果冻影院

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A surgeon鈥檚 tools have come a long way since the crude blades and saws of the 18th and 19th century. Great advancements in technology have meant that is now not uncommon to see robotic systems in operating theatres and clinics assisting with healthcare procedures. This is an area of growth that seems unlikely to slow down; estimates have projected that the market for medical robotic systems will exceed $17 billion by 2020.

One particularly exciting intersection of research is the marriage of surgical robotic technologies and medical imaging. Whilst robotic systems are frequently used in minimally invasive surgery, imaging inside the body is restricted by the access port. Robotic assisted imaging works to overcome this limitation by combining the autonomy and actuation capabilities of robots with innovative new imaging techniques. This can aid with detection of disease and allow surgeons to navigate and operate with greater precision. We are delighted to be able to showcase an example of this at our exhibition stand at听听(28th September 鈥� 1st October). Please visit us at stall 1229 to watch our Kuka arm robot with an endoscope in action and hear more about our related research.

GIFT-Surg鈥檚 use of robotics in fetal surgery

Teams at 果冻影院 are looking at ways in which the Kuka arm and other surgical robots can be incorporated to advance research understandings and capabilities. A research project called听听(GIFT-Surg) is working on applying these new technologies to fetal surgery. GIFT-Surg is led by 果冻影院 in collaboration with听听in Belgium,听,听听and听.

A particular fetal condition that the GIFT-Surg team are using surgical robotics to assist with is听twin-to-twin transfusion syndrome听(TTTS). TTTS is a complication affecting 10-15% of identical twins who share the same placenta. The disease is caused by the presence of abnormal blood vessels (anastomising vessels) in the shared placenta leading to an imbalance in the blood circulation between the twins. The condition results in uneven transfusion meaning that the donor twin is often underweight and anaemic due to deprivation of blood, whilst the recipient twin鈥檚 heart is strained by overload of blood.

TTTS is currently treated in minimally invasive surgery through the insertion of a foetoscope to identify the anastomising vessels, followed by the cauterisation of these vessels with a laser coagulator (see image below). One of the primary challenges of this surgery is the limited field view of the fetoscopic video guidance, worsened by the cloudy amniotic fluid in the womb and instability of imaging caused by movement. The poor visibility hinders surgeons鈥� ability to accurately locate and cauterise all abnormal vessels. GIFT-Surg researchers are developing technology that combines novel image analysis techniques with advancements in surgical robotics. Using mosaicking it will generate a full 3D model of the placenta from a series of limited 2D fetoscopic images, enabling more accurate navigation and cauterisation.

How can robotic assisted imaging help improve the effectiveness of cancer screening campaigns?

Cancer is the leading cause of death worldwide, accounting for around 13% of total deaths. Screening for cancer is so important because it allows for early detection and treatment of the disease, drastically improving patients鈥� survival rates. As a result of this there has been a real push in healthcare towards encouraging mass cancer screening campaigns, in both high-income and low-income countries. However, there are many factors that have limited the effectiveness of these campaigns including reluctance of patients and lack of resources. Researchers are increasingly taking an interdisciplinary approach to tackle these challenges, using engineering techniques and innovative robotic technologies to help improve screening processes. To demonstrate this, we are going to look more at two very different projects that Dr Danail Stoyanov, who leads 果冻影院鈥檚听, is helping collaborate on.

Colorectal diseases like听colorectal cancer听(CRC) affect a significant number of people worldwide, with an especially high incidence rate in high-income countries. Early diagnosis of CRC is particularly crucial with a 90% survival rate compared to a less than 7% survival rate for those with advanced disease. For this reason, regular screening is recommended to patients who are older or have a family history of CRC. The screening process most commonly used is a colonoscopy, which involves steering a long semi-rigid tube through the patient鈥檚 colon. However, the invasiveness, discomfort and frequent pain caused by this procedure leaves many patients reluctant to attend regular screenings, whilst the steering technique itself is difficult to learn and subjectively dependent on the skill of the operator.

The听听project (Endoscopic Versatile robotic guidancE, diagnoSis and theraPy of magnetic-driven soft-tethered endoluminAl robots) aims to overcome these challenges by developing an integrated robotic platform for the navigation of a soft-tethered colonoscope that could help diagnosis and treat patients painlessly. The EndoVESPA colonoscopic methodology uses sensing strategies and magnetic control to navigate the endoscope through the colon, eradicating the feeling of discomfort caused by conventional colonoscopy techniques. The hope is that this painless procedure will increase patients鈥� acceptance of the process, enhancing the effectiveness of mass screening campaigns. EndoVESPA鈥檚 research consortium includes听听(SSSA), 果冻影院,听,听,听听and听.

In other areas of the world, effective screening for cancer faces other challenges which robotic assisted imaging could help to solve. For instance,听gastric cancer听is the second leading cause of cancer death worldwide. Whilst screening programmes have been shown to be incredibly effective in reducing mortality rates through early detection and treatment, they have been particularly hard to carry out in rural and underdeveloped areas. This problem is especially potent in rural China where high levels of gastroesophageal cancer coincide with a shortage of medical resources and personnel over vast distances, leading to higher mortality rates than in any other country.

To tackle this, a multidisciplinary听听of researchers led by Prof Pietro Valdastri at the听听have developed听robotic capsule endoscopes which are soft-tethered, swallowable and, crucially, ultra low-cost. The miniature 鈥減ill camera鈥澨齣s portable and can be swallowed comfortably without sedation, enabling the screening process to be carried out effectively by volunteers in low-resource areas rather than needing doctors.听After each procedure the capsule outer shell and soft tether are discarded, leaving the small endoscopic camera to be听reused.听The team estimates that this will allow a target cost per procedure of just 拢2, compared to a capital cost ca. 拢400听vs听拢80,000 for existing technology.听These features mean that this research has the potential to completely transform the gastric cancer screening process in rural China, enabling far more procedures and saving many lives through early detection. If successful, this platform听could be extended much more widely听across other low-and-middle-income countries too.听听

Surgical Robotics at 果冻影院

The cutting-edge research taking place at 果冻影院 in surgical robotics and robotic assisted imaging is supported by听听and the听听research group. As this field grows the boundaries of what is possible in surgical robotics continue to be pushed, enabling these innovative new technologies to deliver patient-focused results.

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