Objective: To evaluate and optimize the design of a removable and inexpensive internal stabilization device to reduce the effect of intention tremor during laryngeal microsurgery.
Study Design And Setting: In this laboratory investigation, stabilizers were designed and constructed to allow a nonobstructing view of the surgical field, permit simple insertion and removal, and accommodate microsurgical instruments. Prototype stabilizers were tested by using a Dedo laryngoscope, a measurement grid, and video recording equipment, which recorded instrument tremor within the magnified operative field for later analysis. Physicians also rated instrument stability, mobility, visualization, and ease of use on a survey form.
Results: Instrument tremor was reduced approximately 90%, with little obstruction of view of the surgical field. Instrument range of motion was reduced but improved rapidly as the stabilizer bar was moved further from the tip of the laryngoscope.
Conclusions: Use of a stabilization device in the laryngoscope lumen reduces instrument tremor and has the potential to improve surgical performance during laryngeal microsurgery.
Ebm Rating: B-3.
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http://dx.doi.org/10.1016/j.otohns.2004.10.012 | DOI Listing |
ISA Trans
January 2025
School of Electronics Engineering, Kyungpook National University, Daegu 41566, Republic of Korea. Electronic address:
Hand-held robotic instruments enhance precision in microsurgery by mitigating physiological tremor in real time. Current tremor filtering algorithms in these instruments often employ nonlinear phase prefilters to isolate the tremor signal. However, these filters introduce phase distortion in the filtered tremor, compromising accuracy.
View Article and Find Full Text PDFClin Neurol Neurosurg
December 2024
Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Objective: The Fahn-Tolosa-Marín Clinical Rating Scale for Tremor (CRST) includes three parts (tremor severity, motor task performance, functional disability) and a separate global assessment of impairment completed by both the patient and examiner. Although the CRST is used to determine tremor severity and the efficacy of treatments for tremor, the instrument may not sufficiently capture the patient's perspective. The objective of this study was to determine the association of the CRST subpart and total scores with the global assessment.
View Article and Find Full Text PDFJ Clin Med
November 2024
Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
: Hyperkinetic movement disorders involve excessive, involuntary movements such as ataxia, chorea, dystonia, myoclonus, tics, and tremor. Recent advances in artificial intelligence (AI) allow investigators to integrate multimodal instrumented movement measurements and imaging techniques and to analyze these data together at scale. In this systematic review, we aim to characterize AI's performance in diagnosing and quantitatively phenotyping these disorders.
View Article and Find Full Text PDFCureus
November 2024
Department of Surgery, Baghdad Teaching Hospital, Medical City Complex, Baghdad, IRQ.
Long surgical instruments, particularly in brain endoscopy, often compromise precision and control due to the physical distance between the surgeon's hand and the instrument's tip, increasing the likelihood of tremors. Various technological solutions, including robotics, have been proposed to address this issue. This report outlines the development of a pseudo-perception system aimed at improving control over long instruments in neurosurgical procedures by manipulating visual feedback to enhance the surgeon's sense of proximity to the instrument's tip.
View Article and Find Full Text PDFInt J Med Robot
December 2024
School of Mechanical Engineering, Tiangong University, Tianjin, China.
Background: In recent years, laparoscopic surgical robots have rapidly developed. However, most focus on the overall robotic systems, with few summaries on the laparoscopic surgical robots and the master manipulators.
Methods: This paper provides a summary and analysis of typical laparoscopic surgical robots, including the strengths and limitations of existing laparoscopic surgical robots.
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