An original device for intraoperative detection of small indeterminate nodules†

Бармин, В. В.; Sadovnichy, Victor; Sokolov, Mikhail; Пикин, О. В.; Амиралиев, А. М.

doi:10.1093/ejcts/ezu161

Cited by 15 publications

(11 citation statements)

References 24 publications

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“…The experiment used a mechanoreceptor with 19 pressure sensors and an operating head with a diameter of 2 cm. The result was concordant with the result of MTEC utilization in detection of pulmonary lesions during thoracoscopy where detection rate was 0.81 (95% confidence interval: [0.62, 0.94]) 21. At the same time, for conventional instrumental palpation by lung forceps, detection rate was only 0.37.…”

Section: Discussionsupporting

confidence: 82%

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Instrumental tactile diagnostics in robot-assisted surgery

Solodova¹,

Galatenko²,

Накашидзе³

et al. 2016

MDER

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BackgroundRobotic surgery has gained wide acceptance due to minimizing trauma in patients. However, the lack of tactile feedback is an essential limiting factor for the further expansion. In robotic surgery, feedback related to touch is currently kinesthetic, and it is mainly aimed at the minimization of force applied to tissues and organs. Design and implementation of diagnostic tactile feedback is still an open problem. We hypothesized that a sufficient tactile feedback in robot-assisted surgery can be provided by utilization of Medical Tactile Endosurgical Complex (MTEC), which is a novel specialized tool that is already commercially available in the Russian Federation. MTEC allows registration of tactile images by a mechanoreceptor, real-time visualization of these images, and reproduction of images via a tactile display.Materials and methodsNine elective surgeries were performed with da Vinci™ robotic system. An assistant performed tactile examination through an additional port under the guidance of a surgeon during revision of tissues. The operating surgeon sensed registered tactile data using a tactile display, and the assistant inspected the visualization of tactile data. First, surgeries where lesion boundaries were visually detectable were performed. The goal was to promote cooperation between the surgeon and the assistant and to train them in perception of the tactile feedback. Then, instrumental tactile diagnostics was utilized in case of visually undetectable boundaries.ResultsIn robot-assisted surgeries where lesion boundaries were not visually detectable, instrumental tactile diagnostics performed using MTEC provided valid identification and localization of lesions. The results of instrumental tactile diagnostics were concordant with the results of intraoperative ultrasound examination. However, in certain cases, for example, thoracoscopy, ultrasound examination is inapplicable, while MTEC-based tactile diagnostics can be efficiently utilized.ConclusionThe study proved that MTEC can be efficiently used in robot-assisted surgery allowing correct localization of visually undetectable lesions and visually undetectable boundaries of pathological changes of tissues.

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Section: Discussionsupporting

confidence: 82%

“…Previously, MTEC was successfully utilized in traditional endoscopic surgeries,21 but its applicability in a framework of robotic surgery remained unstudied. Our study showed that after a short training, one can correctly localize visually undetectable pathological changes using MTEC.…”

Section: Introductionmentioning

confidence: 99%

Instrumental tactile diagnostics in robot-assisted surgery

Solodova¹,

Galatenko²,

Накашидзе³

et al. 2016

MDER

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“…Novel techniques have also been developed, including a tactile mechanoreceptor as well as the use of mobile CT for intra-operative localization (66,67).…”

Section: Discussionmentioning

confidence: 99%

CT-guided microcoil VATS resection of lung nodules: a single-centre experience and review of the literature

et al. 2016

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Background: Video-assisted thoracoscopic surgery (VATS) is standard of care for small lung resections at many centres. Computed tomography (CT)-guided insertion of microcoils can aid surgeons in performing VATS resections for non-palpable lung nodules deep to the lung surface.Methods: Retrospective analysis of CT-guided microcoil insertions prior to VATS lung resection at a single institution from October 2008 to January 2014.Results: A total of 63 patients were included (37% male, mean age 61.6±11.4 years). Forty-two patients (67%) had a history of smoking, with 10 current smokers. Sixty one (97%) patients underwent wedge resection and 3 (5%) patients had segmentectomy. Three (5%) patients required intra-operative staple line re-resection for positive or close margins. Eleven (17%) patients had a completion lobectomy, 5 of which were during the same anaesthetic. The average time between the CT-guided insertion and start of operation was 136.6±89.0 min, and average operative time was 84.0±53.3 min. The intra-operative complication rate was 5% (n=3), including 1 episode of hemoptysis, and 2 conversions to thoracotomy. The post-operative complication rate was 8% (5 patients), and included 2 air leaks, 1 hemothorax (drop in hemoglobin), 1 post chest tube removal pneumothorax, and one venous infarction of the lingula after lingula-sparing lobectomy requiring completion lobectomy. . Average post-operative length of stay was 2.2 days. A diagnosis was made for all patients.Conclusions: CT-guided microcoil insertion followed by VATS lobectomy is safe, with short operative times, short length of stay and 100% diagnosis of small pulmonary nodules. This technique will become more important in the future with increasing numbers of small nodules detected on CT as part of lung cancer screening programs.

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“…MTEC allows intraoperative mechanoreceptor tactile examination of tissues and is already used in endoscopic surgery [14][15][16]. As methods for automated analysis of medical tactile images are still insufficient, validation results in particular and the developed clustering algorithm in general provide new opportunities for the medical domain applications.…”

Section: Validationmentioning

confidence: 99%

A Greedy Clustering Algorithm Based on Interval Pattern Concepts and the Problem of Optimal Box Positioning

Nersisyan

Pankratieva

Staroverov

et al. 2017

Journal of Applied Mathematics

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We consider a clustering approach based on interval pattern concepts. Exact algorithms developed within the framework of this approach are unable to produce a solution for high-dimensional data in a reasonable time, so we propose a fast greedy algorithm which solves the problem in geometrical reformulation and shows a good rate of convergence and adequate accuracy for experimental high-dimensional data. Particularly, the algorithm provided high-quality clustering of tactile frames registered by Medical Tactile Endosurgical Complex.

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An original device for intraoperative detection of small indeterminate nodules†

Abstract: The tactile mechanoreceptor is an effective tool for detection of impalpable pulmonary lesions during thoracoscopy.

Cited by 15 publications

References 24 publications

Instrumental tactile diagnostics in robot-assisted surgery

Instrumental tactile diagnostics in robot-assisted surgery

CT-guided microcoil VATS resection of lung nodules: a single-centre experience and review of the literature

A Greedy Clustering Algorithm Based on Interval Pattern Concepts and the Problem of Optimal Box Positioning

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