The time taken to perform tasks yields significantly more information about the integrated human-robot system than simply studying the speed of movement of the robot.
Nonlinear analysis techniques have recently been used in the characterization of complex physiological signals seen in pathological disorders such as epilepsy and cardiac fibrillation. In this study a series of controlled swallows from an asymptomatic demonstration group was investigated using oesophageal manometry. The nonlinear measure of complexity, largest Lyapunov exponents and phase portraits were then used to explore the complexity of motility patterns at different points within the oesophagus. Results indicate greater complexity within the region of the striated muscle in the upper oesophagus than that observed within the region of smooth muscle in the lower oesophagus. Phase portraits showed that manometry patterns within the asymptomatic demonstration group could be quite different, highlighting the problems in clinical diagnosis. The characterization of motility disorders associated with complex manometry patterns such as diffuse oesophageal spasm (DOS) and nonspecific motility disorder (NOMD) still represents a diagnostic challenge. The use of nonlinear techniques enabling the quantitative and qualitative measurement of oesophageal complexity is considered in the classification of such disorders.
Port fixity to the abdominal wall during laparoscopic surgery declines with time. The insertion of ports using a blunt-tipped trocar is associated with significantly greater stability and fixity of the port to the abdominal wall. The use of blunt-tipped trocars is recommended for routine practice in laparoscopic surgery.
We present the technical details of a new system for the synchronous recording and review of a combined oesophageal manometry and video fluoroscopic barium swallow examination. The system developed uses a portable manometry recorder and personal computer (PC) with an integrated digital video acquisition system. These are controlled using software to enable the real time capture of digital video and manometric data throughout the combined examination. The recorded pressure waveforms can then be synchronously displayed on a screen with the recorded digital video of the fluoroscopic barium swallow.This new tool enables both comparative measurement and detailed analysis of the relationship between visualized bolus transport and pressure measurements. It provides for a deeper understanding and improved clinical assessment of complex motility disorders over those obtained when these two modalities are applied separately. The system is easily incorporated into a clinical radiology suite and it is both user and patient friendly. It uses readily available computer hardware together with multimedia software and is a comparatively economical addition to the radiology suite with the manometry analysis available fulfilling the criteria laid down by the Clinical Associates Group of the British Society of Gastroenterology.
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