To explore the feasibility of applying magnetic stimulation technology to the movement control of animal robots, the influence of coil radius, number of turns and other factors on the intensity, depth and focus of magnetic stimulation was simulated and analyzed for robot pigeons. The coil design scheme was proposed. The coil was placed on the head and one of the legs of the pigeon, and the leg electromyography (EMG) was recorded when magnetic stimulation was performed. Results showed that the EMG was significantly strengthened during magnetic stimulation. With the reduction of the output frequency of the magnetic stimulation system, the output current was increased and the EMG was enhanced accordingly. Compared with the brain magnetic stimulation, sciatic nerve stimulation produced a more significant EMG enhancement response. This indicated that the magnetic stimulation system could effectively modulate the functions of brain and peripheral nerves by driving the coil. This study provides theoretical and experimental guidance for the subsequent optimization and improvement of practical coils, and lays a preliminary theoretical and experimental foundation for the implementation of magnetic stimulation motion control of animal robots.
Objective To broaden the current understanding of the usage willingness about artificial intelligence (AI) robots and relevant influence factors for elderly patients. Methods The elderly patients in the inpatient ward, outpatient department and physical examination of the Department of Geriatrics, West China Hospital of Sichuan University were selected by convenient sampling for investigation between February and April 2020, to explore the willingness of elderly patients to use AI robots and related influencing factors. Results A total of 446 elderly patients were included. There were 244 males and 202 females. The willingness to use AI robots was (14.40±3.62) points. There were statistically significant differences among the elderly patients with different ages, marital status, living conditions, educational level, current health status, current vision status, current hearing status, self-care ability and family support in their willingness to use AI robots (P<0.05). Multiple linear regression analysis showed that age, education level and family support were the influencing factors of use intention (P<0.05). Among the elderly patients, 60.76% had heard of AI robots, but only 28.03% knew the medical application of AI robots, and only 13.90% had used AI robot services. Most elderly patients (>60%) thought that some adverse factors may reduce their usage willingness, like “the price is too expensive” and “the use is complex, or I don’t know how to use”. Conclusions Elderly patients’ cognition of AI robots is still at a low level, and their willingness to use AI robots is mainly affected by age, education level and family support. It is suggested to consider the personalized needs of the elderly in terms of different ages, education levels and family support, and promote the cheap and user-friendly AI robots, so as to improve the use of AI robots by elderly patients.
During transfer tasks, the dual-arm nursing-care robot require a human-robot mechanics model to determine the balance region to support the patient safely and stably. Previous studies utilized human-robot two-dimensional static equilibrium models, ignoring the human body volume and muscle torques, which decreased model accuracy and confined the robot ability to adjust the patient’s posture in three-dimensional spatial. Therefore, this study proposes a three-dimensional spatial mechanics modeling method based on individualized human musculoskeletal multibody dynamics. Firstly, based on the mechanical features of dual-arm support, this study constructed a foundational three-dimensional human-robot mechanics model including body posture, contact position and body force. With the computed tomography data from subjects, a three-dimensional femur-pelvis-sacrum model was reconstructed, and the individualized musculoskeletal dynamics was analyzed using the ergonomics software, which derived the human joint forces and completed the mechanic model. Then, this study established a dual-arm robot transfer platform to conduct subject transfer experiments, showing that the constructed mechanics model possessed higher accuracy than previous methods. In summary, this study provides a three-dimensional human-robot mechanics model adapting to individual transfers, which has potential application in various scenarios such as nursing-care and rehabilitating robots.
ObjectiveTo explore the clinical efficacy and share the experience of Da Vinci robot assisted choledochal cyst resection in children. MethodThe data of children including preoperative, intraoperative, and postoperative details who underwent Da Vinci robot assisted choledochal cyst resection in the Department of Pediatric Surgery, West China Hospital of Sichuan University from April 2018 to June 2022 were collected and analyzed. ResultsA total of 200 patients were collected in this study, 54 of whom were males and 146 were females. The male to female was 1∶2.70. The age was (46±33) months and the body weight was (15.77±7.10) kg. The main symptoms were abdominal pain (136 cases, 68.0%), jaundice (62 cases, 31.0%), abdominal distension (20 cases, 10.0%), and abdominal mass (23 cases, 11.5%). The diameter of cyst was (3.46±2.01) cm. There were 153 cases of type Ⅰa, 35 cases of type Ⅰc, 1 case of type Ⅱ, and 11 cases of type Ⅳ. The operation time was (179.9±10.3) min, the intraoperative fluid infusion was (397.4±26.4) mL, the intraoperative blood loss was (21.5±10.9) mL, the liquid intake time was (3.01±0.35) d, the solid intake time was (3.80±0.27) d, and the postoperative hospitalization time was (7.44±0.94) d. The intraoperative blood transfusion was performed in 4 cases (2.0%). There were 7 cases (3.5%) of postoperative complications, including 2 cases of biliary leakage, 2 cases of incomplete intestinal obstruction, and 1 case of anastomotic bleeding, which were improved by conservative treatment. Anastomotic stenosis occurred in 1 case, and the Roux-en-Y anastomosis was performed again. Biliary loop torsion obstruction occured in 1 case, which received reoperation restoring the biliary loop and closing the mesangial fissure. ConclusionsFrom the results of this study, Da Vinci robotic surgical system can obviously reduce the difficulty of choledochal cyst resection in children. It has the advantages of safe, beautiful incision, clear exposure, rapid recovery, and less complications.
ObjectiveTo explore the application of 5G remote robotic surgery in distal gastrectomy for gastric cancer and evaluate the feasibility and advantages of the “3+2” model “seven-step method”. MethodsThe situations at preoperative, intraoperative and postoperative follow-up of a patient who underwent 5G remote robotic distal gastrectomy for gastric cancer with “3+2” model “seven-step method” in Gansu Provincial People’s Hospital were summarized, and based on our experience of robotic surgery, the application advantages of “3+2” model “seven-step method” in 5G remote robotic distal gastrectomy for gastric cancer was explored. ResultsThe operative time of this case was 190 min, the intraoperative blood loss was 50 mL, the network delay was 43.554 ms, and no intraoperative adverse events occurred. After a one-year follow-up, the patient recovered well, with no complications, good diet and good quality of life. ConclusionsThe “3+2” model “seven-step method” is feasible for 5G remote robotic distal gastrectomy. Further research requires an increased sample size and extended follow-up period.
The application of robots in thoracic surgery is mainly based on the da Vinci general surgery robot. With the popularization of artificial intelligence (AI) application scenarios, the combination of AI and robots is more closely, and there is a strong clinical demand and huge application space for the development of specialized disease-specific robotic systems for thoracic surgery. This article aims to systematically describe the history of the rise of specialized surgical robots and the status of the localization of surgical robots in China, propose the concept of applying AI to the research and development of integrated specialized disease-specific robots in thoracic surgery, and clarify the ethics and prospects that intelligent specialized disease-specific surgical robots will face.
ObjectiveTo re-evaluate the systematic review and meta-analysis (SR/MAs) of the efficacy of robot-assisted pedicle screw placement. MethodsThe CNKI, VIP, WanFang Data, SinoMed, PubMed, Embase, Cochrane Library, and Web of Science databases were electronically searched to collect SR/MAs of robot-assisted pedicle screw placement from inception to April 28, 2023. Two reviewers independently screened literature, extracted data and then assessed the quality of reports, methodological quality, risk of bias, and the strength of evidence quality by using PRISMA, AMSTAR-Ⅱ, ROBIS, and GRADE tool. ResultsA total of 20 SR/MAs were included. The results of the included studies showed that robot-assisted pedicle screw placement was more accurate and had a lower number of complications compared with freehand pedicle screw placement. The quality of reports, methodology, and evidence for pedicle screw placement efficiency in all SR/MAs were low or extremely low, with a high risk of bias. The main reasons included high heterogeneity of included studies, unclear research methods and selection criteria, and missing key reporting processes. ConclusionRobot-assisted pedicle screw placement may have better clinical efficiency than traditional freehand pedicle screw placement. But the quality of relational SR/MAs is low.
In order to calibrate the hand-eye transformation of the surgical robot and laser range finder (LRF), a calibration algorithm based on a planar template was designed. A mathematical model of the planar template had been given and the approach to address the equations had been derived. Aiming at the problems of the measurement error in a practical system, we proposed a new algorithm for selecting coplanar data. This algorithm can effectively eliminate considerable measurement error data to improve the calibration accuracy. Furthermore, three orthogonal planes were used to improve the calibration accuracy, in which a nonlinear optimization for hand-eye calibration was used. With the purpose of verifying the calibration precision, we used the LRF to measure some fixed points in different directions and a cuboid’s surfaces. Experimental results indicated that the precision of a single planar template method was (1.37±0.24) mm, and that of the three orthogonal planes method was (0.37±0.05) mm. Moreover, the mean FRE of three-dimensional (3D) points was 0.24 mm and mean TRE was 0.26 mm. The maximum angle measurement error was 0.4 degree. Experimental results show that the method presented in this paper is effective with high accuracy and can meet the requirements of surgical robot precise location.
Objective To investigate the clinical effect of the DaVinci robot system and laparoscopic radical gastrectomy. Methods Propensity score matching and retrospective cohort study were adopted. Data of 446 patients who underwent robotic or laparoscopic radical gastrectomy in the Department of Gastrointestinal Surgery, Xijing Hospital, the First Affiliated Hospital of Air Force Military Medical University from January 2014 to April 2021 were collected. Among them, 174 cases underwent robotic and 272 cases underwent laparoscopic surgery. Using the method of propensity score matching, 133 cases were selected from robotic operation group and laparoscopic operation group respectively as the research object. The perioperative indexes of the two groups were compared. Kaplan-Meier survival analysis was used to draw the survival curve and calculate the survival rate. Cox regression model was used to analyze the risk factor of prognosis. Results There was no significant difference in baseline data between the robotic surgery group and the laparoscopic surgery group after propensity score matching (P>0.05). The operative time of the two groups [(236.47±50.32) min vs. (230.64±44.51) min, t=1.000, P=0.318], the number of lymph nodes dissected [(23.32±6.58) vs. (23.95±6.03), t=–0.826, P=0.410], the time of first anal exhaust [(3.46±0.77) days vs. (3.38±0.75) days, t=0.882, P=0.378], and the length of postoperative hospital stay [(6.98±2.84) days vs. (6.94±3.61) days, t=0.094, P=0.925] were similar, the differences were not statistically significant. Compared with the laparoscopic surgery group, the robotic surgery group had less intraoperative bleeding [(83.76±58.23) mL vs. (116.54±58.58) mL, t=–4.577, P<0.001], but the total hospitalization expenses was higher [(10.04±1.92) ten-thousand Yuan vs. (6.80±1.27) ten-thousand Yuan, t=16.211, P<0.001]. The incidence of postoperative complications between the two groups (χ2=0.057, P=0.812) and Clavien-Dindo classification of complications (Z=–0.440, P=0.965) were similar between the two groups, the differences were not statistically significant. The 3-year survival situation was similar between the two groups (P=0.356). Body mass index [RR=0.803, 95%CI (0.698, 0.924), P=0.002], TNM-staging [Ⅱ -stage vs.Ⅰ -stage, RR=4.152, 95%CI (1.121, 15.385), P=0.033; Ⅲ -stage vs.Ⅰ -stage, RR=5.476, 95%CI (1.458, 20.558), P=0.012] and postoperative complications [with vs. without, RR=3.262, 95%CI (1.283, 8.293), P=0.013] were prognostic factors for 3-year survival. Conclusion Compared with laparoscopic radical gastrectomy, robotic radical gastrectomy has the same short-term and long-term prognosis.
ObjectiveTo evaluate the early effectiveness of the robot-assisted total hip arthroplasty (THA) via direct superior approach (DSA).MethodsBetween March 2021 and April 2021, 11 patients (11 hips) were treated with a robot-assisted THA via DSA. There were 7 males and 4 females, with an average age of 55 years (range, 26-73 years). There were 5 patients of osteoarthritis secondary to hip dysplasia and 6 patients of osteonecrosis of femoral head. Preoperative hip Harris score was 55.8±6.3. The operation time, volume of blood loss, length of incision, postoperative blood transfusion and hospital stay, and the incidence of surgical complications were recorded. The visual analogue scale (VAS) score and Harris score were used to evaluate hip joint pain and function. The leg length discrepancy (LLD) was measured on the X-ray films. The inclination angle and anteversion angle of the acetabular component were also measured, and the difference between the planned and actual values were compared.ResultsOne THA was performed via conventional posterolateral approach finally because of poor exposure. The rest of 10 THAs were performed with assistance of robotic arm via DSA. The average operation time was 89 minutes (range, 65-120 minutes); the average length of incision was 10.5 cm (range, 9-13 cm); and the average blood loss was 400 mL (range, 110-740 mL). One patient was given a blood transfusion for 2 unit. All incisions healed by first intention and no neurovascular injury, deep vein thrombosis, or fracture occurred. The length of hospital stay after operation was 2-6 days (mean, 4.4 days). The duration of follow-up was 1-3 months (mean, 2.1 months). The VAS score was 0 in 9 patients and 2 in 1 patient at the day of discharge. At last follow-up, the hip Harris score was 84.9±6.7, showing significant difference when compared with that before operation (t=−8.717, P=0.000). The inclination and anteversion angles were (37.4±2.0)° and (17.1±4.5)°, respectively, and there was no significant difference when compared with the planned values [(38.2±1.6)°, (16.6±3.7)°] (t=1.809, P=0.104; t=–1.103, P=0.299). The LLD ranged from –2 to 4 mm. No complication such as dislocation, aseptic loosening, or periprosthetic joint infection occurred. ConclusionThe robot-assisted THA via DSA has encouraged early effectiveness.