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Purpose: We describe details and outcomes of a novel technique for optimizing the surgical field during robotic distal pancreatectomy (RDP) for distal pancreatic lesions, which has become common with potential advantages over laparoscopic surgery. Methods: For suprapancreatic lymph node dissection and splenic artery ligation, we used the basic center position with a scope through the midline port. During manipulation of the perisplenic area, the left position was used by moving the scope to the left medial side. The left lateral position is optionally used by moving the scope to the left lateral port when scope access to the perisplenic area is difficult. In addition, early splenic artery clipping and short gastric artery dissection for inflow block were performed to minimize bleeding around the spleen. We evaluated retrospectively the surgical outcomes of our method using a scoring system that allocated one point for blood inflow control and one point for optimizing the surgical view in the left position. Results: We analyzed 34 patients who underwent RDP or R-radical antegrade modular pancreatosplenectomy (RAMPS). The left position was applied in 14 patients, and the left lateral position was applied in 6. Based on the scoring system, only the 0-point group (n = 8) had four bleeding cases (50%) with splenic injury or blood pooling; the other 1-point or 2-point groups (n = 13, respectively) had no bleeding cases (p = 0.0046). Conclusion: Optimization of the surgical field using scope transition and inflow control ensured safe dissection during RDP. [ABSTRACT FROM AUTHOR]

Cerebellar strokes induce coordination disorders that can affect activities of daily living. Evidence-based neurorehabilitation programs are founded on motor learning principles. The cerebellum is a key neural structure in motor learning. It is unknown whether and how well chronic cerebellar stroke individuals (CCSIs) can learn to coordinate their upper limbs through bimanual motor skill learning. The aim was to determine whether CCSIs could achieve bimanual skill learning through a serious game with the REAplan® robot and to compare CCSIs with healthy individuals (HIs). Over three consecutive days, sixteen CCSIs and eighteen HIs were trained on an asymmetric bimanual coordination task ("CIRCUIT" game) with the REAplan® robot, allowing quantification of speed, accuracy and coordination. The primary outcomes were the bimanual speed/accuracy trade-off (BiSAT) and bimanual coordination factor (BiCo). They were also evaluated on a bimanual REACHING task on Days 1 and 3. Correlation analyses between the robotic outcomes and clinical scale scores were computed. Throughout the sessions, BiSAT and BiCo improved during the CIRCUIT task in both HIs and CCSIs. On Day 3, HIs and CCSIs showed generalization of BiSAT, BiCo and transferred to the REACHING task. There was no significant between-group difference in progression. Four CCSIs and two HIs were categorized as "poor learners" according to BiSAT and/or BiCo. Increasing age correlated with reduced BiSAT but not BiCo progression. Over three days of training, HIs and CCSIs improved, retained, generalized and transferred a coordinated bimanual skill. There was no between-group difference, suggesting plastic compensation in CCSIs. Clinical trial NCT04642599 approved the 24th of November 2020. [ABSTRACT FROM AUTHOR]

Science teachers have been urged to use emerging technologies, such as robots, in ways that empower K-12 students as active participants responsible for their learning and knowledge development within the scientific domain. And yet, little is known about whether the use of robots effectively supports students' epistemic agency in science learning. The purpose of this qualitative case study was to investigate to what extent elementary preservice teachers use educational robots in ways that promote epistemic agency in science lessons. Seven data sources were gathered for this study: individual reflections about lesson planning and lesson design, team reflection about teaching with robots, robotics-enhanced science lessons, posters, video-recorded presentations about designed lessons, and participant interview. A framework of epistemic practices for science inquiry was adopted to analyze the data followed by qualitative thematic analysis. Results indicate that the use of robots in science lessons promotes content assimilation rather than self-driven inquiry, robot movement rather than evidence drives science explanations, science activities with robots are situated in a social vacuum, and robot assembly and programming are underutilized in the lessons. Implications for preservice science teacher education and future research are discussed. [ABSTRACT FROM AUTHOR]

Background: Transversus abdominis release (TAR) is an effective technique for treating large midline and off-midline hernias. Recent studies have demonstrated that robotic TAR (rTAR) is technically feasible and associated with improved outcomes compared to open surgery. There is no published experience to date describing abdominal wall reconstruction using the novel robotic platform HUGO RAS System (Medtronic®). Methods: All consecutive patients who underwent a rTAR in our institution were included. Three of the four arm carts of the HUGO RAS System were used at any given time. Each arm configuration was defined by our team in conjunction with Medtronic® personnel. rTAR was performed as previously described. Upon completion of the TAR on one side, a redocking process with different, mirrored arms angles was performed to continue with the contralateral TAR. Operative variables and early morbidity were recorded. Results: Ten patients were included in this study. The median BMI was 31 (21–40.6) kg/m2. The median height was 1.6 m (1.5–1.89 m). A trend of decreased operative time, console time, and redocking time was seen in these consecutive cases. No intraoperative events nor postoperative morbidity was reported. The median length of stay was 3 (1–6) days. Conclusion: Robotic TAR utilizing the HUGO RAS system is a feasible and safe procedure. The adoption of this procedure on this novel platform for the treatment of complex abdominal wall hernias has been successful for our team. [ABSTRACT FROM AUTHOR]

During the last two decades, parallel robots have become more ubiquitous, employed in a great variety of sectors, from food to aerospace industries. In fact, they are much more efficient than their serial counterparts in terms of performing fast motions and consuming less energy. However, due to their mechanical complexity, they present a highly complex non-linear dynamics, which makes the modelling and control tasks difficult. Aiming to improve the performance and robustness of the control laws already used to control this type of mechanisms, previously, the authors proposed two novel laws of hybrid control, implemented in the joint space, in order to improve the dynamic behavior of parallel robots when performing fast motion tasks. Among the goals of the current work, one can mention to adapt the two laws of hybrid control, proposed in the previous work, by implementing them in the task space. Additionally, the peculiarities related to the dynamic formulation and the tuning of controller gains are also shown. Furthermore, a comparison of the performances of the pure and hybrid control techniques, implemented in both joint and task spaces, is presented as well, by executing the same paths and using adequate metrics. In the selected paths, experiments revealed that the hybridization process of pure control laws in the task space provides a significant reduction of the path-tracking and steady-state errors. [ABSTRACT FROM AUTHOR]

In spite of its intrinsic complexities, the passive gait of bipedal robots on a sloping ramp is a subject of interest for numerous researchers. What distinguishes the present research from similar works is the consideration of flexibility in the constituent links of this type of robotic systems. This is not a far-fetched assumption because in the transient (impact) phase, due to the impulsive forces which are applied to the system, the likelihood of exciting the vibration modes increases considerably. Moreover, the human leg bones that are involved in walking are supported by viscoelastic muscles and ligaments. Therefore, for achieving more exact results, it is essential to model the robot links with viscoelastic properties. To this end, the Gibbs-Appell formulation and Newton's kinematic impact law are used to derive the most general form of the system's dynamic equations in the swing and transient phases of motion. The most important issue in the passive walking motion of bipedal robots is the determination of the initial robot configuration with which the system could accomplish a periodic and stable gait solely under the effect of gravitational force. The extremely unstable nature of the system studied in this paper and the vibrations caused by the impulsive forces induced by the impact of robot feet with the inclined surface are some of the very serious challenges encountered for achieving the above-mentioned goal. To overcome such challenges, an innovative method that uses a combination of the linearized equations of motion in the swing phase and the algebraic motion equations in the transition phase is presented in this paper to obtain an eigenvalue problem. By solving this problem, the suitable initial conditions that are necessary for the passive gait of this bipedal robot on a sloping surface are determined. The effects of the characteristic parameters of elastic links including the modulus of elasticity and the Kelvin-Voigt coefficient on the walking stability of this type of robotic systems are also studied. The findings of this parametric study reveal that the increase in the Kelvin-Voigt coefficient enhances the stability of the robotic system, while the increase in the modulus of elasticity has an opposite effect. [ABSTRACT FROM AUTHOR]

Educational robotics has been adopted to create interactive and engaging learning environments to develop computational thinking (CT) in K-12 learners. This study systematically examined 22 peer-reviewed empirical research articles on the use of educational robotics to develop CT in young learners (pre-kindergarten to 6th grade) published between 2012 and 2021. The findings revealed that using robotics activities to develop CT has mostly been studied in the formal education settings with the duration of robotics curricular activities ranging from 80 minutes to 24 hours. The five CT skills studied most often include Sequencing, Conditionals, Loops, Debugging, and Algorithmic Thinking. The different versions of LEGO Mindstorms are the most frequently adopted robotic kits in the examined studies. The most frequently adopted learning and instructional strategies in the robotics activities include collaborative learning, project-based learning, and embodied learning. This paper identified and discussed developmentally appropriated CT skills, robotics kits, and pedagogical approaches suitable for supporting CT development in young learners. The findings can guide educators and instructional designers for future robotics activity design and development endeavors. This paper also identified gaps in the current research and recommended directions for advancing research in adopting robotics to develop CT in young learners. [ABSTRACT FROM AUTHOR]

Pelvic fixation is commonly used in correcting pelvic obliquity in pediatric patients with neuromuscular scoliosis and in preserving stability in adult patients with lumbosacral spondylolisthesis or instances of traumatic or osteoporotic fracture. S2-alar-iliac screws are commonly used in this role and have been proposed to reduce implant prominence when compared to traditional pelvic fusion utilizing iliac screws. The aim of this technical note is to describe a technique for robotically navigated placement of S2-alar-iliac screws in pediatric patients with neuromuscular scoliosis, which (a) minimizes the significant exposure needed to identify a bony start point, (b) aids in instrumenting the irregular anatomy often found in patients with neuromuscular scoliosis, and (c) allows for greater precision than traditional open or fluoroscopic techniques. We present five cases that underwent posterior spinal fusion to the pelvis with this technique that demonstrate the safety and efficacy of this procedure. [ABSTRACT FROM AUTHOR]

Background: Robotic technology is an important tool in surgical innovation, with robots increasingly being used in the clinical setting. Robots can be used to enhance accuracy, perform remote actions, or to automate tasks. One such surgical task is suturing, a repetitive, fundamental component of surgery that can be tedious and time consuming. Suturing is a promising automation target because of its ubiquity, repetitive nature, and defined constraints. This systematic review examines research to date on autonomous suturing. Methods: A systematic review of the literature focused on autonomous suturing was conducted in accordance with PRISMA guidelines. Results: 6850 articles were identified by searching PubMed, Embase, Compendex, and Inspec. Duplicates and non-English articles were removed. 4389 articles were screened and 4305 were excluded. Of the 84 remaining, 43 articles did not meet criteria, leaving 41 articles for final review. Among these, 34 (81%) were published after 2014. 31 (76%) were published in an engineering journal9 in a robotics journal, and 1 in a medical journal. The great majority of articles (33, 80%) did not have a specific clinical specialty focus, whereas 6 (15%) were focused on applications in MIS/laparoscopic surgery and 2 (5%) on applications in ophthalmology. Several suturing subtasks were identified, including knot tying, suture passing/needle insertion, needle passing, needle and suture grasping, needle tracking/kinesthesia, suture thread detection, suture needle shape production, instrument assignment, and suture accuracy. 14 articles were considered multi-component because they referred to several previously mentioned subtasks. Conclusion: In this systematic review exploring research to date on autonomous suturing, 41 articles demonstrated significant progress in robotic suturing. This summary revealed significant heterogeneity of work, with authors focused on different aspects of suturing and a multitude of engineering problems. The review demonstrates increasing academic and commercial interest in surgical automation, with significant technological advances toward feasibility. [ABSTRACT FROM AUTHOR]

Background: The increasing use of robotic systems for anti-reflux operations prompted this study to evaluate and compare the efficacy of robotic and Laparo-Endoscopic Single-Site (LESS) approaches. Methods: From 2012, 228 robotic fundoplication and 518 LESS fundoplication patients were prospectively followed, analyzing perioperative metrics. Data are presented as median (mean ± SD); significance at p ≤ 0.05. Results: Patients undergoing a robotic vs. LESS fundoplication were 67 (64 ± 13.7) vs. 61 (59 ± 15.1) years-old with BMIs of 25 (25 ± 3.2) vs. 26 (25 ± 3.9) kg/m2 (p = 0.001 and 1.00, respectively). 72% of patients who underwent the robotic approach had a previous abdominal operation(s) vs 44% who underwent the LESS approach (p = 0.0001). 38% vs. 8% had a re-operative fundoplication (p = 0.0001), 59% vs. 45% had a type IV hiatal hernia (p = 0.0004). Operative duration was 160 (176 ± 76.7) vs. 130 (135 ± 50.5) min (p = 0.0001). There were 0 (robotic) vs. 5 (LESS) conversions to a different approach (p = 0.33). 5 Patients vs. 3 patients experienced postoperative complications (p = 0.06), and length of stay (LOS) was 1 (2 ± 2.6) vs. 1 (1 ± 3.2) days (p = 0.0001). Patient symptomatic dysphagia preoperatively for the robotic vs. LESS approach was scored as 2 (2.4 ± 1.9) vs. 1 (1.9 ± 1.6). Postoperatively, symptomatic dysphagia was scored as 1 (1.5 ± 1.6) vs. 1 (1.7 ± 1.7). The change in these scores was − 1 (− 1 ± 2.2) vs. 0 (− 0.5 ± 2.2) (p = 0.004). Conclusion: Despite longer operative times and LOS in older patients, the robotic approach is efficient in undertaking very difficult operations, including patients with type IV or recurrent hiatal hernias. Furthermore, preoperative anti-reflux operations were more likely to be undertaken with the robotic approach than the LESS approach. The patient's postoperative symptomatic dysphagia improved relatively more than after the LESS approach. The vast majority of patients who underwent the LESS approach enjoyed improved cosmesis, thus, making LESS a stronger candidate for more routine operations. Despite patient selection bias, the robotic and LESS approaches to anti-reflux operations are safe, efficacious, and should be situationally utilized. [ABSTRACT FROM AUTHOR]

Application of time-series complexity measures (also known as entropies) has been quite useful in many Biomedical Engineering fields as in Brain–Computer Interfaces (BCI). Nevertheless, recently-proposed-entropy parameters referred to as dynamic complexity measures have not concretely been tested in BCI environment. The novelty of our research is evaluating the performance of Dynamic Bivariate Multiscale Entropy parameters (DBMSE) as alternative to typical classification algorithms in BCI, as common spatial patterns (CSP). After developing BCI training, the statistical results showed that CSP performed better than our initial DBMSE (DBMSE-I). This entropy uses a constant threshold r. However, after tunably including that quantity r, DBMSE-I improved to be almost as good as CSP. This updated entropy parameter was referred to as DBMSE-II. Since the limitations of these results were attributed to the shortness of the EEG records, a short-term-DBMSE (named here DBMSE-III) was developed. The findings revealed that DBMS-III had a slightly better performance than CSP outcomes, thus offering a new classifier alternative in BCI. Besides, we present entropy paths that reveal high/low complexity brain activity. This will be useful to identify EEG electrodes to move a robot within a preliminary assistance protocol in progress. Summing up: Besides knowing that DBMSE parameters are a good choice to show brain dynamics, DBMSE-III proved to be an alternative as classifier for CSP in our study, allowing interaction with a robot. In fact, we offer in this document a complete development from theory to execution of software and hardware. This experience will help support people with disabilities and their carers. [ABSTRACT FROM AUTHOR]

Improving the energy efficiency of robots remains a crucial challenge in soft robotics, with energy harvesting emerging as a promising approach to address it. This study presents a functional soft robotic composite called OPV-DEA, which integrates flexible organic photovoltaic (OPV) and dielectric elastomer actuator (DEA). The composite can simultaneously generate electrostatic bending actuation and harvest energy from external lights. Owing to its simplicity and inherent flexibility, the OPV-DEA is poised to function as a fundamental building block for soft robots. This study aimed to validate this concept by initially establishing the fabrication process of OPV-DEA. Subsequently, experimental samples are fabricated and characterized. The results show that the samples exhibit a voltage-controllable bending actuation of up to 15.6° and harvested power output of 1.35 mW under an incident power irradiance of 11.7 mW/cm2. These performances remain consistent even after 1000 actuation cycles. Finally, to demonstrate the feasibility of soft robotic applications, an untethered swimming robot equipped with two OPV-DEAs is fabricated and tested. The robot demonstrates swimming at a speed of 21.7 mm/s. The power consumption of the robot is dominated by a high-voltage DC-DC converter, with a value approximately 1.5 W. As a result, the on-board OPVs cannot supply the necessary energy during locomotion simultaneously. Instead, they contribute to the overall system by charging a battery used for the controller on board. Nevertheless, these findings suggest that the OPV-DEA could pave the way for the development of an unprecedented range of functional soft robots. [ABSTRACT FROM AUTHOR]

Background: Presacral tumors are a rare entity typically treated with an open surgical approach. A limited number of minimally invasive resections have been described. The aim of the study is to evaluate the safety and efficacy of roboticresection of presacral tumors. Methods: This is a retrospective single system analysis, conducted at a quaternary referral academic healthcare system, and included all patients who underwent a robotic excision of a presacral tumor between 2015 and 2023. Outcomes of interest were operative time, estimated blood loss, complications, length of stay, margin status, and recurrence rates. Results: Sixteen patients (11 females and 5 males) were included. The median age of the cohort was 51 years (range 25–69 years). The median operative time was 197 min (range 98–802 min). The median estimated blood loss was 40 ml, ranging from 0 to 1800 ml, with one patient experiencing conversion to open surgery after uncontrolled hemorrhage. Urinary retention was the only postoperative complication that occurred in three patients (19%) and was solved within 30 days in all cases. The median length of stay was one day (range 1–6 days). The median follow-up was 6.7 months (range 1–110 months). All tumors were excised with appropriate margins, but one benign and one malignant tumor recurred (12.5%). Ten tumors were classified as congenital (one was malignant), two were mesenchymal (both malignant), and five were miscellaneous (one malignant). Conclusions: Robotic resection of select presacral pathology is feasible and safe. Further studies must be conducted to determine complication rates, outcomes, and long-term safety profiles. [ABSTRACT FROM AUTHOR]

Due to rapid advancement in the field of electrical and electronic devices in wearable electronics and robotics technology, the demand for flexible electrode material is increasing day by day. To fabricate such an electrode material having the capability to store electrical energy and sustain maximum applied stress, poly acrylic acid-based hydrogel cross-linked via physical and chemical cross-linker was fabricated. Hydrogel loaded with 50 µL poly pyrrole cross-linked via N, N′-Methylenebisacrylamide, and Fe3+ shows the maximum peak current i.e. 0.24 mA at 1.0 V as compared to other synthesized hydrogels. The small diameter of the Nyquist plot infers the least charge transfer resistance, however, the capacitance calculated is 2.27 nF. Mechanical strength in terms of storage moduli deduces the elastic nature of synthesized hydrogel having storage moduli of 1.17 kPa which is much higher to be used as electrode material in robots because of sustaining maximum applied external stress. The high conductivity of polyacrylic acid-based hydrogel by applying external AC and DC makes it a favorable candidate to be used as a flexible electrode in wearable electronics and robotics technology. [ABSTRACT FROM AUTHOR]

Higher education faculty members incorporate technologies into their teaching and learning practices in higher education for the benefit of their learners. Hence, general technologies, such as presentation software, online classrooms, and learning management systems are ubiquitous in higher education teaching practices. However, emerging technologies (i.e., augmented reality, virtual reality, robotics, tangible user interfaces, wearable technologies, and mixed reality) are not currently in wide use in higher education. As emerging technologies can broaden access to content and increase accessibility for all learners, investigating faculty members' intention to incorporate these technologies was explored in this study. Faculty participants from higher education institutions (N = 174) completed a 33-item survey, based on the theoretical framework of the decomposed theory of planned behavior. A path analysis of factors that influence faculty members' intention to integrate emerging technologies in teaching and learning were conducted. Results indicated that attitude, subjective norms, and perceived behavioral control are indicators of intention to use emerging technologies in teaching and learning. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate the influence of increasing the tibial boundaries in functional alignment on femoral component orientation in total knee arthroplasty (TKA). Methods: A retrospective review of a database of robotic‐assisted TKAs using a digital joint tensioning device was performed (BalanceBot®; Corin). A total of 692 TKAs with correctable deformity were included. Functional alignment with a tibia‐first balancing technique was simulated by performing an anatomic tibial resection to recreate the native medial proximal tibial angle within certain boundaries (A, 87–90°; B, 86–90°; C, 84–92°), while accounting for wear. After balancing the knee, the resulting amount of femoral component outliers in the coronal and axial plane was calculated for each group and correlated to the coronal plane alignment of the knee (CPAK) classification. Results: The proportion of knees with high femoral component varus (>96°) or valgus (<87°) alignment increased from 24.5% (n = 170) in group A to 26.5% (n = 183) in group B and 34.2% (n = 237) in group C (p < 0.05). Similarly, more knees with high femoral component external rotation (>6°) or internal rotation (>3°) were identified in group C (33.4%, n = 231) than in group B (23.7%, n = 164) and A (18.4%, n = 127) (p < 0.05). There was a statistically significant (p < 0.01) overall increase in knees with both femoral component valgus <87° and internal rotation >3° from group A (4.0%, n = 28) to B (7.7%, n = 53) and C (15.8%, n = 109), with CPAK type I and II showing a 12.9‐ and 2.9‐fold increase, respectively. Conclusion: Extending the tibial boundaries when using functional alignment with a tibia‐first balancing technique in TKA leads to a statistically significant higher percentage of knees with a valgus lateral distal femoral angle < 87° and >3° internal rotation of the femoral component, especially in CPAK type I and II. Level of Evidence: Level IV. [ABSTRACT FROM AUTHOR]

Medjool date thinning automation is essential for reducing Medjool production labor and improving fruit quality. Thinning automation requires motion planning based on feature extraction from a segmented fruit bunch and its components. Previous research with focused bunch images attained high success in bunch component segmentation but less success in establishing correct association between the two components (a rachis and spikelets) that form one bunch. The current study presents an algorithm for improved component segmentation and association in the presence of occlusions based on integrating deep neural networks, traditional methods building on bunch geometry, and active vision. Following segmentation with Mask-R-CNN, segmented component images are converted to binary images with a Savitzky–Golay filter and an adapted Otsu threshold. Bunch orientation is calculated based on lines found in the binary image with the Hough transform. The orientation is used for associating a rachis with spikelets. If a suitable rachis is not found, bunch orientation is used for selecting a better viewpoint. The method was tested with two databases of bunches in an orchard, one with focused and one with non-focused images. In all images, the spikelets were correctly identified [intersection over union (IoU) 0.5: F1 0.9]. The average orientation errors were 18.15° (SD 12.77°) and 16.44° (SD 11.07°), respectively, for the focused and non-focused databases. For correct rachis selection, precision was very high when incorporating orientation, and when additionally incorporating active vision recall (and therefore F1) was high (IoU 0.5: orientation: precision 0.94, recall 0.44, F1 0.60; addition of active vision: precision 0.96, recall 0.61, F1 0.74). The developed method leads to highly accurate identification of fruit bunches and their spikelets and rachis, making it suitable for integration with a thinning automation system. [ABSTRACT FROM AUTHOR]

Purpose: To verify the usefulness of haptic feedback in telesurgery and improve the safety of telerobotic surgery. Methods: The surgeon's console was installed at two sites (Fukuoka and Beppu; 140 km apart), and the patient cart was installed in Fukuoka. During the experiment, the surgeon was blinded to the haptic feedback levels and asked to grasp the intestinal tract in an animal model. The surgeon then performed the tasks at each location. Results: No marked differences in task accuracy or average grasping force were observed between the surgeon locations. However, the average task completion time was significantly longer, and the system usability scale (SUS) was significantly lower rating for remote operations than for local ones. No marked differences in task accuracy or task completion time were observed between the haptic feedback levels. However, with haptic feedback, the organ was grasped with a significantly weaker force than that without it. Furthermore, with haptic feedback, experienced surgeons in robotic surgery tended to perform an equivalent task with weaker grasping forces than inexperienced surgeons. Conclusion: The haptic feedback function is a tool that allows the surgeon to perform surgery with an appropriate grasping force, both on site and remotely. Improved safety is necessary in telesurgery; haptic feedback will thus be an essential technology in robotic telesurgery going forward. [ABSTRACT FROM AUTHOR]

Background: The KangDuo surgical robot (KD-SR-01) was recently developed in China. This study aims to evaluate the short-term outcomes of KD-SR-01 for colorectal cancer surgery. Methods: This is a multicentre randomised controlled noninferiority trial conducted in three centers in China. Enrolled patients were randomly assigned at a 1:1 ratio to receive surgery using the KD-SR-01 system (KD group) or the da Vinci Xi (DV) robotic system (DV group). The primary endpoint was the success rate of operation. The second endpoints were surgical outcomes, pathological outcomes, and postoperative outcomes. Results: Between July 2022 and May 2023. A total of 100 patients were included in the trial and randomly assigned to the KD group (50 patients) and the DV group (50 patients). All cases were completed successfully without conversion to laparoscopic surgery. The time to flatus and the incidence of postoperative complications of Clavien-Dindo grade II or higher grade were comparable between the two groups. Surgeons reported a high level of comfort with the KD-SR-01 system. In the subgroup analysis of different operative procedures, there were no significant differences in docking time, console time, blood loss, and the length of the incision for extraction between the two groups. There were no differences in pathological outcomes including maximum tumor diameter, circumferential resection margin, distal resection margin, and number of harvested lymph nodes. Conclusions: The KD-SR-01 system was a viable option for colorectal cancer robotic surgery, with acceptable short-term outcomes comparable to the da Vinci Xi robotic system. [ABSTRACT FROM AUTHOR]

Developing robotic applications with human–robot interaction for the service sector raises a plethora of challenges. In these settings, human behavior is essentially unconstrained as they can stray from the plan in numerous ways, constituting a critical source of uncertainty for the outcome of the robotic mission. Application designers require accessible and reliable frameworks to address this issue at an early development stage. We present a model-driven framework for developing interactive service robotic scenarios, allowing designers to model the interactive scenario, estimate its outcome, deploy the application, and smoothly reconfigure it. This article extends the framework compared to previous works by introducing an analysis of the impact of human errors on the mission's outcome. The core of the framework is a formal model of the agents at play—the humans and the robots—and the robotic mission under analysis, which is subject to statistical model checking to estimate the mission's outcome. The formal model incorporates a formalization of different human erroneous behaviors' phenotypes, whose likelihood can be tuned while configuring the scenario. Through scenarios inspired by the healthcare setting, the evaluation highlights how different configurations of erroneous behavior impact the verification results and guide the designer toward the mission design that best suits their needs. [ABSTRACT FROM AUTHOR]

Robotics competitions boosts the development of STEM education, but gender disparity in this field remains rarely addressed by researchers. This study focused on the World Robot Olympiad (WRO) and tried to explore the gender differences through investigation method. The research questions are as follows: RQ1, what is the tendency of girls' participation in WRO from 2015 to 2019 in terms of the four competition categories and three age groups? RQ2, what advantages and challenges do the all-girl teams have from the perspectives of parents, coaches and students? The results showed that among the 5956 participants in the 2015–2019 WRO finals, girls accounted for only 17.3%. The Open Category that emphasized creativity attracted relatively more girl participants. As age group moved up, the number of girl participants decreased. The qualitative results showed that the focuses of coaches, parents and students was not exactly the same. All-girl team have the advantages in their communication, presentation and collaboration skills but less good at robot building. The results indicated the importance of promoting girl's participation in robot competitions and STEM fields. Coaches, mentors and parents need to provide girls with more support and encouragement in learning STEM subjects, especially at the junior high school level. Organizers of related competitions should give girls more exposure and opportunities by adjusting the mechanism. [ABSTRACT FROM AUTHOR]

To perform a set of tasks in a robotic network cloud system as fast as possible, it is recommended to use a scheduling approach that minimizes the makespan. The makespan is defined as the time between the start of the first scheduled task and the completion of all scheduled tasks. Load balancing is a technique to distribute incoming tasks across processing units in a way that the resource utilization is optimized and the makespan is minimized. Robotic network cloud systems can be conceptualized as graphs, with nodes representing hardware with independent computing power and edges representing data transmissions between the nodes. The initial scheduler assigns a set of newly arrived tasks to the processing units capable of performing them. To reduce the response time we can replicate some of the tasks and assign them to different processing units. This results in some tasks becoming redundant. Assigning redundant tasks refers to determining which processing unit should receive the replicated tasks. Load balancing for redundant allocation can be viewed as assigning tasks to multiple processing units with different resource sizes so that the load is evenly distributed among the units. We propose a technique for load balancing, the ordered balancing algorithm, to minimize the makespan in the redundant allocation and scheduling problem. We prove theoretically the correctness of the proposed algorithm and illustrate with simulations, using R version 4.0.3, the obtained results that outperform other recent load balancing proposals. [ABSTRACT FROM AUTHOR]

The concept of geo-localization broadly refers to the process of determining an entity's geographical location, typically in the form of Global Positioning System (GPS) coordinates. The entity of interest may be an image, a sequence of images, a video, a satellite image, or even objects visible within the image. Recently, massive datasets of GPS-tagged media have become available due to smartphones and the internet, and deep learning has risen to prominence and enhanced the performance capabilities of machine learning models. These developments have enabled the rise of image and object geo-localization, which has impacted a wide range of applications such as augmented reality, robotics, self-driving vehicles, road maintenance, and 3D reconstruction. This paper provides a comprehensive survey of visual geo-localization, which may involve either determining the location at which an image has been captured (image geo-localization) or geolocating objects within an image (object geo-localization). We will provide an in-depth study of visual geo-localization including a summary of popular algorithms, a description of proposed datasets, and an analysis of performance results to illustrate the current state of the field. [ABSTRACT FROM AUTHOR]

Purpose: Total knee arthroplasty (TKA) is a common orthopedic surgery, yet postoperative dissatisfaction persists in around 20% of cases. Robotic total knee arthroplasty (rTKA) promises enhanced precision, but its impact on patient satisfaction compared to conventional TKA remains controversial (cTKA). This systematic review aims to evaluate patient satisfaction post-rTKA and compare outcomes with cTKA. Methods: Papers from the following databases were identified and reviewed: PubMed, Scopus, Web of Science, and the Cochrane Online Library, using keywords like "Knee replacement," "Total knee arthroplasty," "Robotic," and "Patient satisfaction." Extracted data included patient satisfaction measures, Knee Society Score, Oxford Knee Score, Forgotten Joint Score, SF-36, HSS, and KOOS. Statistical analysis, including odds ratio and 95% CI was performed using R software. Heterogeneity was assessed using Cochrane's Q test. Results: The systematic review included 17 articles, involving 1148 patients (571 in the rTKA group and 577 in the cTKA group) assessing patient satisfaction following rTKA. An analysis of proportions reveals rTKA satisfaction rate was 95%, while for cTKA, it was 91%. A meta-analysis comparing rTKA and cTKA found no statistically significant difference in patient satisfaction. Additionally, various patient-reported outcome measures (PROMs) were examined, showing mixed results across different studies and follow-up periods. Conclusions: The results of this study found no difference in patient satisfaction outcomes in the short to mid-term for rTKA compared to conventional methods. This study does not assert superiority for the robotic approach, highlighting the need for careful consideration of various factors influencing outcomes in knee arthroplasty. [ABSTRACT FROM AUTHOR]

Background: The aim of the present study is to compare outcomes of the robotic hand-sewn, linear- and circular-stapled techniques performed to create an intrathoracic esophagogastric anastomosis in patients who underwent Ivor-Lewis esophagectomy. Methods: Patients who underwent a planned Ivor-Lewis esophagectomy were retrospectively analysed from prospectively maintained databases. Only patients who underwent a robotic thoracic approach with the creation of an intrathoracic esophagogastric anastomosis were included in the study. Patients were divided into three groups: hand-sewn-, circular stapled-, and linear-stapled anastomosis group. Demographic information and surgery-related data were extracted. The primary outcome was the rate of anastomotic leakages (AL) in the three groups. Moreover, the rate of grade A, B and C anastomotic leakage were evaluated. In addition, patients of each group were divided in subgroups according to the characteristics of anastomotic fashioning technique. Results: Two hundred and thirty patients were enrolled in the study. No significant differences were found between the three groups about AL rate (p = 0.137). Considering the management of the AL for each of the three groups, no significant differences were found. Evaluating the correlation between AL rate and the characteristics of anastomotic fashioning technique, no significant differences were found. Conclusions: No standardized anastomotic fashioning technique has yet been generally accepted. This study could be considered a call to perform ad hoc high-quality studies involving high-volume centers for upper gastrointestinal surgery to evaluate what is the most advantageous anastomotic technique. [ABSTRACT FROM AUTHOR]

The manufacturing sector is a fundamental pillar of worldwide economies, contributing markedly to global economic growth. However, the manufacturing industry is persistently confronted with issues impeding its development and expansion, such as manpower shortages, safety concerns, high initial investment for installation, and long return on investment. Within this context, machine tending has become a crucial component of the manufacturing process and potentially serves as a viable solution to the afore-mentioned predicaments. Over the past 5 years, implementing automated machine-tending systems has widely extended from simulation or laboratory environments to practical applications in manufacturing workshops as robotics and artificial intelligence develop rapidly. To fully benefit from the potential of machine-tending applications, it is necessary to comprehend and tackle its associated challenges. Therefore, this paper aims to contribute to the evolution of machine-tending applications by investigating the impacts of emerging trends of advanced technologies, such as autonomous mobile robots, computer vision, machine learning, and deep learning. This systematic literature review is based on the Protocol of Preferred Reporting Items for Systematic Review and Meta-Analyses to analyze the 50 scientific literature related to machine tending in the last five years. [ABSTRACT FROM AUTHOR]

Mobile manipulator robots that combine mobile platforms and robotic arms have been attracting considerable attention in recent years. In this paper, the motion control problem of the mobile manipulator system is considered with the following proposed control strategy. Firstly, a decoupled dynamic model is created to increase operation safety and to reduce complexity such that the independent controllers can be designed for the mobile system and the manipulator system. Subsequently, an effective reference trajectory generator is proposed to guide the mobile manipulator systems to the proper position for the manipulation being able to grip the target. Thereafter, the fuzzy controllers are designed for the mobile system to eliminate the tracking error and for the manipulator system to accomplish the gripping mission. The stability of the mobile manipulator control system can be guaranteed by the Lyapunov theory. Finally, the numerical simulations are given to demonstrate the effectiveness of the proposed approach. From the simulation results, it can be seen that this paper as well as other compared methods have good control response in case of small controller gain, in which the convergence time are about 4–5 s. However, by increasing the controller gain to improve the control response, the other methods will make the system unstable or the controller output will produce a large amount of chattering. The proposed controller in this paper can not only decrease the convergence time, from 5 to 3 s, but also provide a smooth control response. [ABSTRACT FROM AUTHOR]

Purpose: Surgery offers exciting opportunities but comes with demanding challenges that require attention from both surgical program administrators and aspiring surgeons. The hashtag #NoTrainingTodayNoSurgeonsTomorrow on 핏 (previously Twitter) underscores the importance of ongoing training. Our scoping review identifies educational challenges and opportunities for the next generation of surgeons, analyzing existing studies and filling gaps in the literature. Methods: Following the PRISMA guidelines, MEDLINE/PubMed was searched in February 2022, using the MeSH terms "surgeons/education," for articles in English or German on general, abdominal, thoracic, vascular, and hand surgery and traumatology targeting medical students, surgical residents, future surgeons, and fellows. Results: The initial search yielded 1448 results. After a step-by-step evaluation process, 32 publications remained for complete review. Three main topics emerged: surgical innovations and training (n = 7), surgical culture and environment (n = 19), and mentoring (n = 6). The articles focusing on surgical innovations and training mainly described the incorporation of structured surgical training methods and program initiatives. Articles on surgical culture examined residents' burnout, well-being, and gender issues. Challenges faced by women, including implicit bias and sexual harassment, were highlighted. Regarding mentoring, mentees' needs, training challenges, and the qualities expected of both mentors and mentees were addressed. Conclusion: At a time of COVID-19-driven surgical innovations, the educational and working environment of the new generation of surgeons is changing. Robotic technology and other innovations require future surgeons to acquire additional technological and digital expertise. With regard to the cultural aspects of training, surgery needs to adapt curricula to meet the demands of the new generation of surgeons, but even more it has to transform its culture. [ABSTRACT FROM AUTHOR]

Purpose: It was hypothesized that robotic arm‐assisted total knee arthroplasty (RA‐TKA) using additionally a gap‐balancing instrumentation will show high accuracy in executing the planning in femoral and tibial component placement throughout the range of knee motion (ROM) during TKA surgery. Methods: Prospectively collected data were analysed for patients undergoing RA‐TKA. A cruciate retaining cemented design was implanted using the MAKO® robotic system. Lower limb alignment at 0°, 30°, 45°, 60° and 90° of flexion was recorded at the beginning of surgery and finally after implantation of the components. A ligament tensioner was inserted after tibial precut to measure the extension and flexion gap, and final component placement was planned based on 3D CT images. Femoral and tibial component placement was measured in all three planes. Results: A total of 104 patients were included (mean age 69.4 ± 9 years; 44 male, 60 female). The difference in component placement after planning and final implantation showed less valgus of 0.7° ± 1.4° (p < 0.001), less external rotation of 0.6° ± 1.9° (p = 0.001) and less flexion of 0.9° ± 1.8° (p < 0.001) for the femoral component. The tibial component was placed in more varus of 0.2° ± 0.9° (p = 0.056) and more posterior slope of 0.5° ± 0.9° (p < 0.001). The lower limb alignment in extension was 4.4° ± 5.2° of varus of the native knee and changed to 1.2° ± 1.9° of varus after TKA (p < 0.01). Conclusion: Robotic‐assisted TKA helps to achieve the target of alignment and component placement very close to the planning. It allows optimal component placement of off‐the‐shelf implants respecting patient's specific anatomy. Level of Evidence: Level II. [ABSTRACT FROM AUTHOR]

Purpose: Tourniquet use during total knee arthroplasty (TKA) remains controversial. There are limited data demonstrating the effect of tourniquet use on flexion and extension gaps. The use of a tourniquet can theoretically affect the kinematics of the knee joint, specifically the extension and flexion gaps and the laxity, by mechanically compressing the soft tissues including the muscles above the knee joint. Therefore, this study was designed to prospectively evaluate changes in flexion and extension gaps with and without the use of a tourniquet. Methods: The following prospective study included 50 consecutive patients who underwent TKA using a surgical robot. The inclusion criteria were advanced osteoarthritis (OA) and varus‐alignment or valgus‐alignment <3° (hip‐knee‐ankle angle, standing long‐leg X‐ray), and the exclusion criteria were BMI >35 kg/m2 and mechanical axis in >3° valgus. A CR‐TKA was performed, and the medial and lateral gaps (in mm) throughout the full range of motion in 10° increments were recorded. The procedure was conducted both with and without an applied tourniquet (350 mmHg). Results: No significant differences were observed in the medial joint space. By contrast, the lateral gap showed significant differences in 10–20° of flexion (with a tourniquet 1.9 mm vs. without a tourniquet 2.1 mm, p = 0.018), 20–30° (1.6 vs. 1.8 mm, p = 0.02), 100–110° (0.9 vs. 1.1 mm, p = 0.021), and 110–120° (0.8 vs. 1 mm, p = 0.038). Thus, at the above degrees of flexion on the lateral side, there was a decrease in the mean of 0.2 mm with the use of a tourniquet. Conclusion: Although the use of a tourniquet showed a detectable change in the lateral gap in four 10° segments of flexion, clinical relevance with an average difference of 0.2 mm is not achieved. Thus, the use of a tourniquet in TKA can still be advocated based on the presented data. Level of Evidence: Level I. [ABSTRACT FROM AUTHOR]

Cold spraying has emerged as a promising technique for the repair of metallic components. Manipulating the cold spray gun by industrial robots, referred to as robot-guided cold spraying, enables flexible and controlled material deposition. This work proposes a concept for automated planning of robotic cold spray paths and trajectories, enabling effective and efficient material deposition at specified repair locations. The concept incorporates predefined cold spray parameterizations and boundary conditions to provide the best possible material deposition for the individual repair application. The concept begins with the extraction of the volume to be filled. This volume is then sliced into suitable adaptively curved layers and converted into point clouds for path planning. Subsequently, the cold spray path is converted into a trajectory by adding a calculated spray velocity profile to produce the required locally varying layer thicknesses. In addition, simulation of the material deposition and a kinematic analysis of the simulated trajectory are performed. These are utilized as performance indicators for assessing deposit quality and material efficiency, enabling the validation and improvement of the parameterized trajectory. Finally, the implementation of the entire concept is demonstrated by representative use cases. The results demonstrate successful automated path and trajectory planning by the proposed concept, contributing to the overall goal of automated repair of damaged components by cold spraying. [ABSTRACT FROM AUTHOR]

Medical imaging-based triage is a critical tool for emergency medicine in both civilian and military settings. Ultrasound imaging can be used to rapidly identify free fluid in abdominal and thoracic cavities which could necessitate immediate surgical intervention. However, proper ultrasound image capture requires a skilled ultrasonography technician who is likely unavailable at the point of injury where resources are limited. Instead, robotics and computer vision technology can simplify image acquisition. As a first step towards this larger goal, here, we focus on the development of prototypes for ultrasound probe securement using a robotics platform. The ability of four probe adapter technologies to precisely capture images at anatomical locations, repeatedly, and with different ultrasound transducer types were evaluated across more than five scoring criteria. Testing demonstrated two of the adapters outperformed the traditional robot gripper and manual image capture, with a compact, rotating design compatible with wireless imaging technology being most suitable for use at the point of injury. Next steps will integrate the robotic platform with computer vision and deep learning image interpretation models to automate image capture and diagnosis. This will lower the skill threshold needed for medical imaging-based triage, enabling this procedure to be available at or near the point of injury. [ABSTRACT FROM AUTHOR]

Purpose: Robot-assisted surgical systems for performing total knee arthroplasty (TKA) have gained significant attention. This study was designed to compare the surgical outcomes in primary TKA surgery between the recently developed "SkyWalker" robot system and the more commonly used MAKO robot. Methods: A total of 75 patients undergoing primary TKA surgery by the same surgical team were included in this study, with 30 patients in the "SkyWalker" group and 45 patients in the "MAKO" group. We documented the osteotomy plan for both robotic systems. The lower limb alignment angles were evaluated by postoperative radiographic assessment. The operation time, estimated blood loss, postoperative hospital stays, and changes in laboratory indexes were collected during hospitalization. In addition, a comparative evaluation of knee functional assessments and complications was conducted during six month and one year follow-ups. Results: There were no significant differences between the two groups in terms of the accuracy of restoring lower limb alignment, estimated blood loss, or operation time. The knee function assessments at six months and one year postoperatively were similar in both groups. Except for day three after surgery, the level of interleukin-6 (IL-6) and the change in IL-6 (∆IL-6) from preoperative baseline were higher in the "SkyWalker" group than in the MAKO group (median: 20.53 vs. 14.17, P=0.050 and median: 17.30 vs. 10.09, P=0.042, respectively). Additionally, one patient from the MAKO group underwent revision surgery at nine months postoperatively due to ongoing periprosthetic discomfort. Conclusions: The newly developed "SkyWalker" robot showed comparable efficacy to the MAKO robot in terms of lower limb alignment accuracy and postoperative six month and one year follow-up of clinically assessed resumption of knee function. [ABSTRACT FROM AUTHOR]

Purpose: Robotic lateral lymph node dissection (LLND) has been described as a safe and feasible procedure for local advanced rectal cancer. The aim of this study was to evaluate the learning curve for robotic-assisted LLND. Methods: We collected data on 78 consecutive patients who underwent robotic-LLND at our hospital. The learning curve was analyzed using the cumulative sum (CUSUM) method to assess changes in the unilateral LLND operative times across the case sequence. Results: Among the 78 patients, 52 underwent bilateral LLND and 26 underwent unilateral LLND. A total of 130 consecutive data were recorded. We arranged unilateral robotic-LLND operative times and calculated cumulative sum values, allowing the differentiation of three phases: phase I (learning period, cases 1–51); phase II (proficiency period, cases 52–83); and phase III (mastery period, cases 84–130). As the learning curve accumulated, the operation time and estimated blood loss of unilateral robotic-LLND decreased significantly with each phase (P < 0.05). By 12 months after surgery, the International Prostatic Symptom Score of patients at phase III was significantly lower than at phase I (P < 0.05). Conclusion: The CUSUM curve shows three phases in the learning of robotic-LLND. The estimated learning curve for robotic-assisted rectal-LLND is achieved after 51 cases. [ABSTRACT FROM AUTHOR]

Background: Currently, widely used robotic surgical systems do not provide force feedback. This study aimed to evaluate the impact and benefits of a force feedback function on the suturing procedure. Methods: Twenty surgeons were recruited and divided into young (Y-group, n = 11) and senior (S-group, n = 9) groups, based on their years of surgical experience. The effect of the force feedback function on suturing quality was evaluated using an objective assessment system (A-LAP mini, Kyoto Kagaku Co., Ltd., Kyoto, Japan). Each participant completed the suturing task on intestinal model sheets with the robotic contact force feedback on and off. The task accomplishment time (s), maximal force (Newton, N) applied to the robotic forceps, and quality of suturing (assessed by A-LAP mini) were recorded as performance parameters. Results: In total, the maximal force applied to the robotic forceps was significantly decreased with the robotic force feedback switched on (median [interquartile range]: 2.8 N (2.3–3.2)) as compared with when the feedback was switched off (3.4 N (2.7–4.0), P < 0.001). The contact force feedback function did not affect the objectively assessed suturing score (18 points (17.7–19.0) versus 18 points (17.0–19.0), P = 0.421). The contact force feedback function slightly shortened the task accomplishment time in the Y-group (552.5 s (466.5–832) versus 605.5 s (476.2–689.7), P = 0.851) but not in the S-group (566 s (440.2–703.5) versus 470.5 s (419.7–560.2), P = 0.164). Conclusions: With the contact force feedback function, the suturing task was completed with a smaller maximal force, while maintaining the quality of suturing. Because the benefits are more apparent in young surgeons, robots with the contact force feedback function will facilitate the educational process in novice surgeons. [ABSTRACT FROM AUTHOR]

Background: Trans-abdominal pre-peritoneal (TAPP) hernia repair is a complex procedure that presents several challenges. Even though, due to the high prevalence of inguinal hernia, TAPP technique is increasing in frequency and robotic Abdominal Wall Surgery (rAWS) is emerging as a valuable tool in this regard. Although inguinal TAPP procedure principles have been published and simulation is needed, the availability of validated models remains scarce. Methods: A new low-cost model was developed to simulate inguinal rTAPP repair. For validity assessment, a new TAPP-specific fidelity questionnaire and assessment scale were developed to compare the performance of novices and experts in the simulated procedure. The models used were assessed at 60 min for execution and quality score. Results: Twenty-five residents and specialists from all over the country participated in this study. Execution, quality, and global performance was higher in the seniors group compared to juniors (8.91 vs 6.36, p = 0.02; 8.09 vs 5.14, p <.001; and 17 vs. 11,5, p <.001, respectively). Overall fidelity was assessed as being very high [4.41 (3.5–5.0), α =.918] as well as face [4.31 (3.0–5.0), α =.867] and content validity [4.44 (3.2–5.0), α =.803]. Participants strongly agreed that the model is adequate to be used with the DaVinci® Robot [4.52 (3.5–5.0), α =.758]. Conclusion: This study shows face, content, and construct validity of the model for inguinal TAPP simulation, including for robotic surgery. Therefore, the model can be a valuable tool for learning, understanding, practicing, and mastering the TAPP technique prior to participating in the operating room. [ABSTRACT FROM AUTHOR]

Background: Network latency is the most important factor affecting the performance of telemedicine. The aim of the study is to assess the feasibility and efficacy of a novel network latency management system in 5G telesurgery. Methods: We conducted 20 telesurgery simulation trials (hitching rings to columns) and 15 remote adrenalectomy procedures in the 5G network environment. Telemedicine Network Latency Management System and the traditional "Ping command" method (gold standard) were used to monitor network latency during preoperative simulated telesurgery and formal telesurgery. We observed the working status of the Telemedicine Network Latency Management System and calculated the difference between the network latency data and packet loss rate detected by the two methods. In addition, due to the lower latency of the 5G network, we tested the alert function of the system using the 4G network with relatively high network latency. Results: The Telemedicine Network Latency Management System showed no instability during telesurgery simulation trials and formal telesurgery. After 20 telesurgery simulation trials and 15 remote adrenalectomy procedures, the p-value for the difference between the network latency data monitored by the Telemedicine Network Latency Management System and the "Ping command" method was greater than 0.05 in each case. Meanwhile, the surgeons reported that the Telemedicine Network Latency Management System had a friendly interface and was easy to operate. Besides, when the network latency exceeded a set threshold, a rapid alarm sounded in the system. Conclusion: The Telemedicine Network Latency Management System was simple and easy to operate, and it was feasible and effective to use it to monitor network latency in telesurgery. The system had an intuitive and concise interface, and its alarm function increased the safety of telesurgery. The system's own multidimensional working ability and information storage capacity will be more suitable for telemedicine work. [ABSTRACT FROM AUTHOR]

Background: Few studies assessed robotic in emergency setting and no solid evidence was demonstrated. The aim of this study was to evaluate the feasibility and safety of robot‐assisted transabdominal preperitoneal (R‐TAPP) repair for the treatment of incarcerated inguinal hernia. Methods: We retrospectively searched from a prospectively maintained database patients who underwent R‐TAPP or open surgery for incarcerated inguinal hernias from January 2018 to March 2023. The primary endpoint was to assess safety and feasibility of the R‐TAPP compared to the standard approach. For eligible patients, data was extracted and analyzed using a propensity score‐matching (PSM). Results: Thirty‐four patients were retrieved from our database, 15 underwent R‐TAPP, while 19 underwent open surgery. Mean age was 73.1 ± 14.6 years, 30 patients (88.2%) were male and mean BMI was 23.5 ± 3.2 kg/m2. No intraoperative complication occurred. Three cases requiring small bowel resection were all in the open surgery group (p = 0.112). The operative time was 108 ± 31 min versus 112 ± 31 min in the R‐TAPP and open surgery groups (p = 0.716). Seven postoperative complications occurred, only one classified as severe was in the open surgery group. The length of hospital stay was 2.9 ± 1.8 in the R‐TAPP versus 4.2 ± 2.3 min in the open surgery group (p = 0.077). PSM analysis showed similar postoperative outcomes and costs in both groups. Conclusions: Despite its limitations, our study appears to endorse the safety and feasibility of the robotic‐assisted treatment for incarcerated inguinal hernia. This approach yielded comparable results to open surgery, albeit in a limited number of patients, suggesting it might be a viable alternative. [ABSTRACT FROM AUTHOR]

Background: The da Vinci single‐port system (SPS) (Intuitive Surgical, Sunnyvale, CA, USA) was designed for single‐port (SP) surgery. Although we have reported our clinical outcomes using the SPS for a simple procedure in general thoracic surgery, major pulmonary resection had been performed only in cadaveric experiments to date. This study evaluated the feasibility of SP subcostal robotic major pulmonary resection using the SPS. Here, we present our initial clinical experience of SP subcostal robotic major pulmonary resection at our institution. Methods: Twenty‐five patients with lung cancer underwent SP major subcostal pulmonary resection using the SPS between March and November 2022. Patient characteristics, intraoperative and perioperative outcomes were assessed. Questionnaires were used to evaluate patient satisfaction with the cosmetic results and quality of life through face‐to‐face or telephone interviews on postoperative day 30. Results: All patients underwent major pulmonary resection with complete radical resection (R0). Nineteen patients underwent lobectomy, whereas six patients underwent segmentectomy. The mean docking time and total operative time were 4.16 ± 1.19 min (range, 2.3–7.8 min) and 197.6 ± 55.33 min (range, 130–313 min), respectively. No patients underwent conversion to open thoracotomy. One patient required an additional assistant port due to severe pleural adhesions. Conclusions: SP subcostal robotic major pulmonary resection using the SPS is feasible and safe. With the continuous development of robotic technology and surgical techniques, we believe that more complex general thoracic surgeries will be performed in the future using SPS. [ABSTRACT FROM AUTHOR]

This work is the extended version of a paper presented at the conference HMM2021, about the history of mechanical engineering. First, the initial cultural and industrial steps in the robotic field in Japan are introduced, to display the beginning of this interlaced path, before WW2; then, in the context of the aftermaths of the war, some famous anime heroes are presented as ancestors of the coming mecha anime series. The rising research in the field of robotics and more generally the developments of contemporary Japanese automation industry are then drawn, as a technological substrate for mecha conception. In particular, Masahiro Mori studies are taken into consideration to identify an actual robot design pattern to apply to the following comparative description and examination of the different mecha; finally, thanks to this analysis, the common breeding ground whence robotics and mecha (and their reciprocal influences) arise, is outlined. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate decision-makers' views on changes that robotics will create in welfare services. The purpose was also to discover what the opportunities and challenges are in human–robot interaction during these changes and how to manage these changes. As a research method, an online survey was used. The survey was sent to Finnish decision-makers (N = 184). They were divided into three groups: Techno-positive (n = 66), Techno-neutral (n = 47), and Techno-critical (n = 71). According to the results, more than 80% of the respondents saw that robots can offer support in existing work tasks, and more than 70% saw that the robots can do existing tasks. The most often mentioned challenges were the reduction of interaction and the reduction of human touch. Further, there are various knowledge needs among the respondents. Most of the knowledge needs were not based on the technical use of the robots; rather, they were quite scattered. The results suggest that successful use and implementation of robots in welfare services require a comprehensive plan and change agents. This study suggests that techno-positive people could act as change agents, assisting in implementing the changes. In addition, to manage change in the welfare services it is essential to improve the quality of the information, solve the resistance to change, create organizational awareness, and understanding, and establish a psychological commitment to change the processes. [ABSTRACT FROM AUTHOR]

In the realm of robotics and automation, robot teleoperation, which facilitates human–machine interaction in distant or hazardous settings, has surged in significance. A persistent issue in this domain is the delays between command issuance and action execution, causing negative repercussions on operator situational awareness, performance, and cognitive load. These delays, particularly in long-distance operations, are difficult to mitigate even with the most advanced computing advancements. Current solutions mainly revolve around machine-based adjustments to combat these delays. However, a notable lacuna remains in harnessing human perceptions for an enhanced subjective teleoperation experience. This paper introduces a novel approach of sensory manipulation for induced human adaptation in delayed teleoperation. Drawing from motor learning and rehabilitation principles, it is posited that strategic sensory manipulation, via altered sensory stimuli, can mitigate the subjective feeling of these delays. The focus is not on introducing new skills or adapting to novel conditions; rather, it leverages prior motor coordination experience in the context of delays. The objective is to reduce the need for extensive training or sophisticated automation designs. A human-centered experiment involving 41 participants was conducted to examine the effects of modified haptic cues in teleoperations with delays. These cues were generated from high-fidelity physics engines using parameters from robot-end sensors or physics engine simulations. The results underscored several benefits, notably the considerable reduction in task time and enhanced user perceptions about visual delays. Real-time haptic feedback, or the anchoring method, emerged as a significant contributor to these benefits, showcasing reduced cognitive load, bolstered self-confidence, and minimized frustration. Beyond the prevalent methods of automation design and training, this research underscores induced human adaptation as a pivotal avenue in robot teleoperation. It seeks to enhance teleoperation efficacy through rapid human adaptation, offering insights beyond just optimizing robotic systems for delay compensations. [ABSTRACT FROM AUTHOR]

This paper focuses on optimising pick-and-place tasks performed by a dual-arm collaborative robot in a specific shoe manufacturing industry environment. The robot must identify the pieces of a shoe placed on a tray, pick them up, and place them in a shoe mold for further processing. The shoe pieces arrive on the tray in random positions and angles and can be picked up in a different order. Optimising these tasks could increase the assembly speed of each unit and improve shoe production. To achieve this goal, a mathematical model based on binary integer linear programming (BILP) has been developed. This model determines the optimal sequence for picking and placing the shoe pieces in the mold, thus minimising the time required for picking and decision-making. The effectiveness of this approach has been tested using two 3-piece unit shoe models: one for training and another for validation. These models encompass a total of 500 trays. An analysis of the results reveals that BILP offers advantages for task motion planning in complex environments with multiple trajectories and the potential for collisions between arms. The model's generalizability to shoes with n assembly pieces further confirms its robustness for various piece counts. [ABSTRACT FROM AUTHOR]

Trans oral robotic surgery (TORS) is a minimally invasive technique for head and neck cancers. It is shown favourable recovery and long-term functionality outcomes compared to traditional treatments. Our department at the Royal Surrey County Hospital implemented a service transformation project for a TORS programme in December 2019. The "plan, do, study and act" (PDSA) quality improvement model was used. This incorporated logistical, training, clinical and financial aspects. Twenty-five patients were selected for oropharyngectomy, tonsillectomy or tongue base resections over a period of 1 year. Patients were matched with similar patients undergoing the same non-robotic procedures. TORS showed an improvement in time required to return to normal diet and time needing regular analgesia. Peri-operative complications were similar in both groups. An improving learning curve was observed over time for console times. [ABSTRACT FROM AUTHOR]

Purpose: The use of robotic assisted surgery is increasing but training residents in its use may be associated with increased operative time and cost. The objective of this study is to compare the operative time of robotic incisional/ventral hernia repair (RIVHR) and robotic inguinal hernia repair (RIHR) when performed with and without a resident or fellow trainee. Methods: A review of prospectively collected data was performed on all patients who underwent RIVHR and RIHR by a single surgeon over a 9-year period (2014–2023). Study variables included presence of trainee (resident or fellow), procedure time, console time, and recurrent hernia. Primary outcomes include procedure time and console time. Results: A total of 402 surgeries were included for analysis. Residents assisted in 190 (47%) of the procedures, while fellows assisted in 97 (24%), and 115 (29%) were performed without a trainee. Median (IQR) console times in RIVHR assisted by fellows was 102 (72–145) minutes, compared to 90 (71–129) minutes among surgeries assisted by residents and 65 (52–82) minutes among surgeries performed without a trainee (p < 0.0001), a similar trend was observed for RIHR. The duration of hernia repair assisted by trainees was significantly longer than surgeries performed without a trainee. Conclusion: Operative time for RIVHR and RIHR is significantly lower when performed without a trainee. However, RIHR assisted by residents showed a consistent decrease in operative time over the 9-year period. [ABSTRACT FROM AUTHOR]

Purpose: Thoracoabdominal hernias remain a rare and poorly understood entity. Data remain sparse as terminology varies in the literature and case reports demonstrate wide variability in technique. We present a novel approach for repair of thoracoabdominal hernias using the robotic platform. Methods: Two patients underwent a robotic thoracoabdominal hernia repair in June 2022. They were followed for 1 year with CT scans every 6 months to exclude recurrence. Patient demographics and peri-operative details including defect size, closure technique, mesh size, length of stay, and complications were reported. Results: Both patients successfully underwent a robotic repair of a thoracoabdominal hernia, addressing the intercostal hernia, diaphragmatic disruption, and flank hernia discretely during the operation. One patient had an uneventful recovery and discharged on post-operative day 3; the other developed a small bowel obstruction due to an early port site hernia which required surgical intervention. He eventually discharged on post-operative day 9. At one year, there is no clinical or radiographic evidence of recurrence for either patient. Conclusion: Robotic thoracoabdominal hernia repair is feasible and offers a minimally invasive repair option for these extremely complex hernias. [ABSTRACT FROM AUTHOR]

Purposes: To compare the robotic-assisted and the traditional freehand percutaneous scaphoid fixation in number of guidewire attempts, duration of fluoroscopy time, amount of radiation dose, and screw centrality. Methods: Twenty cadaveric specimens were randomized into either the robotic or freehand group. The scaphoids in both groups were fixed by either the same attending or resident from our hand surgery department. The operation duration, amount of radiation from intraoperative fluoroscopy, total fluoroscopy time, and the number of guidewire attempts were documented and compared. Postoperatively, all the specimens had a computed tomography (CT) scan performed, and the difference in the final position of the screw and the central axis of the scaphoid was examined. Results: In the robotic group, all the guide wires were satisfactorily positioned within a single attempt, while the median number of attempts in the traditional freehand group was 18 (quaternion 14–65). This also meant that the surgeon in the robotic group experienced significantly lower radiation exposure dose and time as compared to the freehand group. There were no significant differences in the final screw position as compared to the central axis of the scaphoid in both groups. Although there was no difference in surgeon performance in the robotic group, the operative time for the attending was significantly lower as compared to the resident in the freehand group. Conclusion: Robotic-assisted surgery for scaphoid fracture fixation is superior to the traditional freehand method as it facilitates accurate screw placement with lower radiation exposure and fewer guide wire attempts. [ABSTRACT FROM AUTHOR]

Difficulties with social interaction characterise children with Autism Spectrum Disorders and have a negative impact in their everyday life. Integrating a social-humanoid robot within the standard clinical treatment has been proven promising. The main aim of this randomised controlled study was to evaluate the effectiveness of a robot-assisted psychosocial intervention and the secondary aim was to investigate potential differences between a robot-assisted intervention group and a control group receiving intervention by humans only. The analysis of the results showed that robot-assisted intervention could be beneficial by improving children's psychosocial skills. This improvement was highlighted by neuropsychological testing and parent reporting. Group comparison only presented minimal statistically significant differences. The study underpins the potential of robot-assisted interventions to augment standard care. [ABSTRACT FROM AUTHOR]

Interventional oncology offers minimally invasive treatments for malignant tumors for curative and palliative purposes based on the percutaneous insertion of needles or catheters into the target location under image guidance. Robotic systems have been gaining increasing attention as tools that provide potential advantages for image-guided interventions. Among the robotic systems developed for intervention, those relevant to the oncology field are mainly those for guiding or driving the needles in non-vascular interventional procedures such as biopsy and tumor ablation. Needle-guiding robots support planning the needle path and align the needle robotically according to the planned trajectory, which is combined with subsequent manual needle insertion by the physician through the needle guide. Needle-driving robots can advance the needle robotically after determining its orientation. Although a wide variety of robotic systems have been developed, only a limited number of these systems have reached the clinical phase or commercialization thus far. The results of previous studies suggest that such interventional robots have the potential to increase the accuracy of needle placement, facilitate out-of-plane needle insertion, decrease the learning curve, and reduce radiation exposure. On the other hand, increased complexity and costs may be a concern when using robotic systems compared with conventional manual procedures. Further data should be collected to comprehensively assess the value of robotic systems in interventional oncology. [ABSTRACT FROM AUTHOR]

Background: The rapid adoption of robotics within minimally invasive surgical specialties has also seen an explosion of new technology including multi- and single port, natural orifice transluminal endoscopic surgery (NOTES), endoluminal and "on-demand" platforms. This review aims to evaluate the validation status of current and emerging MIS robotic platforms, using the IDEAL Framework. Methods: A scoping review exploring robotic minimally invasive surgical devices, technology and systems in use or being developed was performed, including general surgery, gynaecology, urology and cardiothoracics. Systems operating purely outside the abdomen or thorax and endoluminal or natural orifice platforms were excluded. PubMed, Google Scholar, journal reports and information from the public domain were collected. Each company was approached via email for a virtual interview to discover more about the systems and to quality check data. The IDEAL Framework is an internationally accepted tool to evaluate novel surgical technology, consisting of four stages: idea, development/exploration, assessment, and surveillance. An IDEAL stage, synonymous with validation status in this review, was assigned by reviewing the published literature. Results: 21 companies with 23 different robotic platforms were identified for data collection, 13 with national and/or international regulatory approval. Of the 17 multiport systems, 1 is fully evaluated at stage 4, 2 are stage 3, 6 stage 2b, 2 at stage 2a, 2 stage 1, and 4 at the pre-IDEAL stage 0. Of the 6 single-port systems none have been fully evaluated with 1 at stage 3, 3 at stage 1 and 2 at stage 0. Conclusions: The majority of existing robotic platforms are currently at the preclinical to developmental and exploratory stage of evaluation. Using the IDEAL framework will ensure that emerging robotic platforms are fully evaluated with long-term data, to inform the surgical workforce and ensure patient safety. [ABSTRACT FROM AUTHOR]