Search Results (208)

This paper presents the PRONOBIS project, an ultrasound-only, robotically assisted, deep learning-based system for prostate scanning and biopsy treatment planning. The proposed system addresses the challenges of precise prostate segmentation, reconstruction and inter-operator variability by performing fully automated prostate scanning, real-time CNN-transformer-based image processing, 3D prostate reconstruction, and biopsy needle position planning. Fully automated prostate scanning is achieved by using a robotic arm equipped with an ultrasound system. Real-time ultrasound image processing utilizes state-of-the-art deep learning algorithms with intelligent post-processing techniques for precise prostate segmentation. To create a high-quality prostate segmentation dataset, this paper proposes a deep learning-based medical annotation platform, MedAP. For precise segmentation of the entire prostate sweep, DAF3D and MicroSegNet models are evaluated, and additional image post-processing methods are proposed. Three-dimensional visualization and prostate reconstruction are performed by utilizing the segmentation results and robotic positional data, enabling robust, user-friendly biopsy treatment planning. The real-time sweep scanning and segmentation operate at 30 Hz, which enable complete scan in 15 to 20 s, depending on the size of the prostate. The system is evaluated on prostate phantoms by reconstructing the sweep and by performing dimensional analysis, which indicates 92% and 98% volumetric accuracy on the tested phantoms. Three-dimansional prostate reconstruction takes approximately 3 s and enables fast and detailed insight for precise biopsy needle position planning. Full article

Biomimetic robotics and sensor technologies are reshaping the landscape of healthcare and rehabilitation. Despite significant progress across various domains, many areas within healthcare still demand further bio-inspired innovations. To advance this field effectively, it is essential to synthesize existing research, identify persistent knowledge gaps, and establish clear frameworks to guide future developments. This systematic review addresses these needs by analyzing 89 peer-reviewed sources retrieved from the Scopus database, focusing on the application of biomimetic robotics and sensing technologies in healthcare and rehabilitation contexts. The findings indicate a predominant focus on enhancing human mobility and support, with rehabilitative and assistive technologies comprising 61.8% of the reviewed literature. Additionally, 12.36% of the studies incorporate intelligent control systems and Artificial Intelligence (AI), reflecting a growing trend toward adaptive and autonomous solutions. Further technological advancements are demonstrated by research in bioengineering applications (13.48%) and innovations in soft robotics with smart actuation mechanisms (11.24%). The development of medical robots (7.87%) and wearable robotics, including exosuits (10.11%), underscores specific progress in clinical and patient-centered care. Moreover, the emergence of transdisciplinary approaches, present in 6.74% of the studies, highlights the increasing convergence of diverse fields in tackling complex healthcare challenges. By consolidating current research efforts, this review aims to provide a comprehensive overview of the state of the art, serving as a foundation for future investigations aimed at improving healthcare outcomes and enhancing quality of life. Full article

As artificial intelligence (AI) becomes ubiquitous across various fields, understanding people’s acceptance and trust in AI systems becomes essential. This review aims to identify quantitative measures used to measure trust in AI and the associated studied elements. Following the PRISMA guidelines, three databases were consulted, selecting articles published before December 2023. Ultimately, 45 articles out of 1283 were selected. Articles were included if they were peer-reviewed journal publications in English reporting empirical studies measuring trust in AI systems with multi-item questionnaires. Studies were analyzed through the lenses of cognitive and affective trust. We investigated trust definitions, questionnaires employed, types of AI systems, and trust-related constructs. Results reveal diverse trust conceptualizations and measurements. In addition, the studies covered a wide range of AI system types, including virtual assistants, content detection tools, chatbots, medical AI, robots, and educational AI. Overall, the studies show compatibility of cognitive or affective trust focus between theorization, items, experimental stimuli, and level of anthropomorphism of the systems. The review underlines the need to adapt measurement of trust in the specific characteristics of human–AI interaction, accounting for both the cognitive and affective sides. Trust definitions and measurement could be chosen depending also on the level of anthropomorphism of the systems and the context of application. Full article

Background: While there is an abundance of comparative studies on open, laparoscopic, and robotic-assisted distal pancreatectomies (RDPs) available in the literature, direct comparisons between RDP and hand-assisted laparoscopic distal pancreatectomy (HALDP) are limited. This study aimed to assess the safety and efficacy of RDPs in comparison to HALDPs in the treatment of pancreatic lesions. Methods: This study reviewed 97 patients who underwent distal pancreatectomy at Carmel Medical Center between 2008 and 2024. After excluding 40 patients (24 open and 16 pure laparoscopic resections), the final cohort comprised 57 patients: 20 RDPs and 37 HALDPs. The primary outcomes included peri-operative parameters, while secondary outcomes encompassed 90-day morbidity and mortality. Results: RDPs led to significantly longer operative times (3.9 vs. 2.5 h, p < 0.001) but resulted in shorter hospital stays (4.7 vs. 5.8 days, p = 0.02) and a higher number of harvested lymph nodes (11 vs. 5.4, p = 0.01). While clinically significant pancreatic fistula rates were numerically higher in the RDP group (35% vs. 16.2%, p = 0.18), this difference was not statistically significant. Overall, complication rates were comparable (55% vs. 43.2%, p = 0.39). Severe morbidity (Clavien–Dindo ≥ IIIa) was absent in the RDP group compared to 8% in the HALDP group (p = 0.04). No 90-day mortality was observed in either group. Conclusions: This study indicates that although RDP involves longer operative times, it may provide certain advantages for patients, such as shorter hospital stays, better lymph node retrieval, and a notable decrease in postoperative morbidity when compared to HALDP. Larger prospective studies are needed to validate these results and to determine the most effective surgical approach for distal pancreatectomy. Full article

Background/Objectives: Prostate cancer ranks as the second-most prevalent cancer globally, and is the fifth-ranking cause of cancer-related mortality. Radical prostatectomy presents a significant risk of postoperative sequelae, including erectile dysfunction. Postoperative erectile dysfunction adversely affects the patient’s quality of life and can severely impact total treatment satisfaction. Nomograms have demonstrated efficacy in forecasting diverse outcomes in urology. We sought to create a nomogram to facilitate a more precise, evidence-based, and individualized prediction of erectile function outcomes following radical prostatectomy. Between January 2018 and January 2022, one hundred and eleven prostate cancer patients had robot-assisted radical prostatectomy, excluding those who had undergone prior transurethral prostatectomy, radiotherapy, or hormone therapy. Demographics, medical records, preoperative and postoperative erectile function statuses, and IIEF scores (≥17 indicating retained erections, <17 indicating full erectile dysfunction) were evaluated. Outcomes: Patients’ ages ranged from 45 to 76 years, with an average of 61.18 ± 6.72 years. Patients in the emergency department were considerably older (p = 0.004; p < 0.01) and exhibited elevated Charlson Comorbidity Indices (3.63 ± 0.85; p = 0.004; p < 0.01). Preoperative IIEF scores in ED patients were lower (14.29 ± 5.34), although obturator internus thickness (20.61 ± 2.91) and intraprostatic urethra length (36.48 ± 9.3) were considerably elevated. Altered surgical techniques were linked to maintained erections (p = 0.002; p < 0.01), but traditional approaches were connected with erectile dysfunction (p = 0.007; p < 0.01). Bilateral nerve-sparing procedures were more prevalent among patients preserving erectile function (p = 0.003; p < 0.01). Conclusions: The nomogram, which includes age, Charlson Comorbidity Index, preoperative IIEF, obturator internus thickness, intraprostatic urethra length, surgical technique, and degree of nerve preservation, provides clinicians with a pragmatic instrument for forecasting postoperative erectile dysfunction in prostate cancer patients. Full article

Background/Objectives: The aim of this case series is to evaluate the outcomes and safety of video-assisted mastectomy, illustrating the harmonious collaboration of oncologic and plastic surgery. This novel minimally invasive technique allows immediate prosthetic reconstruction and represents a cost-effective alternative to robotic breast surgery. Methods: Video-assisted, single-port nipple-sparing mastectomies were performed in patients with small to medium-sized breasts, followed by immediate direct-to-implant reconstruction with either prepectoral or dual plane implant placement. The patients’ electronic medical records were analyzed, including demographic characteristics, operative times and histopathology reports. Results: A total of 18 patients underwent successful video-assisted mastectomy, without conversion to traditional open procedure. Fifteen of the operations were risk-reducing mastectomies. Twelve patients had complementary procedures performed concurrently on the previously operated contralateral breast (delayed reconstruction/expander-to-implant exchange). Moreover, three patients benefited from additional minimally invasive techniques during the same surgery (prophylactic laparoscopic hysterectomy). Immediate breast reconstruction with polyurethane or microtextured breast implants up to 450 cc was performed, with satisfactory aesthetic outcomes and no cancer recurrences at 6 to 12 months postoperative follow-up. Early complications included transient hypercapnia, areolar congestion and cellulitis. No skin necrosis or implant-related complications were reported. The most frequently encountered late issues were contour irregularities. Conclusions: Video-assisted mastectomy facilitates the safe removal of proven pathologic or healthy breast tissue with minimal damage to the breast’s skin envelope, facilitating single-stage breast reconstruction. Full article

Background/Objectives: The potential advantages of robotic assistance in spinal procedures are a growing area of interest, and patient perception plays a key role in its broader acceptance. However, public perception of robotic surgery in spinal operations remains unexplored. This study aims to assess the general public’s perceptions, expectations, and concerns regarding robot-assisted spine surgery. Methods: In the fall of 2024, a questionnaire was distributed to attendees at a public open day at the Neurocenter of Southern Switzerland, where the Globus ExcelsiusGPS™ spine surgery robot was demonstrated live on a mannequin. The 15-item questionnaire assessed demographic data, prior knowledge of medical robots, mental representations of surgical robots, expectations, and emotions after witnessing the demonstration. Data were analyzed using descriptive statistics, chi-square, Wilcoxon, McNemar tests, and logistic regression analysis. Results: A total of 109 questionnaires were collected. Most participants were female (64.4%) and had no direct experience with spinal pathology (79.8%). While 87.2% were aware of robotic surgery in general, only 65.1% specifically knew about its use in spine surgery. After witnessing the live demonstration, 81.9% felt reassured by the robot′s presence in surgery, compared to 61.3% before the demonstration (p = 0.007). Preference for robot-assisted surgery increased from 50.5% to 64.5% (p < 0.001). Notably, individuals with back-related issues showed greater confidence in the robot’s capabilities (p = 0.032). Conclusions: The general public perceives robotic spine surgery positively, viewing it as faster, more precise, and capable of performing tasks not readily performed by humans. The study highlights the importance of live demonstrations in enhancing trust and acceptance of robotic systems. Its findings have economic implications, as patients may be more likely to choose hospitals offering robot-assisted spine surgery. However, it is essential to also acknowledge alternative methods, such as computer-assisted navigation, which has demonstrated efficacy in spine surgery. Full article

Obesity is a major global health challenge associated with significant metabolic and gastrointestinal comorbidities. While metabolic and bariatric surgery remains the gold standard for durable weight loss, the desire for additional options has fueled the development of endoscopic bariatric therapies (EBTs) as another tool for weight loss. This review examines established EBTs, including endoscopic sleeve gastroplasty (ESG), intragastric balloons (IGBs), and transoral outlet reduction (TORe), alongside emerging therapies such as duodenal mucosal resurfacing (DMR), incisionless anastomosis creation, and fully automated endoscopic gastric remodeling systems. ESG has demonstrated durable weight loss, favorable safety, and superior cost-effectiveness compared to pharmacotherapy alone, while combination strategies using EBTs and anti-obesity medications (AOMs), particularly GLP-1 receptor agonists, have resulted in greater total-body weight loss than either modality alone. Genetic variation, particularly within the leptin–melanocortin pathway, may predict response to endoscopic interventions and guide personalized treatment selection. Novel investigational procedures such as DMR, automated or robotic gastric remodeling, and magnetic or ultrasound-assisted gastric bypass show promising early results. Endoscopic therapies are poised to become increasingly central to the personalized, scalable management of obesity and related metabolic diseases. Full article

This article presents a series of innovative systems developed through student laboratory projects, comprising two autonomous vehicles, a quadrupedal walking robot, an active ankle-foot orthosis, a ball-on-beam balancing mechanism, a ball-on-plate system, and a manipulator arm, all actuated by pneumatic artificial muscles (PAMs). Due to their flexibility, low weight, and compliance, fluidic muscles demonstrate substantial potential for integration into various mechatronic systems, robotic platforms, and manipulators. Their capacity to generate smooth and adaptive motion is particularly advantageous in applications requiring natural and human-like movements, such as rehabilitation technologies and assistive devices. Despite the inherent challenges associated with nonlinear behavior in PAM-actuated control systems, their biologically inspired design remains promising for a wide range of future applications. Potential domains include industrial automation, the automotive and aerospace sectors, as well as sports equipment, medical assistive devices, entertainment systems, and animatronics. The integration of self-constructed laboratory systems powered by PAMs into control systems education provides a comprehensive pedagogical framework that merges theoretical instruction with practical implementation. This methodology enhances the skillset of future engineers by deepening their understanding of core technical principles and equipping them to address emerging challenges in engineering practice. Full article

Introduction: Mastering microsurgery requires advanced fine motor skills, hand–eye coordination, and precision, making it challenging for novices. Robot-assisted microsurgery offers benefits, such as eliminating physiological tremors and enhancing precision through motion scaling, which may potentially make learning microsurgical skills easier. Materials and Methods: Sixteen medical students without prior microsurgical experience performed 160 anastomoses in a synthetic model. The students were randomly assigned into two cohorts, one starting with the conventional technique (HR group) and one with robotic assistance (RH group) using the Symani surgical system. Results: Both cohorts showed a reduction in procedural time and improvement in SAMS scores over successive attempts, with robotic anastomoses demonstrating a 48.2% decrease in time and a 54.6% increase in SAMS scores. The decreases were significantly larger than the RH group (p < 0.05). The quality of the final anastomoses was comparable in both groups (p > 0.05). Discussion: This study demonstrated a steep preclinical learning curve for robot-assisted microsurgery (RAMS) among novices in a synthetic, preclinical model. No significant differences in SAMS scores between robotic and manual techniques after ten anastomoses. Robot-assisted microsurgery required more time per anastomosis, but the results suggest that experience with RAMS may aid in manual skill acquisition. The study indicates that further exploration into the sequencing of robotic and manual training could be valuable, especially in designing structured microsurgical curricula. Full article

Orthopedics is undergoing a transformative shift driven by personalized medical technologies that enhance precision, efficiency, and patient outcomes. Virtual surgical planning, robotic assistance, and real-time 3D navigation have revolutionized procedures like total knee arthroplasty and hip replacement, offering unparalleled accuracy and reducing recovery times. Integrating artificial intelligence, advanced imaging, and 3D-printed patient-specific implants further elevates surgical precision, minimizes intraoperative complications, and supports individualized care. In sports orthopedics, wearable sensors and motion analysis technologies are revolutionizing diagnostics, injury prevention, and rehabilitation, enabling real-time decision-making and improved patient safety. Health-tracking devices are advancing recovery and supporting preventative care, transforming athletic performance management. Concurrently, breakthroughs in biologics, biomaterials, and bioprinting are reshaping treatments for cartilage defects, ligament injuries, osteoporosis, and meniscal damage. These innovations are poised to establish new benchmarks for regenerative medicine in orthopedics. By combining cutting-edge technologies with interdisciplinary collaboration, the field is redefining surgical standards, optimizing patient care, and paving the way for a highly personalized and efficient future. Full article

Many new technologies focused mainly on improving surgical accuracy were first developed in total knee arthroplasty and have not yet shown significant value. These non-significant clinical improvements could potentially be explained by an inadequate target. In this current concept paper, the authors will describe how artificial intelligence (AI), robotic-assisted surgery, and custom implants allow the definition of new targets and the standardization of the TKA process. As paradoxical as it may be, new technologies in TKA will allow for better standardization in the overall way in which this procedure is carried out. Achieving this goal can be accomplished by incorporating AI-driven tools into the medical field. These tools are intended to enhance decision making, refine surgical planning, and increase the precision and consistency of surgical procedures. Moreover, custom implants with personalized alignment, beyond restoring native anatomy, will define new targets and standardize the whole TKA process. Full article

This review aims to place open, laparoscopic, computerized (robotic), and image-guided robotic surgical interventions in the context of complex medical surgeries, taking into account patient well-being, staff effort, and task reliability. It deduces the specificities of each technique and subsequently focuses on image-guided interventions and their practice in staff training, preparation, and implementation of a possible autonomous intervention. These complex interventions are intended to be minimally invasive (MI), precise, and safe therapies. The accuracy of robotic positioning could be improved by reductions in complexity and uncertainty involved in the intervention procedure. These can be achieved by matching the real controlled procedure and its virtual replica. The contribution discusses considerations for staff training and/or the planning of surgical interventions using real and virtual phantoms, and the use of augmented matched digital twins (DTs) for real interventions. This paper successively approaches open, laparoscopic and robotic surgeries, image-guided robotic interventions, the control and DT monitoring of MRI-assisted interventions, MRI field ruling equations and MRI compatibility, DT monitoring involvements in surgical interventions, and it ends with a discussion and main conclusions. The different topics presented in this article, although explicit, are reinforced by examples from the literature to facilitate a deeper understanding. The outcome of this review highlights the importance of robotic imaging-assisted procedures involving MI, nonionizing, and precise interventions. It also illustrates the potential of DTs combined with digital tools to offer an effective solution for the management of these interventions. The exploitation of such a suitable digital environment allows the planning, forecasting, prospecting, training, and execution, with staff in the loop, of surgical activities in general. This methodology allows for the precise consideration of specific anatomies, particularly in microsurgery and neurosurgery. Full article

Iatrogenic ureteral strictures are uncommon but challenging to manage. We present our expertise in laparoscopic and robot-assisted laparoscopic ureteroureterostomy (LUU and RAUU) for lumbar and iliac strictures and laparoscopic ureteral reimplantation for pelvic strictures. A descriptive study was conducted on nine adult patients who underwent minimally invasive procedures. Six had lumbar or iliac ureteral strictures—five due to ureterorenoscopy and one following pancreaticoduodenectomy for pancreatic cancer. Three developed pelvic strictures after ureterorenoscopy. Preoperative evaluation included a medical history review, abdominal ultrasound, and CT scan. Success was characterized by the absence of symptoms and the lack of obstruction on follow-up imaging at one year. All procedures were technically feasible, with a median operating time of 105 min and a median hospital stay of four days. No major complications occurred. One patient experienced ureteral stricture recurrence following a laparoscopic approach for a lumbar stricture, and required a permanent double-J stent. At a median follow-up of 38 months, 88.88% of patients remained asymptomatic with preserved renal function. Our findings suggest that robotic and laparoscopic ureteral reconstruction performed by experienced surgeons at a tertiary center is a safe and effective option with a low complication rate. Full article

The global aging trend is becoming increasingly severe, and the demand for life assistance and medical rehabilitation for frail and disabled elderly people is growing. As the best solution for assisting limb movement, guiding limb rehabilitation, and enhancing limb strength, exoskeleton robots are becoming the focus of attention from all walks of life. This paper reviews the progress of research on upper limb exoskeleton robots, sEMG technology, and intention recognition technology. It analyzes the literature using keyword clustering analysis and comprehensively discusses the application of sEMG technology, deep learning methods, and machine learning methods in the process of human movement intention recognition by exoskeleton robots. It is proposed that the focus of current research is to find algorithms with strong adaptability and high classification accuracy. Finally, traditional machine learning and deep learning algorithms are discussed, and future research directions are proposed, such as using a deep learning algorithm based on multi-information fusion to fuse EEG signals, electromyographic signals, and basic reference signals. A model with stronger generalization ability is obtained after training, thereby improving the accuracy of human movement intention recognition based on sEMG technology, which provides important support for the realization of human–machine fusion-embodied intelligence of exoskeleton robots. Full article