The last decades, when robots have appeared in the operating room, showed the possibility of surgery enhancement by improving precision, repeatability, stability and dexterity. However, taking into consideration still existing limitations of robotics in surgery, and treating the robots as medical devices with the highest degree of safety level requirements, one must take a number of complex actions when preparing the experimental clinical application of a new modern robot Robin Heart. Presented paper describes the current state of procedures carried out in the Robin Heart project of surgery robots prepared for clinical application. Based on experiences with the devices existing on the market and, first of all, thanks to knowledge and expertise gained by our team during last 12 years, intensive work are currently done in order to introduce both mechanical and electronic modifications as well as to improve the safety system. As far as human resources are concerned, a professional team able to carry out the robot-supported surgery is prepared based on the created system of technical and functional trainings on simulation stands, which also includes the developed operation planning procedures. The first telemanipulator designed for clinical practice is the Robin Heart Vision – endoscopic system manipulator.
Introduction: The prolongation of the life of men results in the growing number of people suffering from benign prostatic hyperplasia (BPH). In 2010, BPH concerned more than 200 million men in the whole world, which at that time made up 6% of the population of men at large. Currently, the population of men in the world amounts about three billion six hundred million. The modern surgical treatment of BPH consists of minimally invasive techniques, including laser systems. Aim: Evaluation of the eff ectiveness of photoselective vaporization of the prostate (PVP) on the basis of subjective parameters assessed by patients using IPSS and QoL questionnaires as well as objective parameters obtained from results of urodynamic tests. Material and Methods: Between 2012 and 2015, 120 patients with benign prostatic hyperplasia were included in the study and underwent PVP. Finally, 77 patients were included in the study. In all patients, IPSS and QoL sheets were carried out 1, 6 and 12 months, and urodynamic tests 12 months after the surgical treatment. Results: The statistically signifi cant change in the value of each parameter assessed: decrease in the IPSS, QoL, PVR, Pmax, Pop, the degree of obstruction according to Schäfer and ICS nomogram, and an increase in the values of Qmax and Qave. Conclusions: Photoselective vaporization of the prostate is an eff ective method of therapy in patients with benign prostatic hyperplasia.
One of the most common reasons for horse lameness is subchondral bone cysts (SBCs), which are especially evident in young horse athletes. It is believed that SBC development is strongly associated with an individual’s bone growth and/or bone microstructure impairment. Current methods of SBC treatment include pharmacological treatment or surgical procedures which may allow the bone within the cyst to rebuild and be restored to properly developed bone tissue. Thus, we propose filling the SBCs with a 3D complex of alginate hydrogel and autologous adipose derived mesenchymal stem cells (ASCs). We have observed at the in vitro level, that this hydrogel complex induces osteogenic and chondrogenic differentiation potential through the upregulation of bone morphogenetic protein, osteopontin, collagen type I and aggrecan mRNA levels. Moreover, we detected the creation of a 3D extracellular matrix (EM). To investigate the complex in vivo, we chose 8 horses of varying age suffering from SBC, which resulted in lameness, to undergo experimental surgery. We documented the horses’ clinical appearance, lameness and radiographic appearance, to determine that there was clinical improvement in 87.75% of the patients (n=7, out of 8 horses) 6 months postoperatively and 100% (n=8, out of 8 horses) a year after surgery. These results are promising for the potential of this procedure to become the standard in SBC treatment.