detection in parenchymal organs and their resection by use of a micromagnetic needle detection system (MNDS). A micromagnetic needle (maximum magnetic flux density = 120 mT) and a micromagnetic needle-setting device were used. An in vitro laboratory study with a gumball within gelatin representing a tumor was conducted to calculate detection rates and to measure the time required for resection by MNDS.
View Article and Find Full Text PDFObjectives: Previous reports have indicated that small breast cancers without lymph node metastasis present a favorable prognosis. However, 10-20% of patients with T1 N0 invasive ductal carcinoma experience recurrence and have a poor prognosis. The objective of this study was to examine whether certain metastasis-related factors are prognostic of cancer recurrence in such patients at risk for relapse.
View Article and Find Full Text PDFIntraoperative Tumor site recognition is extremely difficult during laparoscopic surgical treatment of early-stage gastrointestinal carcinoma. A novel marking method that uses both metallic clips and a marking clip detector system (MCDS, Olympus Optical Co., Tokyo, Japan) modified from a metal detector system, was designed by the authors.
View Article and Find Full Text PDFBackground/purpose: Bile duct carcinoma still continues to have an unfavorable prognosis, despite an improved rate of curative resection and the development of surgical techniques. We evaluated the expression of matrix metalloproteinases (MMPs), tissue inhibitors of metalloproteinases (TIMPs), and intercellular adhesive factors (E-cadherin, alpha-catenin, beta-catenin) in cancer, dysplastic lesions, and normal (nonatypical) epithelia (glandulous ducts) in patients with bile duct carcinoma. Positivity rates for these factors were compared among the three histological types to examine the characteristics of bile duct dysplasia.
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