Robot rehabilitation has been a primary therapy method for the urgent rehabilitation demands of paralyzed patients after a stroke. The parameters in rehabilitation training such as the range of the training, which should be adjustable according to each participant’s functional ability, are the key factors influencing the effectiveness of rehabilitation therapy. Therapists design rehabilitation projects based on the semiquantitative functional assessment scales and their experience. But these therapies based on therapists’ experience cannot be implemented in robot rehabilitation therapy. This paper modeled the global human-robot by Simulink in order to analyze the relationship between the parameters in robot rehabilitation therapy and the patients’ movement functional abilities. We compared the shoulder and elbow angles calculated by simulation with the angles recorded by motion capture system while the healthy subjects completed the simulated action. Results showed there was a remarkable correlation between the simulation data and the experiment data, which verified the validity of the human-robot global Simulink model. Besides, the relationship between the circle radius in the drawing tasks in robot rehabilitation training and the active movement degrees of shoulder as well as elbow was also matched by a linear, which also had a remarkable fitting coefficient. The matched linear can be a quantitative reference for the robot rehabilitation training parameters.
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.
Objective To compare the accuracy and effectiveness of orthopaedic robot-assisted minimally invasive surgery versus open surgery for limb osteoid osteoma. Methods A clinical data of 36 patients with limb osteoid osteomas admitted between June 2016 and June 2023 was retrospectively analyzed. Among them, 16 patients underwent orthopaedic robot-assisted minimally invasive surgery (robot-assisted surgery group), and 20 patients underwent tumor resection after lotcated by C-arm X-ray fluoroscopy (open surgery group). There was no significant difference between the two groups in the gender, age, lesion site, tumor nidus diameter, and preoperative pain visual analogue scale (VAS) scores (P>0.05). The operation time, lesion resection time, intraoperative blood loss, intraoperative fluoroscopy frequency, lesion resection accuracy, and postoperative analgesic use frequency were recorded and compared between the two groups. The VAS scores for pain severity were compared preoperatively and at 3 days and 3 months postoperatively.Results Compared with the open surgery group, the robot-assisted surgery group had a longer operation time, less intraoperative blood loss, less fluoroscopy frequency, less postoperative analgesic use frequency, and higher lesion resection accuracy (P<0.05). There was no significant difference in lesion resection time (P>0.05). All patients were followed up after surgery, with a follow-up period of 3-24 months (median, 12 months) in the two groups. No postoperative complication such as wound infection or fracture occurred in either group during follow-up. No tumor recurrence was observed during follow-up. The VAS scores significantly improved in both groups at 3 days and 3 months after surgery when compared with preoperative value (P<0.05). The VAS score at 3 days after surgery was significantly lower in robot-assisted surgery group than that in open surgery group (P<0.05). However, there was no significant difference in VAS scores at 3 months between the two groups (P>0.05). Conclusion Compared with open surgery, robot-assisted resection of limb osteoid osteomas has longer operation time, but the accuracy of lesion resection improve, intraoperative blood loss reduce, and early postoperative pain is lighter. It has the advantages of precision and minimally invasive surgery.
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.
ObjectiveTo compare short- and medium-term effects of Leonardo da Vinci robot-assisted and traditional mitral valvuloplasty.MethodsWe conducted a retrospective analysis of 74 patients who underwent mitral valvuloplasty in our hospital from January 2015 to March 2017. The patients were divided into two groups according to the mode of operation: a da Vinci group (n=29, 13 males, 16 females at an average age of 52 years) and a routine group (n=45, 18 males, 27 females at an average age of 53 years). The perioperative data of patients in the two groups were compared and analyzed.ResultsThere was no significant difference in sex, age, weight, height, body mass index (BMI), cardiac function (NYHA), hypertension, diabetes, postoperative blood transfusion and postoperative complications between the two groups (P>0.05). The tracheal intubation time, ICU retention time, hospital stay time, blood loss and postoperative drainage in the da Vinci group were shorter or less than those in the routine group (P<0.05). The operation time, cardiopulmonary bypass time and aortic clamping time in the da Vinci group were longer than those in the routine group (P<0.05). Different surgical procedures had no significant effect on left atrial diameter (LAD), left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF) and mitral regurgitation (MR) 3 years after operation. There was no interaction between the mode of operation and the time of follow-up. There was no significant difference in echocardiographic evaluation in the same period (P>0.05).ConclusionDa Vinci operation shortens the rehabilitation process of patients compared with traditional surgery. For short- and medium-term follow-up results, there is no difference between Leonardo da Vinci and traditional mitral valve surgeries, and the clinical effect of da Vinci robot-assisted mitral valvuloplasty is satisfactory, which is worthy of further clinical promotion.
In recent years, reports of domestic robot-assisted total knee arthroplasty have gradually increased. In response to problems that may arise during the perioperative period, West China Hospital of Sichuan University has adopted measures such as the establishment of multidisciplinary team, adequate preoperative evaluation, precise intraoperative operations, and whole process optimization management (incision management, pain management, functional exercise and follow-up management). Combined with the actual clinical situation, a domestic robot-assisted total knee arthroplasty management program during the perioperative period was explored and formulated to promote the recovery of patients. This article introduces the above-mentioned program, and aims to provide a reference for the management optimization of domestic robot-assisted total knee arthroplasty during the perioperative period.
Objective To investigate the accuracy and safety of percutaneous screw fixation for pelvic and acetabular fractures with remote navigation of orthopedic robot based on 5G technology. Methods Between January 2021 and December 2021, 15 patients with pelvic and/or acetabular fractures were treated with percutaneous screws fixation which were placed by remote navigation of orthopedic robot based on 5G technology. There were 8 males and 7 females. The age ranged from 20 to 98 years, with an average of 52.1 years. The causes of trauma included traffic accident injury in 6 cases, falling from height injury in 6 cases, fall injury in 2 cases, and heavy object smashing injury in 1 case. The time from injury to operation ranged from 3 to 32 days, with an average of 10.9 days. There were 8 cases of simple pelvic fractures, 2 simple acetabular fractures, and 5 both pelvic and acetabular fractures. There were 7 cases of pelvic fractures of Tile type B2, 2 type B3, 1 type C1, and 3 type C2; 4 cases of unilateral anterior column fracture of the acetabulum, 2 bilateral anterior column fractures, and 1 anterior wall fracture. CT images within 5 days after operation were collected for screw position assessment. The screw planning time and guidewire placement time were recorded, as well as the presence of intraoperative adverse events and complications within 5 days after operation. Results All patients achieved satisfactory surgical results. A total of 36 percutaneous screws were inserted (20 sacroiliac screws, 6 LC Ⅱ screws, 9 anterior column screws, and 1 acetabular apical screw). In terms of screw position evaluation, 32 screws (88.89%) were excellent and 4 screws (11.11%) were good; there was no screw penetrating cortical bone. The screw planning time ranged from 4 to 15 minutes, with an average of 8.7 minutes. The guidewire placement time ranged from 3 to 10 minutes, with an average of 6.8 minutes. The communication delayed in 2 cases, but the operation progress was not affected, and no serious intraoperative adverse events occurred. No delayed vascular or nerve injury, infection, or other complications occurred within 5 days after operation. No cases need surgical revision. ConclusionThe fixation of pelvic and acetabular fractures by percutaneous screw with remote navigation of orthopedic robot based on 5G technology is accurate, safe, and reliable.
ObjectiveTo investigate the safety and efficiency of robotic lung segmentectomy.MethodsThe clinical data of 110 patients receiving robotic or thoracoscopic segmentectomy in our hospital between June 2015 and June 2019 were retrospectively analyzed. The patients were divided into a robotic group [n=50, 13 males and 37 females aged 53.0 (46.0, 60.0) years] and a thoracoscopic group [n=60, 21 males and 39 females aged 61.0 (53.0, 67.0) years]. A propensity score-matched analysis was adopted to compare the perioperative data between the two groups.ResultsAfter the propensity score-matched analysis, 34 patients were included in each group. In comparison with the thoracoscopic group, patients in the robotic group had less blood loss [40.0 (20.0, 50.0) mL vs. 60.0 (40.0, 80.0) mL, P<0.001], more stations of lymph node dissection [7.0 (6.0, 8.0) vs. 4.0 (3.0, 6.0), P<0.001], larger number of lymph node dissection [15.0 (11.0, 21.0) vs. 10.0 (6.0, 14.0), P=0.002], and a higher total cost of hospitalization [97.0 (92.0, 103.0) thousand yuan vs. 54.0 (42.0, 59.0) thousand yuan, P<0.001].ConclusionIn contrast with the thoracoscopic segmentectomy, robotic segmentectomy has a similar operative safety, but less blood loss and a thorough lymphadenectomy.
In order to seek a patient friendly and low-cost intestinal examination method, a structurally simple pneumatic soft intestinal robot inspired by inchworms is designed and manufactured. The intestinal robot was consisted of two radially expanding cylindrical rubber film airbags for anchoring and one low density polyethylene film airbag for axial elongation, which achieved movement in the intestine by mimicking the crawling of inchworms. Theoretical derivation was conducted on the relationship between the internal air pressure of the anchored airbag and the free deformation size after expansion, and it pointed out that the uneven deformation of the airbag was a phenomenon of expansion instability caused by large deformation of the rubber material. The motion performance of the intestinal robot was validated in different sizes of hard tubes and ex vivo pig small intestine. The running speed in the ex vivo pig small intestine was 4.87 mm/s, with an anchoring force of 2.33 N when stationary, and could smoothly pass through a 90 ° bend. This work expects to provide patients with a new method of low pain and low-cost intestinal examination.
Objective To evaluate the early effectiveness of navigation-free robot-assisted total knee arthroplasty (TKA) compared to traditional TKA in the treatment of knee osteoarthritis combined with extra-articular deformities. Methods The clinical data of 30 patients with knee osteoarthritis combined with extra-articular deformities who met the selection criteria between June 2019 and January 2024 were retrospectively analyzed. Fifteen patients underwent CORI navigation-free robot-assisted TKA and intra-articular osteotomy (robot group) and 15 patients underwent traditional TKA and intra-articular osteotomy (traditional group). There was no significant difference in age, gender, body mass index, affected knee side, extra-articular deformity angle, deformity position, deformity type, and preoperative knee range of motion, American Knee Society (KSS) knee score and KSS function score, and lower limb alignment deviation between the two groups (P>0.05). The operation time, intraoperative blood loss, and complications of the two groups were recorded and compared. The knee range of motion and lower limb alignment deviation were recorded before operation and at 6 months after operation, and the knee joint function was evaluated by KSS knee score and function score. Results There was no significant difference in operation time between the two groups (P>0.05); the intraoperative blood loss in the robot group was significantly less than that in the traditional group (P<0.05). Patients in both groups were followed up 6-12 months, with an average of 8.7 months. The incisions of all patients healed well, and there was no postoperative complication such as thrombosis or infection. At 6 months after operation, X-ray examination showed that the position of the prosthesis was good in both groups, and there was no loosening or dislocation of the prosthesis. The knee joint range of motion, the lower limb alignment deviation, and the KSS knee score and KSS function score significantly improved in both groups (P<0.05) compared to preoperative ones. The changes of lower limb alignment deviation and KSS function score between pre- and post-operation in the robot group were significantly better than those in the traditional group (P<0.05), while the changes of other indicators between pre- and post-operation in the two groups were not significant (P>0.05). Conclusion Compared to traditional TKA, navigation-free robot-assisted TKA for knee osteoarthritis with extra-articular deformities results in less intraoperative blood loss, more precise reconstruction of lower limb alignment, and better early effectiveness. However, long-term effectiveness require further investigation.